Wehrkamp Konstantin, Miksch Rainer C, Polzer Hans, Gilbert Fabian, Bühner Markus, Holzapfel Boris M, Böcker Wolfgang, Neudeck Rouven
Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 81377, Munich, Germany.
OrthoPlus, Lehnbachplatz 2a, Munich, 80333, Germany.
J Med Syst. 2025 Jun 24;49(1):89. doi: 10.1007/s10916-025-02217-9.
This systematic literature review aimed to examine the effects of Virtual Reality (VR), Augmented Reality (AR), and Mixed Reality (MR) head-mounted displays (HMDs) on patient understanding, satisfaction, and anxiety during preoperative informed consent. Following PRISMA-P guidelines (Prospero ID: CRD42023487281), we searched four major databases from their inception to March 24, 2023. Studies were eligible if they utilized VR, AR, or MR HMDs to visualize patient-specific data during informed consent across any medical specialty. Two reviewers independently conducted all steps of the systematic review process, and the risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS). Sixteen studies involving a total of 1067 patients were identified and included. These comprised 10 Randomized Controlled Trials (RCTs) and 6 Non-Randomized Controlled Trials (non-RCTs), including one comparative study and five non-comparative studies. The literature reviewed was heterogeneous, encompassing patients with diverse conditions across various medical specialties, including cardiology, neurosurgery, transplantation surgery, vascular surgery, plastic surgery, and urology. The results demonstrated that VR, AR, and MR HMDs positively impact patient understanding, satisfaction, and anxiety reduction. Notably, the findings were more consistent for VR HMDs compared to the limited and variable literature on AR and MR HMDs. VR, AR, and MR HMDs generally show positive effects on patient understanding, satisfaction, and anxiety in preoperative informed consent. While VR HMDs consistently yield positive outcomes, further research is needed to elucidate the effectiveness and benefits of AR and MR HMDs in preoperative consultations.
本系统文献综述旨在探讨虚拟现实（VR）、增强现实（AR）和混合现实（MR）头戴式显示器（HMD）对术前知情同意过程中患者理解、满意度和焦虑的影响。遵循PRISMA-P指南（Prospero识别号：CRD42023487281），我们检索了四个主要数据库，检索时间从建库至2023年3月24日。如果研究在任何医学专业的知情同意过程中使用VR、AR或MR HMD来可视化患者特定数据，则该研究符合纳入标准。两名评审员独立进行系统综述过程的所有步骤，并使用非随机研究方法学指数（MINORS）评估偏倚风险。共识别并纳入了16项研究，涉及1067名患者。其中包括10项随机对照试验（RCT）和6项非随机对照试验（非RCT），包括1项比较研究和5项非比较研究。所综述的文献具有异质性，涵盖了各个医学专业中患有不同疾病的患者，包括心脏病学、神经外科、移植手术、血管外科、整形外科和泌尿外科。结果表明，VR、AR和MR HMD对患者理解、满意度和焦虑减轻有积极影响。值得注意的是，与关于AR和MR HMD的有限且多变的文献相比，VR HMD的研究结果更为一致。VR、AR和MR HMD在术前知情同意中通常对患者理解、满意度和焦虑有积极影响。虽然VR HMD始终产生积极结果，但仍需要进一步研究以阐明AR和MR HMD在术前咨询中的有效性和益处。
