Augmented Reality in Outpatient Care: A Narrative Review

Extended-Reality Technologies: An Overview of Emerging Applications in Medical Education and Clinical Care.

Creating Augmented Reality (AR) applications can be an arduous process. With most current authoring tools, authors must complete multiple authoring steps in a time-consuming process before they can try their AR application and get a first impression of it. Especially for laypersons, complex workflows set a high barrier to getting started with creating AR applications. This work presents a novel authoring approach for creating mobile AR applications. Our idea is to provide authors with small, ready-to-use AR applications that can be executed and tested directly as a starting point. Authors can then focus on customizing these AR applications to their needs without programming knowledge. We propose to use patterns from application domains to further facilitate the authoring process. Our idea is based on the learning nugget approach from the educational sciences, where a nugget is a small and self-contained learning unit. We transfer this approach to the field of AR authoring and introduce an AR nugget authoring tool. The authoring tool provides pattern-based self-contained AR applications, called AR nuggets. AR nuggets use simple geometric objects to give authors an impression of the AR application. By replacing these objects and further adaptions, authors can realize their AR applications. Our authoring tool draws from non-immersive desktop computers and AR devices. It synchronizes all changes to an AR nugget both to an AR device and a non-immersive device. This enables authors to use both devices, e.g., a desktop computer to type text and an AR device to place virtual objects in the 3D environment. We evaluate our proposed authoring approach and tool in a user study with 48 participants. Our users installed the AR nugget authoring tool on their own devices, worked with it for 3 weeks, and filled out a questionnaire. They were able to create AR applications and found the AR nugget approach supportive. The users mainly used the desktop computer for the authoring tasks but found the synchronization to the AR device helpful to experience the AR nuggets at any time. However, the users had difficulties with some interactions and rated the AR nugget authoring tool in a neutral field.

This work aims to evaluate the effectiveness of knowledge transfer through an Augmented Reality (AR) application, assessing short- and mid-term retention in children and adults with Type 1 diabetes. One objective is to determine if the AR application helps patients learn about the carbohydrate content of different foods (N = 27 Ecuadorian patients). Another objective is to evaluate the usability and satisfaction perceived by the patients. An additional objective is to compare the data from our study in Ecuador with data from a similar study conducted with Spanish children (N = 42). The results show that the AR application is effective for short-term knowledge transfer (p < 0.001) and has a suggestively significant effect on mid-term retention (p < 0.05). The AR application had an equalizing effect on knowledge outcomes between the groups (Ecuador and Spain) despite initial differences. The AR application significantly increased patients' knowledge (p < 0.001) and was effective for both children and adults. Patient satisfaction was high, and learning outcomes were not influenced by age or gender. The AR application is effective for short-term knowledge transfer and mid-term retention, benefiting children and adults regardless of gender. The patients' experience was very positive. Therefore, the AR application is a valuable tool for therapeutic education in diabetes since it offers support that is easily accessible on mobile devices, enabling autonomous learning, and it contributes to the creation of innovative, patient-centered healthcare solutions.

BackgroundRadiology education is crucial in developing the fundamental skills and knowledge for effectively interpreting medical images, planning interventions, and providing high-quality patient care. By incorporating immersive technologies like VR and AR, significant enhancements to preexisting radiology-based teaching and training simulations can enhance learning, visualization, and skill development in radiology. This paper explores four basic types of VR technology used in radiology education, which are non-immersive, semi-immersive, fully immersive, and augmented reality, and their applications. This review talks about the key applications of VR and AR to provide students with real-world training where students gain hands-on experience in a risk-free and controlled environment. Virtual radiography simulation can be used to practice and enhance patient positioning skills without getting exposed to any X-ray radiation. The VERT platform can be used to simulate radiography processes, including patient setup and dose planning. Furthermore, 3D VR simulation provides a detailed three-dimensional model of anatomical structures, enhancing learning. This review also focuses on the applications of AR, such as VIPER (virtual interactive patient education and radiotherapy) and ARTUR (augmented reality for radiographic training). While both VIPER and ARTUR are designed to improve learning and training in radiology, VIPER primarily focuses on patient education, offering a 3D visualization of the radiotherapy process, including treatment rooms, equipment, and patient anatomy. On the other hand, ARTUR is an application that utilizes holograms to provide a 3D image that students can manipulate to practice radiographic positioning.ConclusionsIntegrating VR and AR in radiology education can enhance qualities like learning, visualization, and skill development using interactive and risk-free simulations. Tools like VERT, 3D VR simulation, VIPER, and ARTUR provide users a sense of hands-on experience, transforming the traditional ways of teaching. This review talks in detail about the perception of learners and educators on VR and AR, along with the qualities and skills users can enhance using these technologies. The paper highlights key factors hindering the adoption of these technologies in radiology education.

