Is Virtual Reality the Future of Medicine?

In today’s day and age, the conversation regarding virtual reality has become more prominent as the question of whether the advancement of technology is beneficial to the human race develops into a substantial debate topic within the sociological and scientific fields.

Virtual reality is most common in the context of video games, allowing players to engage from a first person point of view. According to the virtual reality society, ‘virtual reality is the term used to describe a three-dimensional, computer generated environment which can be explored and interacted with by a person. That person becomes part of this virtual world or is immersed within this environment and whilst there, is able to manipulate objects or perform a series of actions.’[1]

As the world of medicine progresses, the use of VR has become incredibly helpful.

In 2016, the percentage of projects developed in virtual reality within the health sector was 47%, that is, between 5 to 10 projects per year. In 2018, this percentage increased by up to 75%, which leads to a production of 20 projects per year.[2] In the medical field, the application of virtual reality offers tools of great utility, of simple usability and high impact. The development ranges from the creation of training experiences to experiences of therapeutic use, or even solutions for conferences and events. The communication needs of the health sector and the development of new tools are constantly changing, therefore, the demand for solutions is increasing.

A clear example of how virtual reality is being applied to clinical practice is the recent project of the Vall d'Hebron Hospital in Barcelona. Developed in 2016, this initiative uses virtual reality for the treatment of attention deficit hyperactivity disorder (ADHD). The team uses hyper-realistic environments to increase the concentration of patients, through a mixture of mindfulness and virtual reality. The University of Valencia also relies on virtual reality for the creation of initiatives that help patients. Under the name of Savia, a project has been created for children with autism. Through this project, they have implemented new educational intervention tools for children with autism spectrum disorders (ASD). Through these virtual reality video games, the children interact with each other, with their educators or with their parents to learn a series of key skills for their development. Another example of this is a virtual reality system developed by a team of researchers at The University of Haifa, Israel. The system encompasses of several different scenarios that are designed to aid children that have autism in learning how to cross a road. The simulation displays a road with traffic and crossings which the child then co-operates with. This causes the user’s stress to minimise and keeps them safe from oncoming traffic . These skills are then transferred into a real life situation, however in a controlled area.[3]

A further use is present in the USA at the University of Washington who have designed a video game [4] thanks to which patients are helped to manage symptoms such as pain and reduce its intensity. This is the Virtual Reality Pain Reduction, a game that aims to make the patient forget the pain. The university found that being drawn into another world drains a lot of attentional resources, leaving less attention available to process pain signals.

Virtual reality has also proven to be important in recent events in the advancements of diagnosis techniques. VR allows a reconstruction of human anatomy to be created through algorithms for graphical rendering which aids a 3D radiological cross section. This allows a see through view for the radiologist which is not interrupted by the clinician who has a clear view of the patient’s anatomy. VR in diagnosis creates increased patient comfort and better cost efficiency and in the future could potentially overrule hands on investigations. An example can be found in virtual endoscopic procedures. There has been deep development in virtual colonoscopy as a screening tool, which has led it to undergo a clinical validation phase.[5]

A further way VR has help diagnosis is through the testing for Alzheimer’s disease. Alzheimer’s disease develops from MCI (mild cognitive impairment). Current cognitive tests are not able to detect any impairment within a patient’s navigation, therefore some researchers from the University of Cambridge alongside Prof. Neil Burgess established a VR test. Involved in the investigation were 45 people with MCI and 41 without. A navigation test was carried out where the participants wore VR headset and walked in a stimulated environment. It was found that some of the participants with MCI performed worse than those without.[6]

Belén Rubio Ballester and colleague Martina Maier investigated the impacts of stroke recovery using virtual reality. Out of 1473 patients with stroke, 30 were randomised to partake in the investigation. These participants were split into 2 groups: a recovery process using VR from an off-the-shelf console or a system specifically built or stroke rehabilitation. These participants were then compared to patients who underwent standard therapy for stroke rehabilitation. There was a significantly greater impact of upper limb recovery from the specified system in comparison to the off-the-shelf console. The scientist concluded that VR recovery was better suited for patients because it kept patients in a safe environment and created a solution that was entertaining.[7]

As well as helping doctors and medical professionals in their diagnosis of patients, there have been cases where the patient themselves benefit from virtual reality to help understand their illness. Patients can be guided through surgical plans through a 360 degree reality reconstruction. This creates a higher patient satisfaction as they are more involved and have a better understanding and engagement of their treatment.[8]

Similarly, systems can be used for preoperative planning in preparation for surgery. It encourages a realistic approach with a wider understanding. In the cases of conformal radiotherapy and stereotactic neurosurgery, it is impossible to carry out a plan without the use of a computer so the introduction of VR further enhances this and makes the process more efficient. In neurosurgery, VR allows the exploration of different approaches to surgery, allowing the medics to experiment with different outcomes and receive predictions of the consequence of surgery. This includes post-surgery appearance of the patient. The VR system allows there to be a personalised tactic where the patient benefits from customised plans due to the success rate and safety of VR enhancement.[9]

The training of medical professionals is also fructified by virtual reality. The mechanism serves as a safety net in a controlled setting where students/people aspiring to move forward in healthcare can learn in a hands-on manner. It allows them to make mistakes and improve from previous attempts without harming anyone. The repetitive nature of this process provides a unique opportunity, which cannot obviously be carried out in real life without harming patients, in a similar way that pilots use simulators which allow them to make adapt and overcome mistakes in a safe manner. Furthermore, VR systems are also used in emergency training for example for first responders. The experience of working with different types of scenarios allows them to practise their reaction and decision-making skills. This then can be carried forward and translated in real life situations with the adequate training and practise. It is considered to be one of the most promising, most effective applications of virtual reality in the medical world.

