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The purpose of this study is to test the efficacy of computer generated imagery (CGI) 360° Video Virtual Reality (360° VVR) versus newly developed live-action 360° VVR film versions of Virtual Reality (VR) in reducing pain in hospital patients.
Drug overdose is the leading cause of accidental death in the United States (US) and prescription pain reliever addiction is driving this epidemic (Center for Disease Control and Prevention [CDC], 2015). There are enough opioid prescriptions written each year to provide every single adult American one bottle of pills (e.g., 259 million prescriptions in 2012) (CDC, 2014) and 78 Americans die every day from an opioid overdose (CDC, 2016). Pain is the most universal medical complaint with 25% of US adults reporting a day-long episode of pain over the previous month and 10% reporting the pain lasted a year or more (National Center for Health Statistics, 2006). Pain and its sequela (including those directly linked to opioid use/abuse) cost the US economy 61.2 billion per year (Stewart, Ricci, Chee, Morganstein, & Lipton, 2003). Accordingly, finding new methods of reducing pain is a priority for the US government. Indeed, on March 18, 2016 the CDC released new guidelines for reducing opioid prescriptions (Dowell, Haegerich, & Chou, 2016) and on March 29, 2016 the White House released a document detailing the actions needed to address this public health problem (The White House, 2016). Both of these documents call for non-medication methods of pain management.
Virtual Reality (VR) is one effective non-pharmacological method that reduces acute and chronic pain. A systematic review of 11 randomized controlled trials (i.e., gold standard for evaluating intervention efficacy) showed that VR reduced pain more than credible control interventions (Malloy & Milling, 2010). Importantly, pointing to room for improvement to current VR interventions for pain, this analysis showed that the level of pain reduction was dependent on how realistic the virtual environments were. There are two primary problems with current VR technology that prevent large-scale use and effectiveness. First, current VR technology uses animated (cartoon like) environments. Patients report this quality prevents full immersion. Studies have shown that many users complain that the computer generated VR stimuli looks unrealistic, eccentric and too much like a video game (Kwon, Powell, & Chalmers, 2013). Virtual reality environments have been traditionally created by programmers using video game assets and computer generated imagery (CGI). While CGI can be used to make intricate virtual environments, unless there is a team of expert digital artists, the virtual stimulus may end up looking rudimentary and exhibit a number of graphical glitches, which could prove distracting in therapy. Furthermore CGI often suffers from the uncanny valley effect: the tendency of CGI representations of people to be viewed as unsettling as the representations become more lifelike. Second, current CGI VR technology is bulky and costly requiring a large computer setup with multiple screens (approximately $30,000 for a setup). Recent advances in VR technology can address both of these concerns, and thus there is potential to develop a more cost-effective application.
Our team has been working with virtual reality for 10 years now conducting several large randomized controlled trials (Powers & Emmelkamp, 2008; Meyerbröker, Powers, van Stegeren, & Emmelkamp, 2012; Powers et al., 2013; Tart et al., 2013). Two major recent innovations are central to this proposal. First, the realism possible in VR has dramatically increased with the use of 360° three-dimensional (3D) high definition (HD) film environments. 360° Video VR is a radical filmmaking technology that can turn live action footage into a 360° environment that users can interact with. 360° VVR is made by filming with an array of multiple HD cameras carefully arranged to capture all angles in a 360° area of a live action event (see Figure 3). Then those angles are stitched together in post-production into a 360° texture sphere and the sphere is then mapped to the head tracker on the users head mounted display. Leading to the effect that when a user turns his head, their view of the live action video footage turns with them in real time (e.g. if the user looks down, the camera pans down and the user sees the floor) allowing the user to look around anywhere in the 360° of filmed footage of the live action event. The benefit of 360° Video VR as opposed to CGI VR is that it is photo realistic, does not suffer from the uncanny valley effect of CGI, and is able to capture nuances of real life fears that are hard to reproduce with CGI. In addition, the projected cost of the end product is approximately $500. This enhanced level of immersion has the potential to dramatically improve the efficacy to reduce acute and chronic pain (see above). Second, deployment of the resulting content to patients is now much smaller and inexpensive (e.g., $99 for a Samsung Galaxy Gear VR (see Figure 4) or $20 for Google Cardboard systems). This technology makes VR accessible to anyone with a smartphone.
The current study seeks to test the efficacy of the standard CGI VVR versus the enhanced 360° 3D HD live-action film versions of VR in reducing pain in hospital patients.
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
Live-Action 360° Video Virtual Reality, CGI 360° Video Virtual Reality
University of Texas at Austin
Not yet recruiting
University of Texas at Austin
Published on BioPortfolio: 2016-12-19T20:38:21-0500
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Used with articles which include video files or clips, or for articles which are entirely video.
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