Objectives. Opioid stewardship interventions promote the appropriate use of prescribed and ordered opioids to reduce the risk of opioid adverse events. Our main objectives were to determine the effectiveness of these interventions in healthcare settings on opioid prescribing and clinical outcomes (e.g., number of opioid prescriptions, opioid dosage, overdose, emergency department visits, and hospitalizations) including unintended consequences (e.g., changes in patient-reported pain intensity), and ways these interventions can be effectively implemented. Methods. We followed rapid review processes of the Agency for Healthcare Research and Quality Evidence-based Practice Center Program. We searched PubMed and the Cochrane Library to identify eligible systematic reviews from January 2019 to April 2023 and primary studies published from January 2016 to April 2023, supplemented by targeted gray literature searches. We included systematic reviews and studies that addressed opioid stewardship interventions implemented in healthcare settings in the United States and that reported on opioid prescribing and clinical outcomes. Findings. Our search retrieved 6,431 citations, of which 34 articles were eligible (including 1 overview of systematic reviews, 13 additional systematic reviews, 13 randomized controlled trials (RCTs) [reported in 14 articles] and 6 nonrandomized studies). Systematic reviews, mostly summarizing pre-post studies, included a wide variety of opioid stewardship practices that focused on patient and family engagement, healthcare organization policy, or clinician knowledge and behavior interventions, in inpatient, perioperative, emergency department, and ambulatory settings. RCTs addressed multicomponent interventions (typically a combination of prescriber education, care management and facilitated access to resources), and patient education and engagement, mainly in ambulatory chronic pain. Opioid stewardship practices involving clinical decision support or electronic health records, or multicomponent interventions (including for chronic pain) were associated with decreases in opioid prescribing or reduced doses and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence for all outcomes). Patient engagement and education interventions had mixed results for opioid prescribing outcomes (insufficient strength of evidence) and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence). The evidence was insufficient on other types of interventions and on outcomes of opioid refill requests and refills, patient satisfaction, or overdose. Barriers included lack of training, workload, gaps in communication, and inadequate access to nonpharmacological resources. Facilitators included clinician and patient acceptance of intervention components. Conclusions. Selected opioid stewardship interventions may be effective for reducing opioid prescribing and dosing without adversely affecting clinical outcomes overall, although strength of evidence was low. Unintended consequences were often not measured or not measured rigorously. Interventions to reduce opioid use should monitor unintended consequences and include access to nonpharmacological pain management resources with appropriate patient education and engagement.

