Kos Tessa M, Colombo Elisa, Bartels L Wilbert, Robe Pierre A, van Doormaal Tristan P C
Image Sciences Institute, University Medical Center Utrecht, Utrecht , The Netherlands.
Department of Neurosurgery, University Medical Center Utrecht, Utrecht , The Netherlands.
Oper Neurosurg (Hagerstown). 2023 Dec 26;26(5):491-501. doi: 10.1227/ons.0000000000001009.
Recent years have shown an advancement in the development of augmented reality (AR) technologies for preoperative visualization, surgical navigation, and intraoperative guidance for neurosurgery. However, proving added value for AR in clinical practice is challenging, partly because of a lack of standardized evaluation metrics. We performed a systematic review to provide an overview of the reported evaluation metrics for AR technologies in neurosurgical practice and to establish a foundation for assessment and comparison of such technologies.
PubMed, Embase, and Cochrane were searched systematically for publications on assessment of AR for cranial neurosurgery on September 22, 2022. The findings were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
The systematic search yielded 830 publications; 114 were screened full text, and 80 were included for analysis. Among the included studies, 5% dealt with preoperative visualization using AR, with user perception as the most frequently reported metric. The majority (75%) researched AR technology for surgical navigation, with registration accuracy, clinical outcome, and time measurements as the most frequently reported metrics. In addition, 20% studied the use of AR for intraoperative guidance, with registration accuracy, task outcome, and user perception as the most frequently reported metrics.
For quality benchmarking of AR technologies in neurosurgery, evaluation metrics should be specific to the risk profile and clinical objectives of the technology. A key focus should be on using validated questionnaires to assess user perception; ensuring clear and unambiguous reporting of registration accuracy, precision, robustness, and system stability; and accurately measuring task performance in clinical studies. We provided an overview suggesting which evaluation metrics to use per AR application and innovation phase, aiming to improve the assessment of added value of AR for neurosurgical practice and to facilitate the integration in the clinical workflow.
近年来，用于神经外科手术术前可视化、手术导航和术中引导的增强现实（AR）技术取得了进展。然而，在临床实践中证明AR的附加价值具有挑战性，部分原因是缺乏标准化的评估指标。我们进行了一项系统综述，以概述神经外科实践中AR技术的报告评估指标，并为评估和比较此类技术奠定基础。
于2022年9月22日在PubMed、Embase和Cochrane系统检索关于评估AR在颅脑神经外科手术中应用的文献。研究结果根据系统评价和Meta分析的首选报告项目指南进行报告。
系统检索共获得830篇文献；对114篇进行了全文筛选，80篇纳入分析。在纳入的研究中，5%涉及使用AR进行术前可视化，用户感知是最常报告的指标。大多数（75%）研究了用于手术导航的AR技术，配准精度、临床结果和时间测量是最常报告的指标。此外，20%研究了AR在术中引导中的应用，配准精度、任务结果和用户感知是最常报告的指标。
对于神经外科手术中AR技术的质量基准，评估指标应针对该技术的风险特征和临床目标。一个关键重点应是使用经过验证的问卷来评估用户感知；确保清晰明确地报告配准精度、准确性、稳健性和系统稳定性；并在临床研究中准确测量任务表现。我们提供了一个概述，建议每个AR应用和创新阶段使用哪些评估指标，旨在改善对AR在神经外科实践中附加价值的评估，并促进其融入临床工作流程。
