Good morning, OMED 2024. Thank you so much for coming for this presentation on the feasibility and acceptability of virtual reality on perceived pain and anxiety during bone marrow biopsies by A.J. Mattal, Navjot Azad, Yaroslav Zuev, Dr. Giuseppe, and Dr. Wan. So a little bit of an introduction on bone marrows and virtual reality. Bone marrow biopsies are medical procedures performed to diagnose and monitor disorders of the blood. Virtual reality is an emerging technology that provides an immersive user experience that has the capacity to treat patients from negative or painful experiences commonly associated with medical procedures. And the purpose of this pilot study was to assess the feasibility and acceptability of using virtual reality as an adjunctive therapy to alleviate physical as well as psychological symptoms in patients receiving bone marrow biopsies. The specific aims of this study, the first one was to examine the effect of virtual reality on perceived pain before and after a bone marrow biopsy in the inpatient and outpatient settings. The second aim was to examine the effect of virtual reality on perceived anxiety before and after a bone marrow biopsy in the inpatient and outpatient settings. The third aim was to assess the difference in comfort levels, effectiveness of distraction method, and the likelihood to repeat the procedure when utilizing standard distraction-based therapy versus the virtual reality distraction-based therapy for the bone marrow biopsies. So in order for the study to occur, our parameters were using a control and an experimental group of a total of 60 participants in the study. The control group contained the patients who received the standard of care and the standard distraction methods, and that was a total of 30 participants. And the experimental group received a virtual reality headset, the MediQuest 2 headset, using the HealthPoint app during the procedure, also consisting of 30 individuals. For the methods of this experiment, for the enrollment, we used an inclusion and exclusion criteria. We had 60 adult participants from the University of Florida Health Oncology and Hematology Ward were enrolled into this study. Inclusion criteria included patients who were scheduled to receive bone marrow biopsies, patients who were older than 18 and could physically tolerate wearing a VR headset. Patients were excluded from the study if they required urgent procedures for severe acute illness and had physical limitations preventing the use of a VR headset or were deemed medically unstable to take part in the study. Then we had the pre- and post-procedural measurements of perceived pain and anxiety. Patients in both the experimental and control group reported their pain and anxiety levels before and after the bone marrow biopsy using a 1-to-5 point scale using the verbal numerical rating scale. A score of 1 correlated with experiencing no pain or anxiety, while a score of 5 correlated with experiencing extreme pain or anxiety during the bone marrow biopsy. For the post-procedural measurements of the comfort levels, distraction effectiveness, and the likelihood to repeat the VR headset, the patient's comfort levels effectiveness of distraction methods during the procedure and the likelihood to repeat it were used using the 1-to-5 scale, 1 being strongly disagree, 5 being strongly agree for the statements. I felt comfortable with the distraction for comfort levels and 1-to-5 again for the statement, I would want to use the same distraction on a medical procedures in the future, 1 being strongly disagree, 5 being strongly agree. And the scores ranged from 1-to-5 again, 1 being strongly disagree, 5 being strongly agree for the agreement of the statement. Using the distraction made me feel less worried about the procedure. So initially for the results, we saw that there was no significant difference within either the VR or the control for the difference in pain perception before and after the procedure. Participants in the VR group mean 2.13 standard deviation plus minus 1.25 or 1.26 responded with significantly lower feelings of anxiety compared to the control that had a mean of 3.42 for anxiety. While the participants in the VR group had a mean of 4.45, they had a higher feeling of comfort compared to the control that had only a 2.1 mean. Participants in the VR group with a mean of 4.32 were significantly more likely compared to the control 1.81 mean to indicate they would repeat the experience. Participants in the VR group were significantly more likely compared to the control to rate their distraction as effective. And by looking at the chart, you can see that the experiences of anxiety and fear before and after the experiment of using the VR headset and their willingness to repeat using the headset. Now taking a look on the right side, we can see three figures. One is the Oculus Quest 2 device that the participants were using during the experiment. Figures 2 and 3 are figures to show you two very soothing experiences that can be encountered using the VR headset, a winter experience and an aqua world experience in figures 2 and 3 respectively. In conclusion, our investigation encourages the feasibility and acceptability of using VR interventions for patients undergoing bone marrow biopsies. However, there are limitations to utilizing VR in the healthcare such as patients feeling claustrophobic or experiencing motion sickness. Despite these limitations, our data suggests that VR can be used as a distraction-based therapy that is non-inferior to the standard of care and provides an enjoyable user experience that reduces the perceived pain and anxiety of non-fidated medical procedures. Thank you so much for everyone attending this conference and taking the time to look at our poster. I hope you have a wonderful OMED and have a wonderful day. Thank you.

virtual reality

pain management

anxiety reduction

medical procedures

distraction therapy