Primary school students often find it difficult to differentiate two dimensional and three-dimensional geometric shapes. Taking advantage of the ability of Virtual Reality (VR) and Augmented Reality (AR) to visualize 3D objects, we evaluate the potential of VR and AR technologies for teaching the lesson of geometric solids to primary school children. To the best of our knowledge there are no previous cases in the literature describing a comparative evaluation of VR and AR technologies in education, and more specifically in the field of mathematics for primary school children. An experimental evaluation was staged to test the following hypothesis: Hypothesis 1: VR and AR applications make the teaching of mathematics more interactive and interesting and they also contribute to a more efficient learning and understanding of mathematical concepts. Hypothesis 2: The use of VR applications is more effective when compared to AR applications for mathematics teaching activities. For the needs of the experimental evaluation, we designed a lesson plan comprised of three activities: Classification of shapes into solid or plane shapes, identification of solid shapes appearing in a typical city environment, and classification of solid shapes. The lesson plan was implemented based on the traditional method that utilizes printed material, three related VR and three AR applications. The developed VR and AR applications for the current research do not require specialized equipment. For the AR applications, the users only need to use their mobile device or tablet and for VR applications they only need to use a mobile phone and low-cost virtual reality glasses. As part of the study 30 fourth, fifth and sixth class primary school students were divided equally into the control group who used the traditional teaching method, and the AR and VR groups who used AR and VR applications respectively. Participants were provided with questionnaires before (pre-test) and after the test (post-test) to measure factors such as user attention, presence, enjoyment, science knowledge, auditory knowledge, and visual knowledge. According to the results, new technologies in education in the form of virtual and augmented reality improve interactivity and student interest in mathematics education, contributing to more efficient learning and understanding of mathematical concepts when compared to traditional teaching methods. No significant difference was observed between virtual and augmented reality technologies with regards to the efficiency of the methods that contribute to the learning of mathematics, suggesting that both virtual and augmented reality display similar potential for educational activities in Mathematics. Based on statistical evidence Hypothesis 1 was accepted and Hypothesis 2 was rejected. The current research is one of the first attempts ever to compare VR and AR technologies for Mathematics teaching activities in primary school. The findings of our research can provide valuable feedback to educators and developers who plan to use or develop VR or AR technologies for educational activities. Given that these days VR and AR applications, like the ones used in the experimental evaluation, do not require highly specialized equipment, the introduction of AR and VR based activities both for in-class and extra curriculum activities provide a promising way for more efficient Mathematics training activities.

In order to mitigate the spread of COVID-19, in the early stages of the pandemic outbreak, postponing elective procedures was recommended all around the world. Outpatient care and dental care were limited to telephone advice and emergency services. Dental staff is particularly vulnerable to SARS-CoV-2 contraction, because of the inevitable contact with patients' body fluids during aerosol-generating procedures. The implementation of diagnostic tests among ambulatory patients could improve the occupational safety among outpatient care personnel. The aim of this review was to introduce information regarding COVID-19 diagnostics with a particular focus on the methods which can be utilized in an outpatient and dental care setting. An online PubMed database review of articles on COVID-19 diagnostics, published on February 12-May 15, 2020, was conducted. Reverse transcription polymerase chain reaction is the gold standard in COVID-19 diagnostics, which determines if a person has an active infection. Unfortunately, its utilization in outpatient care is limited. Serological enzyme-linked immunosorbent assays identify people who were infected, including those who have had an asymptomatic infection, but they do not give sufficient information about the acute infection. Rapid serological assays developed to facilitate testing outside of laboratories, especially in dental offices, are not recommended by the World Health Organization to be used outside research settings, and they should not constitute the basis for clinical decision-making because of frequent false-negative results which may consequently contribute to personnel infections. Out of all available COVID-19 diagnostic methods, rapid serological assays seemed to be a method of choice in outpatient medical care. Unfortunately, their results turned out to be unreliable. The best methods to ensure the occupational safety of medical staff and to avoid cross-infections in outpatient care facilities include a thorough epidemiological interview, temperature measurement to rule out patients with an active infection, and the implementation of strict infection control procedures. Med Pr. 2021;72(2):155-62.

Augmented reality (AR) and mixed reality (MR) are used in many disciplines, especially education, science, health, safety and engineering. It is based on the visualization and interaction of virtual graphic designs in the natural environment with its own hardware and software. In this study, the effect of augmented and mixed reality applications in the training of open-pit mining machines is examined. In the application called AR Book, a booklet containing machine visuals and technical information was created. In the project developed in the Unity real-time development engine, the database created in the Vuforia AR engine and 3D machine models matched with them were used. An image-target-based augmented reality application was implemented in this booklet using Android devices. In another application, a ground-plane-based application was developed for the mixed reality device MS Hololens 2. With the Hand Interactions feature, machines positioned in the natural environment can be controlled with drag, rotate and scale operations, enlarged to gigantic sizes and examined. The evaluations of the training group regarding the use of AR and MR applications together with traditional education were sought. They were also asked to make comparisons between the mobile device and Hololens 2. There have been highly positive results in integrating imaging technologies into education.

