The Real-Time Support Role of Augmented Reality Technology in Shared Decision-Making in Neurosurgery Under the SEGUE...

Area of Science:

• Neurosurgery
• Medical Education
• Human-Computer Interaction

Background:

• Preoperative risk communication in neurosurgery is crucial for shared decision-making (SDM).
• Traditional methods like verbal explanations often fall short in conveying complex neuroanatomy and risks, leading to patient dissatisfaction and potential disputes.
• Augmented reality (AR) offers a novel approach with patient-specific, interactive 3D visualizations to enhance these crucial conversations.

Purpose of the Study:

• To evaluate if AR-assisted preoperative risk communication improves objective understanding and other SDM-related outcomes.
• To compare AR's effectiveness against conventional physical anatomical models within a standardized protocol.
• To assess AR's impact on patient comprehension, satisfaction, anxiety, and communication efficiency.

Main Methods:

• A prospective, single-center, randomized controlled trial involving 62 neurosurgery communication recipients (patients or legally authorized representatives).
• Participants were stratified by surgical approach (frontal, parietal, occipital) and randomized to either an AR group or a control (physical model) group.
• The primary outcome was post-session objective understanding via a knowledge questionnaire; secondary outcomes included subjective understanding, satisfaction, anxiety, and communication duration.

Main Results:

• Objective understanding was significantly higher in the AR group compared to the physical model group (P=.01).
• Communication satisfaction was also markedly higher with AR (P<.001).
• No significant differences were observed in subjective understanding, anxiety changes, or communication duration between the groups. Exploratory analyses indicated greater comprehension gains with AR for parietal and occipital approaches.

Conclusions:

• AR, integrated with patient-specific models and interactivity, enhances objective understanding and satisfaction in preoperative neurosurgical risk communication.
• This visualization tool improves SDM without extending face-to-face communication time.
• Further multicenter trials are recommended to confirm effectiveness and explore implementation and cost-effectiveness.