虚拟现实和增强现实在心肺复苏培训中的效果：系统评价和荟萃分析。

Effectiveness of virtual and augmented reality for cardiopulmonary resuscitation training: a systematic review and meta-analysis.

机构信息

Department of Anesthesiology and Pain Medicine, Hubei Key Laboratory of Geriatric Anesthesia and Perioperative Brain Health, and Wuhan Clinical Research Center for Geriatric Anesthesia, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

School of Public Administration, Hubei University, Wuhan, China.

出版信息

BMC Med Educ. 2024 Jul 5;24(1):730. doi: 10.1186/s12909-024-05720-8.

DOI:10.1186/s12909-024-05720-8

PMID:38970090

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11227211/

Abstract

BACKGROUND

Virtual reality (VR) and augmented reality (AR) are emerging technologies that can be used for cardiopulmonary resuscitation (CPR) training. Compared to traditional face-to-face training, VR/AR-based training has the potential to reach a wider audience, but there is debate regarding its effectiveness in improving CPR quality. Therefore, we conducted a meta-analysis to assess the effectiveness of VR/AR training compared with face-to-face training.

METHODS

We searched PubMed, Embase, Cochrane Library, Web of Science, CINAHL, China National Knowledge Infrastructure, and Wanfang databases from the inception of these databases up until December 1, 2023, for randomized controlled trials (RCTs) comparing VR- and AR-based CPR training to traditional face-to-face training. Cochrane's tool for assessing bias in RCTs was used to assess the methodological quality of the included studies. We pooled the data using a random-effects model with Review Manager 5.4, and assessed publication bias with Stata 11.0.

RESULTS

Nine RCTs (involving 855 participants) were included, of which three were of low risk of bias. Meta-analyses showed no significant differences between VR/AR-based CPR training and face-to-face CPR training in terms of chest compression depth (mean difference [MD], -0.66 mm; 95% confidence interval [CI], -6.34 to 5.02 mm; P = 0.82), chest compression rate (MD, 3.60 compressions per minute; 95% CI, -1.21 to 8.41 compressions per minute; P = 0.14), overall CPR performance score (standardized mean difference, -0.05; 95% CI, -0.93 to 0.83; P = 0.91), as well as the proportion of participants meeting CPR depth criteria (risk ratio [RR], 0.79; 95% CI, 0.53 to 1.18; P = 0.26) and rate criteria (RR, 0.99; 95% CI, 0.72 to 1.35; P = 0.93). The Egger regression test showed no evidence of publication bias.

CONCLUSIONS

Our study showed evidence that VR/AR-based training was as effective as traditional face-to-face CPR training. Nevertheless, there was substantial heterogeneity among the included studies, which reduced confidence in the findings. Future studies need to establish standardized VR/AR-based CPR training protocols, evaluate the cost-effectiveness of this approach, and assess its impact on actual CPR performance in real-life scenarios and patient outcomes.

TRIAL REGISTRATION

CRD42023482286.

摘要

背景

虚拟现实（VR）和增强现实（AR）是新兴技术，可用于心肺复苏（CPR）培训。与传统的面对面培训相比，基于 VR/AR 的培训有可能覆盖更广泛的受众，但关于其提高 CPR 质量的有效性存在争议。因此，我们进行了荟萃分析，以评估 VR/AR 培训与面对面培训相比的效果。

方法

我们检索了从这些数据库成立到 2023 年 12 月 1 日的 PubMed、Embase、Cochrane 图书馆、Web of Science、CINAHL、中国国家知识基础设施和万方数据库，以获取比较 VR 和 AR 基础 CPR 培训与传统面对面培训的随机对照试验（RCT）。使用 Cochrane 偏倚风险评估工具评估纳入研究的方法学质量。我们使用 Review Manager 5.4 进行随机效应模型汇总数据，并使用 Stata 11.0 评估发表偏倚。

结果

纳入了 9 项 RCT（涉及 855 名参与者），其中 3 项为低偏倚风险。Meta 分析显示，基于 VR/AR 的 CPR 培训与面对面 CPR 培训在以下方面无显著差异：胸外按压深度（均数差 [MD]，-0.66mm；95%置信区间 [CI]，-6.34 至 5.02mm；P=0.82）、胸外按压频率（MD，每分钟 3.60 次按压；95%CI，-1.21 至 8.41 次/分钟；P=0.14）、整体 CPR 绩效评分（标准化均数差，-0.05；95%CI，-0.93 至 0.83；P=0.91）以及符合 CPR 深度标准的参与者比例（风险比 [RR]，0.79；95%CI，0.53 至 1.18；P=0.26）和频率标准（RR，0.99；95%CI，0.72 至 1.35；P=0.93）。Egger 回归检验未发现发表偏倚的证据。