Virtual Reality in Clinical Teaching and Diagnostics for Liver Surgery: Prospective Cohort Study.

IF 1.8
JMIR XR and spatial computing Pub Date : 2024-11-27 eCollection Date: 2024-01-01 DOI:10.2196/60383
Joshua Preibisch, Navid Tabriz, Maximilian Kaluschke, Dirk Weyhe, Verena Uslar
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Abstract

Background: Learning and applying anatomy are essential but are studied and done through 2D tools and imaging techniques. This study aims to verify the usefulness of an additional 3D technique and ensure an improvement in the visualization of anatomical structures and pathological findings.

Objective: The study aims to examine the usefulness of virtual reality (VR) technology as an additional tool in medical diagnostics. Groups of students, residents, and specialists in surgery, radiology, and internal medicine evaluated magnetic resonance imaging (MRI) by answering a multiple-choice questionnaire. Subsequently, a virtual 3D display was used for processing. The questionnaire focused on topographical conditions and the transfer of academic knowledge into clinical application. The main objective was to determine anatomical understanding in a comparison between sectional image (2D) presentation and additional VR (3D) presentation, measured through correctly answered questions and processing time. The system usability scale (SUS) was integrated as another criterion for VR usability.

Methods: The cross-over study assessed 63 participants regarding their knowledge of liver anatomy and pathologies based on an interindividual comparison. Group formation according to the respective level of medical training was as follows: students (n=35), residents (n=15), and specialists (n=13). Participants answered 25 multiple-choice questions first using sectional imaging (MRI) in a 2D environment (computer screen) and afterward with the respective segmented 3D model visualized in a VR simulation. The main criteria for the analyses were the number of correctly answered questions and processing time. A customized SUS was used to analyze VR usability. Missing data analysis showed that there were no accounted missing data.

Results: The rate of correct answers improved significantly with the additional use of VR (F 1,59=314.376; P<.001). Using MRI, a significant difference was observed between students and residents (P=.04) and between students and specialists (P<.001). In the VR condition, no significant differences between groups were found. In the MRI condition, significant differences in processing time were observed between students and specialists (P=.02) and between residents and specialists (P=.04). No differences existed between students and residents. With VR, processing time decreased significantly in all groups (F 1,59=280.700; P<.001). Significant differences between students and specialists (P=.02) and between students and residents (P=.004) remained. No notable differences between residents and specialists (P=.72) were found. The SUS showed a subjectively simplified answerability of the questions with additional use of VR. The usefulness and benefits for an additional use of VR were stated.

Conclusions: The additional use of VR suggests statistically significant improvements across all groups. VR seems to enable students and residents to participate in diagnostics and create treatment plans at an early stage. Transferred to clinical practice, this may lead to improvement in diagnostics and interventions. The lack of randomization and a potential learning effect are the main limitations to be addressed in future studies.

虚拟现实在肝脏外科临床教学和诊断中的应用:前瞻性队列研究。
背景:学习和应用解剖学是必不可少的,但通过二维工具和成像技术进行研究和完成。本研究旨在验证额外的3D技术的实用性,并确保在可视化的解剖结构和病理结果的改进。目的:本研究旨在检验虚拟现实(VR)技术作为医学诊断的额外工具的实用性。一组学生、住院医师、外科、放射学和内科专家通过回答多项选择问卷来评估磁共振成像(MRI)。随后,使用虚拟3D显示器进行处理。问卷调查的重点是地形条件和学术知识向临床应用的转移。主要目的是通过正确回答的问题和处理时间来衡量截面图像(2D)呈现和额外的VR (3D)呈现之间的比较,确定解剖理解。系统可用性量表(SUS)作为VR可用性的另一个标准。方法:交叉研究在个体间比较的基础上评估了63名参与者的肝脏解剖和病理知识。根据各自的医学培训水平分组如下:学生(n=35),住院医生(n=15)和专家(n=13)。参与者首先在2D环境(计算机屏幕)中使用断层成像(MRI)回答25个选择题,然后在VR模拟中使用各自的分割3D模型。分析的主要标准是正确回答问题的数量和处理时间。使用定制的SUS来分析VR可用性。缺失数据分析表明,没有统计缺失数据。结果:增加VR的使用,学生和专家之间(PP=.02)、住院医师和专家之间(P=.04)的答对率显著提高(f1,59 =314.376; PP=.04)。学生和住院医生之间没有差异。使用VR后,所有组的处理时间均显著减少(f1,59=280.700; PP= 0.02),学生与住院医师之间的处理时间仍保持不变(P= 0.004)。住院医师与专科医师之间无显著差异(P= 0.72)。SUS显示了一个主观上简化了问题的可回答性,并额外使用了VR。说明了额外使用虚拟现实的有用性和好处。结论:在所有组中,额外使用VR显示统计学上显著的改善。VR似乎可以让学生和住院医生在早期阶段参与诊断并制定治疗计划。转移到临床实践中,这可能会导致诊断和干预的改进。缺乏随机化和潜在的学习效应是未来研究需要解决的主要限制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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