New Study Proves VR Reduces Pain in Hospital Patients

Cedars Sinai Hospital, Los Angeles

Today, the largest study to date at Cedars Sinai Hospital of the impact of virtual reality on pain relief was published in the open access scientific research journal PLOS ONE. This study provides the clearest evidence yet that in-hospital therapeutic VR could be an effective treatment for patients in pain.

Here’s a video narrated by Dr. Brennan Spiegel, the director of health research at Cedars Sinai and the lead author of today’s research paper, explaining how VR was used with patients:

The paper (which is freely available to anybody without a subscription to the journal) is titled Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial, and had as its research objective:

Therapeutic virtual reality (VR) has emerged as an effective, drug-free tool for pain management, but there is a lack of randomized, controlled data evaluating its effectiveness in hospitalized patients. We sought to measure the impact of on-demand VR versus “health and wellness” television programming for pain in hospitalized patients.

Patients were split into two random groups. One group was treated with VR and the other (control) group viewed flat-screen relaxation television programming. The researchers concluded that the VR group reported significantly reduced pain when compared to those just watching TV. Not only that, the study found that virtual reality was the most effective for severe pain (i.e. pain that ranked 7 or higher on a scale of 1 to 10).

Mobi Health News reports:

“There’s been decades of research testing VR in highly controlled environments — university laboratories, the psychology department and so on,” Dr. Brennan Spiegel, director of health services research at Cedars-Sinai and the study’s lead author, told MobiHealthNews. “This study is really letting VR free and seeing what happens. What I mean by that is it’s a pragmatic study where we didn’t want to control every single element of the study, but literally just see [what would happen] if we were to give it to a broad range of people in the hospital with pain; how would it do compared to a control condition already available in the hospital?”

This strength — alongside the substantial size of the patient population, variety of pain types included and direct comparison to an existing multimedia intervention — helps make the clearest case yet for VR’s clinical potential within the hospital, Spiegel continued, and paves the way for live deployments of the technology as part of inpatient care.

“We don’t need more science at this point to justify deploying VR in the hospital or creating virtualist consult services in the hospital. We’ve got enough evidence now, in my opinion, to begin using this in the inpatient environment,” he said. 

Citation: Spiegel B, Fuller G, Lopez M, Dupuy T, Noah B, Howard A, et al. (2019) Virtual reality for management of pain in hospitalized patients: A randomized comparative effectiveness trial. PLoS ONE 14(8): e0219115. https://doi.org/10.1371/journal.pone.0219115

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The Institute for the Future Issues a Report Identifying Leading-Edge Behaviours in Social VR

From time to time on this blog, I have covered academic research involving virtual reality in general (here and here) and social VR in particular (here), and it is wonderful to see a new field of research take shape around social virtual reality. One of those researchers is called, aptly enough, the Institute for the Future:

The Institute for the Future (IFTF) is a Palo Alto, California–based not-for-profit think tank. It was established, in 1968, as a spin-off from the RAND Corporation to help organizations plan for the long-term future, a subject known as futures studies. They describe themselves as:

For over 50 years, businesses, governments, and social impact organizations have depended upon IFTF global forecasts, custom research, and foresight training to navigate complex change and develop world-ready strategies. IFTF methodologies and toolsets yield coherent views of transformative possibilities across all sectors that together support a more sustainable future.

IFTF has just released a report on social VR titled Leading-Edge Behaviors from the New World of Social VR:

They describe their study as follows:

On a handful of platforms around the world, a small group of pioneers are hanging out in 3D environments in 3D bodies. They are willing to endure technical challenges, limited content, and lack of standard practices and etiquette to be the first to inhabit and explore new shared virtual worlds. IFTF spent eight months exploring their environments, communities, and practices. Their experiments provide early signals that point to a future where we each have a personal digital body, and content can be experienced in full 3D space. This will have profound implications for how we socialize, learn, work, engage with content, and take care of ourselves.

This study contains 10 Leading-Edge Behaviors: emerging and innovative user practices likely to play out more broadly over the next few years. Leading-edge Behaviors inspire and inform new products, experience and service ideas, and reveal emerging opportunities and implications. Leading-Edge Behaviors are created through a blend of expert interviews, observational and ethnographic research, and horizon scanning with people pushing the edges of new applications, devices, and platforms.

In fact, I was interviewed a couple of years ago by Lyn Jeffery, a cultural anthropologist who works for IFTF, about my own experiences in social VR (which I believe predates the research in this new report).

I was very surprised and pleased to see my own definition of social VR appearing in this report! (Hey ma, I’m famous!)

Here are the 10 leading-edge behaviours in social VR identified in this report:

This is report which pulls together insights and information from a wide variety of sources in an attempt to identify future trends, and it is well worth your time to read through it in detail. If you are interested in this report, you can find it here (the link is a Adobe Acrobat PDF format slide deck). The report includes links to many other resources, making it a good starting point for your own investigations.

I’d like to thank Lyn Jeffery and the entire team at IFTF for releasing this report to the public for free. It’s a truly valuable contribution to the nascent field of research into various aspects of social VR.

Facebook Demos Highly Realistic Avatar Facial Animation

My Twitter feed keeps delivering news nuggets this week! This is an update to a blogpost I had written earlier this year on this technology.

Facebook Reality Labs has published a research article in the journal ACM Transactions on Graphics, which shows cutting-edge avatar facial animation using multiple cameras attached to a VR headset, and a new multiview image processing technique. (The full paper is free to download from the link above.) The researchers also gave a presentation at the SIGGRAPH 2019 computer graphics conference in Los Angeles.