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Of course, there are some negative implications with VR as with any new advancements. Some concerns may be the amount of time patients require to adapt to VR therapies. For example, for a patient who has just suffered a stroke, they are most likely to be in a fragile physical state therefore immediately enforcing virtual reality therapy may be overwhelming as they have no previous experience with it and will place them in an unknown environment which can cause unease.

In addition, there may be staggers in the translation from virtual reality to real life circumstances. Obviously, the real world and the virtual world are not identical and there is not a 100% certainty that virtual reality will cover all situations as it is manually coded for. This leaves gaps, which may end in an unfortunate event.

Moreover, some systems are yet to be made user friendly. People with impairments may find it hard to navigate the system as some require the use of working limbs. The user interface may also be hard to understand at first which creates a delay in recovery in some cases.

The cost of VR may limit the access to it which may result in an unbalanced field that contains disadvantage and unfairness to those who are ill but cannot afford certain therapies which may cause a drawback in their recovery.

Side effects are very popular in the use of virtual reality with instances of cybersickness, vomiting, nausea, eyestrain and vertigo.[10]

As this piece of technology is relatively new, there is not sufficient research on the linkage between VR and medicine which causes some apprehension.

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In conclusion, although the application of virtual reality is in its infancy, it is propelling medicine forward and enhancing the field greatly. Increasingly, money is being put into developing the applications further, which means that it is being constantly being worked on to form the most efficient version of the system. Recently, the University of Cambridge has been given a grant of £40,000,000 to carry out a three dimensional visualisation of cancerous tumours.[11] The increased research will help bridge the gap between real life and virtual reality. Issues with handling VR without supervision as a first time user can be solved by telecommunication, which is less costly and efficient, increasing the usability.

Virtual reality, evidently, is accelerating the medical field, and although there are setbacks, it is a work in progress and solace should be found not only within it’s astounding impacts and results but also its continuous growth and increasing research to better its efficiency.

[1] Virtual Reality Society. (n.d.). What is Virtual Reality? - Virtual Reality Society. [online] Available at: https://www.vrs.org.uk/virtual-reality/what-is-virtual-reality.html [Accessed 1 Jul. 2019].

[2] La Frontera VR. (n.d.). The Benefits of VR in the Medical Field. [online] Available at: https://www.lafronteravr.com/blog/beneficios-de-la-realidad-virtual-en-el-sector-medico/ [Accessed 3 Jul. 2019].

[3] Virtual Reality Society. (n.d.). Virtual reality treatment for autism - Virtual Reality Society. [online] Available at: https://www.vrs.org.uk/virtual-reality-healthcare/autism-treatment.html [Accessed 7 Jul. 2019].

[4] Hitl.washington.edu. (n.d.). HITLab Projects : VR Pain Control. [online] Available at: http://www.hitl.washington.edu/projects/vrpain/ [Accessed 1 Jul. 2019].

[5] Székely, G, and R M Satava. “Virtual Reality in Medicine. Interview by Judy Jones.” BMJ (Clinical Research Ed.), British Medical Journal, 13 Nov. 1999, www.ncbi.nlm.nih.gov/pmc/articles/PMC1129082/.

[6]ScienceDaily. (2019). Virtual reality can spot navigation problems in early Alzheimer's disease. [online] Available at: https://www.sciencedaily.com/releases/2019/05/190523202607.htm [Accessed 4 Jul. 2019]..

[7] Ballester, B. and Maier, M. (2019). Virtual reality for stroke: is gaming effective for recovery? - On Medicine. [online] On Medicine. Available at: https://blogs.biomedcentral.com/on-medicine/2019/03/07/virtual-reality-stroke-gaming-e%EF%AC%80ective-recovery/ [Accessed 5 Jul. 2019].

[8] VISUALISE. (n.d.). Virtual Reality in the Healthcare Industry. [online] Available at: https://visualise.com/virtual-reality/virtual-reality-healthcare [Accessed 5 Jul. 2019].

[9] Székely, G, and R M Satava. “Virtual Reality in Medicine. Interview by Judy Jones.” BMJ (Clinical Research Ed.), British Medical Journal, 13 Nov. 1999, www.ncbi.nlm.nih.gov/pmc/articles/PMC1129082/.

[10] FERCHE, O., MOLDOVEANU, A., MOLDOVEANUI, F., VOINEA, A. and ASAVE, V. (2016). Challenges and Issues for Successfully Applying Virtual Reality in Medical Rehabilitation - Sound of Vision. [online] Sound of Vision. Available at: https://soundofvision.net/challenges-and-issues-for-successfully-applying-virtual-reality-in-medical-rehabilitation/ [Accessed 5 Jul. 2019].

[11] Medium. (2018). The Present and the Future of VR Technology in Medicine:. [online] Available at: https://medium.com/@AltairVR/the-present-and-the-future-of-vr-technology-in-medicine-12f127317a62 [Accessed 8 Jul. 2019].