Training and education have become increasingly crucial in obtaining new skills in a variety of fields, especially in assembly and disassembly operations. The main issue in mechanical engineering, particularly in the assembly department, was that automobile engine components assembly was found to be complicated and challenging to assemble using an existing method, where they only rely on a video-based method. The purpose of this paper is to create interactive Virtual Reality (VR) and Augmented Reality (AR) applications that allow users to efficiently assist and complete the assembly tasks. In this work, the authors designed and developed a fully immersive VR application using an HTC Vive headset and two AR applications (marker-less AR application and marker-based AR application) using EPSON MOVERIO BT-300 (AR Smart Glasses). Fourteen engineering students from Universiti Putra Malaysia were selected for the experiment. They were divided into four groups: video-based group, VR-based group, marker-less AR group, and marker-based AR group. They are required to complete all four experiments (video-based experiment, VR-based experiment, marker-less AR experiment, and marker-based AR experiment). The results showed that the marker-less AR application is the best impressive method (37% better), the VR application is the second impressive method (23% better) followed by the marker-based AR application is the third impressive method (3% better) compared to the existing video-based guideline. Therefore, the students favored AR and VR applications rather than the existing method to be used in automobile engine assembly tasks.

The use of Augmented Reality (AR) in Industry 4.0 is entirely in line with the principles of the fourth industrial revolution. This technology maximizes human perceptual experience and allows us to interact with information. Therefore, this research takes the opportunity to develop an AR application in healthcare that is related to Coronary Artery Disease (CAD). The purpose of using AR technology in disseminating CAD related information is that AR can attract the public attention as it is an interesting and sophisticated technology today. The scope of this research focuses on the human heart and aims to educate the public about CAD. Every stratum of society can use this application to get an overview of the human heart and they can also know the symptoms of having CAD. By using this AR technology, it can provide information in an engaging way and improve the user experience. The main objective is to study and develop marker-based AR apps in making an AR application in medical. The research was conducted using several proven existing applications that can help in building good applications. This research was designed and developed as a marker-based AR application using software like Vuforia to set the image marker, Microsoft Visual Studio to set the functionality of the application and Unity3D as the software that handles everything, supported by Android SDK software. Tests and evaluations have been performed and can provide information about CAD to the public. Overall, the AR-CAD application results are successfully generated to raise public awareness related of coronary artery disease.

Background3D reconstruction technology could revolutionise medicine. Within surgery, 3D reconstruction has a growing role in operative planning and procedures, surgical education and training as well as patient engagement. Whilst virtual and 3D printed models are already used in many surgical specialities, oesophagogastric surgery has been slow in their adoption. Therefore, the authors undertook a scoping review to clarify the current and future roles of 3D modelling in oesophagogastric surgery, highlighting gaps in the literature and implications for future research.MethodsA scoping review protocol was developed using a comprehensive search strategy based on internationally accepted guidelines and tailored for key databases (MEDLINE, Embase, Elsevier Scopus and ISI Web of Science). This is available through the Open Science Framework (osf.io/ta789) and was published in a peer-reviewed journal. Included studies underwent screening and full text review before inclusion. A thematic analysis was performed using pre-determined overarching themes: (i) surgical training and education, (ii) patient education and engagement, and (iii) operative planning and surgical practice. Where applicable, subthemes were generated.ResultsA total of 56 papers were included. Most research was low-grade with 88% (n = 49) of publications at or below level III evidence. No randomised control trials or systematic reviews were found. Most literature (86%, n = 48) explored 3D reconstruction within operative planning. These were divided into subthemes of pre-operative (77%, n = 43) and intra-operative guidance (9%, n = 5). Few papers reported on surgical training and education (14%, n = 8), and were evenly subcategorised into virtual reality simulation (7%, n = 4) and anatomical teaching (7%, n = 4). No studies utilising 3D modelling for patient engagement and education were found.ConclusionThe use of 3D reconstruction is in its infancy in oesophagogastric surgery. The quality of evidence is low and key themes, such as patient engagement and education, remain unexplored. Without high quality research evaluating the application and benefits of 3D modelling, oesophagogastric surgery may be left behind.

