An Augmented Reality Model for Evaluating Traumatic Craniofacial Fractures

Accurate diagnosis and spatial characterization of craniofacial fractures is critical for treatment planning and precise fracture reduction. Since augmented reality (AR) has potential for better diagnostic evaluation than traditional three-dimensional (3D) reformats, we tested whether our accessible mobile-based AR model improves diagnostic accuracy, spatial understanding, and decreases task cognitive load when clinicians evaluate facial fractures. Clinicians (n = 30) in specialties managing craniofacial trauma assessed a database of mandibular and maxillofacial complex fractures of varying severity using computed-tomography slices supplemented with either traditional 3D reformats (control) or the AR model (experimental), completed diagnostic and spatial characterization tasks, and were evaluated quantitatively and qualitatively on diagnostic accuracy, task cognitive load, and weighted preference for the traditional versus AR model. Most clinicians (83%) preferred the AR model overall. Control and experimental groups had equivalent diagnostic sensitivity and specificity. Less experienced clinicians found the AR model required less effort, was less frustrating, and was preferred for fracture displacement characterization. The AR model had no significant impact on more experienced clinicians. All clinicians found the AR model allowed more intuitive manipulation of the 3D object. Those with less experience preferred the AR model over traditional imaging for diagnostic and educational purposes, whereas more experienced clinicians found that the AR model did not significantly alter their established approach to fracture evaluation. Our mobile-based AR model may be preferable to traditional 3D formats for spatial assessment tasks and decreasing task cognitive load, most notably for less experienced clinicians for whom perioperative practices are less established.