背景:虚拟现实(VR)和增强现实(AR)是新兴的技术,可用于心肺复苏(CPR)培训。与传统的面对面训练相比,基于VR/AR的培训有可能覆盖更广泛的受众,但关于其在提高CPR质量方面的有效性存在争议.因此,我们进行了一项荟萃分析,以评估VR/AR训练与面对面训练相比的有效性.
方法:我们搜索了PubMed,Embase,科克伦图书馆,WebofScience,CINAHL,中国国家知识基础设施,和万方数据库从这些数据库开始到2023年12月1日,用于将基于VR和AR的CPR训练与传统面对面训练进行比较的随机对照试验(RCT)。Cochrane评估随机对照试验偏倚的工具用于评估纳入研究的方法学质量。我们使用ReviewManager5.4的随机效应模型汇总数据,并使用Stata11.0评估发表偏倚。
结果:纳入了9个RCT(涉及855名参与者),其中三个偏倚风险较低。Meta分析显示,基于VR/AR的CPR训练和面对面CPR训练在胸部按压深度方面没有显着差异(平均差异[MD],-0.66mm;95%置信区间[CI],-6.34至5.02mm;P=0.82),胸部按压率(MD,每分钟3.60次按压;95%CI,每分钟-1.21至8.41次按压;P=0.14),整体CPR表现评分(标准化平均差,-0.05;95%CI,-0.93至0.83;P=0.91),以及符合心肺复苏深度标准的参与者比例(风险比[RR],0.79;95%CI,0.53至1.18;P=0.26)和比率标准(RR,0.99;95%CI,0.72至1.35;P=0.93)。Egger回归检验显示没有发表偏倚的证据。
结论:我们的研究表明,基于VR/AR的训练与传统的面对面CPR训练一样有效。然而,纳入的研究之间存在很大的异质性,这降低了人们对调查结果的信心。未来的研究需要建立标准化的基于VR/AR的CPR培训协议,评估这种方法的成本效益,并评估其对现实生活中的实际CPR表现和患者预后的影响。
背景:CRD42023482286。
BACKGROUND: Virtual reality (VR) and augmented reality (AR) are emerging technologies that can be used for cardiopulmonary resuscitation (CPR) training. Compared to traditional face-to-face training, VR/AR-based training has the potential to reach a wider audience, but there is debate regarding its effectiveness in improving CPR quality. Therefore, we conducted a meta-analysis to assess the effectiveness of VR/AR training compared with face-to-face training.
METHODS: We searched PubMed, Embase, Cochrane Library, Web of Science, CINAHL,
China National Knowledge Infrastructure, and Wanfang databases from the inception of these databases up until December 1, 2023, for randomized controlled trials (RCTs) comparing VR- and AR-based CPR training to traditional face-to-face training. Cochrane\'s tool for assessing bias in RCTs was used to assess the methodological quality of the included studies. We pooled the data using a random-effects model with Review Manager 5.4, and assessed publication bias with Stata 11.0.
RESULTS: Nine RCTs (involving 855 participants) were included, of which three were of low risk of bias. Meta-analyses showed no significant differences between VR/AR-based CPR training and face-to-face CPR training in terms of chest compression depth (mean difference [MD], -0.66 mm; 95% confidence interval [CI], -6.34 to 5.02 mm; P = 0.82), chest compression rate (MD, 3.60 compressions per minute; 95% CI, -1.21 to 8.41 compressions per minute; P = 0.14), overall CPR performance score (standardized mean difference, -0.05; 95% CI, -0.93 to 0.83; P = 0.91), as well as the proportion of participants meeting CPR depth criteria (risk ratio [RR], 0.79; 95% CI, 0.53 to 1.18; P = 0.26) and rate criteria (RR, 0.99; 95% CI, 0.72 to 1.35; P = 0.93). The Egger regression test showed no evidence of publication bias.
CONCLUSIONS: Our study showed evidence that VR/AR-based training was as effective as traditional face-to-face CPR training. Nevertheless, there was substantial heterogeneity among the included studies, which reduced confidence in the findings. Future studies need to establish standardized VR/AR-based CPR training protocols, evaluate the cost-effectiveness of this approach, and assess its impact on actual CPR performance in real-life scenarios and patient outcomes.
BACKGROUND: CRD42023482286.