The results are impressive, giving an avatar human-driven, lifelike animations not only of the lower face but also the upper face, which of course if covered by the VR headset:

This is light years ahead of current avatar facial animation technology, such as the avatar facial driver in Sinespace, which operates using your webcam. Imagine being able to conduct a conversation in VR where you can convey the full gamut of facial expressions while you are talking! This is a potential gamechanger for sure. It’s not clear when we can expect to see this technology actually applied to Oculus VR hardware, however. It might still be many years away. But it is exciting!

Virtual Memory Palaces: Combining an Ancient Memory Technique with Modern VR

Cicero (Wikipedia)

The method of loci (also referred to as memory palaces, memory places, or memory spaces) is a technique for remembering information which dates back to the ancient Greek poet Simonides (who lived circa 556 — circa 468 B.C.).

According to the Stanford Encyclopedia of Philosophy:

According to a legend passed on by Cicero (106-43 B.C.E.), the discovery occurred at a banquet in Thessaly which Simonides attended in order to present a lyric poem written in praise of the host. Simonides was called outside shortly after his performance, and during his absence the roof of the banqueting hall suddenly collapsed, crushing the other diners, and mangling many of their corpses beyond recognition. Simonides, however, found he was able to identify the bodies (important for proper burial) by consulting his visual memory image of the people sitting around the banqueting table, which enabled him to identify the corpses according to where they were found. From this experience,

[Simonides] inferred that persons desiring to train this faculty [of memory] must select places and form mental images of the things they wish to remember and store those images in the places, so that the order of the places will preserve the order of the things, and the images of the things will denote the things themselves, and we shall employ the places and images respectively as a wax writing-tablet and the letters written on it. (Cicero, De Oratore, II, lxxxvi – translation: Sutton & Rackham, 1942).

Supposedly, this was the origin of the mnemonic technique known as the method of loci, described by Roman rhetoricians such as Cicero and Quintilian (c.35-c.95 C.E.), and widely employed, in various forms, by orators and others from classical, through medieval, and up until early modern times.

Memory palaces help people remember information by taking advantage of the brain’s natural ability to spatially organize thoughts and concepts. The user associates information with objects and locations in a three-dimensional environment. Here’s a summary of the technique if you are interested in learning it.

A recent academic research paper by Eric Krokos, Catherine Plaisant, and Amitabh Varshney at the Univerity of Maryland, published in the journal Virtual Reality, has shown that people accessing virtual memory palaces in virtual reality (i.e. using a VR headset) were able to remember things better compared to people accessing the same memory palace using a flat computer desktop and mouse. (The research paper is Open Access, which means anybody on the Internet can download and read it without having to pay a publisher, in this case, Springer. You can access the paper for free using the link above, just click on the blue Download PDF button in the upper right-hand corner.)

I was pleased to discover this article, as the experiment was very similar to one that I wanted to conduct in my wildly overambitious research proposal, which unfortunately I had to suspend work on for various practical reasons. (I am currently writing up a paper about my experience. I am now working on developing a new research project involving virtual reality and libraries.)

In the University of Maryland study, testing was done using pre-constructed medieval town and palace environments purchased through TurboSquid, and 42 pictures of the faces of famous people. The pictures of the faces were hand-positioned in the 3D environment. Study participants were given a list of the pictures and names to study before the experiment. Next, each participant was given access to the memory palace, using either a VR headset or a or a desktop monitor with a mouse. Then, they had 5 minutes to study the memory palace with 21 pictures scattered throughout it. Then, in the recall phase, the pictures of the faces were swapped out with numbers, and participants were asked to give a name and level of confidence for their recalled faces for each numbered position. Each study participant was tested in both the town and the palace scenes, and both in VR and desktop mode. (If a face was shown in one set, it was not repeated in the second set. The 21 faces were presented all at once, and users were able to view and memorize the faces in any order of their choosing.)

Images Taken from the Research Paper

Statistical analysis of the experimental results supported the study’s hypothesis that a virtual memory palace experienced in an immersive VR headset led to a more accurate recall than on a mouse-controlled desktop display. Study participants in VR headsets also had a higher level of confidence in their answers than desktop users. A news report on the research project from the University of Maryland website states:

The results showed an 8.8 percent improvement overall in recall accuracy using the VR headsets, a statistically significant number according to the research team.

In post-study questionnaires, all 40 participants said that they were completely comfortable—and adept—in navigating a desktop computer to access information, yet all but two said they preferred the immersive VR environment as a potential learning platform. The questionnaire also found that only two people said they felt “uncomfortable” using VR.

Many of the participants said the immersive “presence” while using VR allowed them to focus better. This was reflected in the research results: 40 percent of the participants scored at least 10 percent higher in recall ability using VR over the desktop display.

In fact, there is already a VR app available which allows you to construct memory palaces and explore them in your VR headset. The product is called Munx VR:

Munx is a VR platform for building memory palaces to learn huge amounts in short time and with full retention. By combining medieval memory techniques with modern technology, we are redefining the way we learn, understand, and retain information in our minds. Imagine knowing the periodic table in the same way you know the layout of your living room, or being able to recall a president or ruler with the same effortlessness of reaching for a mug when making a cup of tea.

If you’re interested, you can get Munx VR on Steam (it’s free). Here’s a promotional video for the product: