I recently attended the Virtual Medicine 2018 conference, held in Los Angeles, California, at Cedars-Sinai Hospital. With physicians, technologists, and other healthcare professionals from 13 countries present, this was one of the first medical conferences focused purely on virtual reality (VR). Over the course of two days, I heard from a variety of speakers, both inside and outside of medicine, on advances in VR research and clinical use. My takeaways from the event are as follows:
1.The opioid overdose epidemic, responsible for more than 42,000 deaths in 2016 alone, according to the CDC, has greatly increased the need for alternative pain management strategies. This was highlighted by multiple speakers at Virtual Medicine, specifically in terms of the potential therapeutic VR has for offering analgesia. While acute pain was discussed — with multiple examples of VR being used for such (labor and delivery, post-operative, procedurals, burn injury care) — chronic pain was of particular interest during the conference. There aren’t many chronic pain VR programs available yet, although several products were demonstrated, from BeHaVR, AppliedVR, and others.
2.Using VR as an assistive device for macular degeneration was one of the more novel applications of the technology demonstrated at Virtual Medicine. Samsung’s chief medical officer, David Rhew, MD, showed how this could be accomplished through the IrisVR software. In short, the preferred retinal locus (region of vision often relied upon when a central scotoma interferes with vision) is magnified through the use of VR. The user can also zoom in virtually while wearing a compatible headset, in something of a hybrid augmented reality (AR) experience.
3.The evidence basis supporting the clinical utilization of VR continues to grow, with a nearly exponential growth in number of studies published over the last several years. These include a 2018 review demonstrating the benefits of VR in treatment of burn injuries and a 2017 review of the efficacy in treating phobias with VR. In general, when VR is compared to traditional interventions, studies have found it is typically non-inferior and/or a supplemental benefit.
4.An increasing number of VR therapy providers are moving towards all-in-one digital pain kits – combing therapeutic VR with local modalities (such as a transcutaneous electrical nerve stimulation unit), activity trackers (Fitbit, heart rate monitors), and educational material on breathing exercises and mindfulness to help manage pain.
5.Lastly, are you interested in medical research with VR? Did you know there is a suggested framework for planning VR studies, developed by a working group of experts in the field? This group, called the “VR-Core” (short for Virtual Reality Committee of Outcomes Research Experts), has produced the model for VR therapy development and clinical validation. It consists of three suggested phases:
a.VR 1 – studies focusing on content development through working with patients and providers
b.VR 2 – trials conducted for testing feasibility, tolerance, initial clinical efficacy
c.VR 3 – randomized controlled trials to evaluate clinically important outcomes
Overall, Virtual Medicine 2018 was an eye-opening introduction to the many ongoing applications of VR in healthcare. Hopefully, it will be an annual event and continue to encourage the development of high-quality studies that further the evidence basis for medical applications of VR.