Objective Opioid stewardship interventions promote appropriate use of opioids. We synthesized evidence from recent studies on the effectiveness of opioid stewardship interventions in United States healthcare settings on opioid prescribing and clinical outcomes. Methods We followed the Evidence-based Practice Center Program's rapid review processes. We searched PubMed and Cochrane for original studies meeting specified inclusion criteria from January 2016 (correlating with the Centers for Disease Control and Prevention Pain Guidelines) to April 2023, supplemented by gray literature searches. Findings Our search identified 13 randomized controlled trials and 6 nonrandomized studies. Randomized controlled trials addressed interventions involving multiple components (typically combining prescriber education, care management, and facilitated access to resources), clinical decision support (CDS) or electronic health records (EHR), and patient education and engagement, mainly in ambulatory chronic pain. Multicomponent interventions and opioid stewardship practices involving CDS or EHR were associated with decreased opioid prescribing or reduced doses and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence for all outcomes). Patient engagement and education interventions had mixed results for opioid prescribing outcomes (insufficient strength of evidence) and no increases in pain, emergency department visits, or hospitalizations (low strength of evidence). Conclusions Selected opioid stewardship interventions may be effective for reducing opioid prescribing without adversely affecting clinical outcomes. Interventions to reduce opioid prescribing should monitor unintended consequences and include access to nonpharmacological pain management resources with patient education and engagement.

Augmented reality (AR) and virtual reality (VR) are emerging technologies with wide potential applications in health care. We performed a scoping review of the current literature on the application of augmented and VR in the field of facial plastic and reconstructive surgery (FPRS). PubMed and Web of Science. According to PRISMA guidelines, PubMed and Web of Science were used to perform a scoping review of literature regarding the utilization of AR and/or VR relevant to FPRS. Fifty-eight articles spanning 1997-2023 met the criteria for review. Five overarching categories of AR and/or VR applications were identified across the articles: preoperative, intraoperative, training/education, feasibility, and technical. The following clinical areas were identified: burn, craniomaxillofacial surgery (CMF), face transplant, face lift, facial analysis, facial palsy, free flaps, head and neck surgery, injectables, locoregional flaps, mandible reconstruction, mandibuloplasty, microtia, skin cancer, oculoplastic surgery, rhinology, rhinoplasty, and trauma. AR and VR have broad applications in FPRS. AR for surgical navigation may have the most emerging potential in CMF surgery and free flap harvest. VR is useful as distraction analgesia for patients and as an immersive training tool for surgeons. More data on these technologies' direct impact on objective clinical outcomes are still needed. N/A Laryngoscope, 134:2568-2577, 2024.

The article deals with prevention of dangerous acts of persons with mental disorders by medical organizations providing mental health care in outpatient settings. Outpatient preventive activities cover two patient groups: those who have not previously committed dangerous acts (primary prevention) and those who have committed such acts. In the latter case prevention concerns repeated dangerous acts (secondary prevention). The main means of outpatient primary prevention are diagnostics of mental disorders and provision of qualified outpatient mental health care. Outpatient care is provided in the form of regular assessment and treatment and in the form of dispensary observation, established regardless of consent of the mentally disordered person or his/her legal representative. Active dispensary observation is established for patients who have a propensity to commit socially dangerous acts. Such observation belongs to measures of both primary and secondary psychiatric prevention and is carried out by outpatient medical organizations in cooperation with the Interior authorities. Another means of outpatient secondary prevention is execution of a compulsory medical measure, such as compulsory observation and treatment by a psychiatrist in outpatient settings. The author, on the basis of studying legal acts, special literature and medical statistics, comes to the conclusion about increasing importance of prevention of dangerous acts of persons with mental disorders by medical organizations providing mental health care in outpatient settings.

Purpose: The aim of the study was to analyze the effect of augmented reality (AR) applications on in-store shopping experience in South Africa. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: AR applications in South African retail stores enhance the in-store shopping experience by improving consumer engagement, convenience, and satisfaction. These technologies allow customers to visualize products in real-time, access detailed information, and receive personalized recommendations, thus reducing perceived purchase risks and aiding decision-making. Overall, AR differentiates brands, attracts more foot traffic, and fosters customer loyalty by offering unique and memorable shopping experiences. Unique Contribution to Theory, Practice and Policy: Technology acceptance model (TAM), flow theory, uses and gratifications theory (UGT) may be used to anchor future studies on effect of augmented reality (AR) applications on in-store shopping experience in South Africa. Retailers should integrate AR applications to create more interactive and engaging in-store experiences. Policymakers should establish clear guidelines on data privacy and protection related to AR applications. This includes ensuring that personal data collected through AR experiences is securely stored and used ethically.