Table 2.

Summary of the study purposes and proposed Google Glass intervention methodology.

Source	Purposea	Interventiona
Borgmann et al, 2016 (urology) [38]	To determine the feasibility, safety and usefulness of GG in urological surgery.	Participating surgeons given free rein to use GG’s features during surgery, such as taking videos and photographs, reviewing patient EMR and laboratory images, and accessing the Internet; patients were checked for postoperative complications to assess safety of GG use
Iqbal et al, 2016 (urology) [35]	To assess the feasibility of using GG as a vital sign monitor during surgery, specifically prostatectomy	GG has potential to decrease reaction time to abnormal patient vitals during surgery; participants performed a prostatectomy on a GreenLight Simulator using a standard vital signs monitor for 20 min and then using GG for 20 min; effectiveness of GG determined by the time taken to respond to abnormal vital signs, and patient blood loss and injuries
Dickey et al, 2016 (urology) [12]	To determine the feasibility of using GG for open urologic surgery as both a surgical assistant and a surgical training tool during the placement of an IPP	Trainees first shown a directional video on the IPP procedure projected onto the live view of the patient through GG; as trainees performed the IPP procedure, live footage of the OR was streamed to a remote physician through GG’s camera feature; the attending physician could provide guidance to the trainee; participants completed postoperative survey on GG
Chimenti & Mitten, 2015 (orthopedics) [13]	To assess the effectiveness of GG as an alternative to standard fluoroscopic techniques in hand surgery	Metacarpal and phalangeal fractures require Kirschner wires to be placed percutaneously with the help of fluoroscopic imaging on an external monitor; GG’s heads-up display used to visualize fluoroscopic imaging without diverting attention from the patient’s hand
Ponce et al, 2014 (orthopedics) [14]	To test the integration of GG with the VIPAAR system and evaluate the extent to which it affects remote communication and guidance between medical professionals	VIPAAR system was integrated with GG to allow a collaborator to remotely view the surgical field of the operating surgeon and virtually insert his or her hands in the surgical field to offer guidance; 2 orthopedic surgeons wore GG; surgeon A performed the shoulder arthroplasty while streaming live video to surgeon B, who was able to provide remote assistance
Armstrong et al, 2014 (orthopedics) [15]	To assess the use of GG in affecting communication, documentation, and consultation among clinicians during the care of a high-risk extremity	GG facilitated Google Hangout between operating surgeon and fellow colleagues intraoperatively; followed 1 surgeon through an intraoperative case & follow-up clinic with 1 patient; used GG to screen share between senior surgeon and junior resident to assess application to medical education
Hashimoto et al, 2016 (general surgery) [16]	To test the safety of GG use in surgery by analyzing the quality of a telementoring video recording of a Whipple procedure	Surgeons were blinded and shown video of the procedure recorded by GG vs iPhone 5; they were then asked to evaluate the video quality
Brewer et al, 2016 (general surgery) [17]	To study GG’s effect on real-time visualization of the trainee’s viewpoint by the instructor to enhance surgical education	Measured TTC completion of needle placement when operative field (quadrants) could be visualized by trainer and trainee vs TTC when trainer could no longer see operative field; 5 needles placed per quadrant
Stewart & Billinghurst, 2016 (general surgery) [39]	To determine whether GG can improve attentiveness to the surgical field by directly displaying surgical navigation information.	GG compared to (1) computer monitor and (2) wearable “through-the-lens” display in a simulated surgical task of positioning and orienting a tool on a plastic distal femur; subcondition: test dominant eye vs nondominant eye; to measure attentiveness in either case, response times were measured in response to LED illumination
Datta et al, 2015 (general surgery) [18]	To evaluate the usefulness of GG in surgical telementoring of hernia surgery	HRFU volunteer surgeons from Germany, Brazil, and US first trained 1 local surgeon each in Paraguay and Brazil by demonstrating the Lichtenstein hernioplasty in person; the local surgeons then performed the procedure while wearing GG, allowing the instructors to view a livestream of the surgery and to provide guidance as necessary
Duong et al, 2015 (cardiology) [32]	To assess the accuracy of interpretation of coronary angiograms recorded using GG	GG was used to record 15 coronary angiograms containing 17 critical findings; participants reviewed GG recordings on an iPad and a computer and compared them to the original angiograms on a desktop; participants were given 1 point for each angiogram in which they were able to determine the correct finding (17=max score); a follow-up satisfaction survey was given to evaluate participants’ satisfaction with GG image quality and ability to give recommendations based on GG videos
Schaer et al, 2015 (cardiology) [40]	To determine whether GG could be used as an ECG monitor and decrease the need for surgeons to divert attention from the operative field	Experimenters simulated 210 ECG rhythms that reflected conditions requiring immediate medical attention; participants asked to identify these issues in as little time as possible & received 1 point for a correct answer; experimental condition: ECG rhythms and heart rate displayed on GG; control condition: ECG and heart rate information displayed on a monitor screen
Golab et al, 2016 (neurosurgery) [36]	To enhance the efficiency of spinal surgery, specifically SDR, using GG	SDR procedure: identify and cut the most responsive nerves, determined by using a probe to send a current through them, producing EMG waveform data; during procedure, the neurosurgeon must often obtain a second opinion from a neurophysiologist across the OR to determine which sensory nerves to sever; GG would help maintain sustained concentration by allowing remote communication; SDR also requires reading EMG data, which would be more efficient if the probe could be integrated with GG
Nakhla et al, 2017 (neurosurgery) [19]	To test GG’s overall ease of use and effectiveness in hands-free video and photograph capture, consolidating and displaying information, and facilitating communication between medical professionals	(1) Case 1 (preoperative): GG used by attending to show residents how to prepare for a minimally invasive lumbar discectomy; GG allows hands-free commands and ability to save videos for future use; (2) case 2 (intraoperative): GG used by attending as he demonstrates the steps of a craniotomy; (3) case 3 (postoperative): GG used to record patients’ postoperative recovery during a surgical mission to Mongolia
Yoon et al, 2016 (neurosurgery) [20]	To assess the safety and feasibility of capturing and streaming neuronavigation images onto GG during spine instrumentation	Video-capture device receives signal from medical imaging device and compresses it to make it compatible with GG; video is streamed on GG screen for the surgeon to watch; measured time it took doctors to place pedicle screws on a spine; control: placed screws using standard image guidance techniques; experimental: placed screws using GG
Evans et al, 2016 (minimally invasive procedures) [21]	To compare first-person video capabilities of GG to traditional third-person techniques	Videos of a simulated CVC internal jugular catheter insertion were taken from first-person perspective using GG and third-person perspective using an observer’s head-mounted camera; videos were compared by 3 expert doctors based on 3 methods: 1 checklist and 2 global rating scales (additive and summative)
Knight et al, 2015 (minimally invasive procedures) [37]	To assess GG’s ability to stream video to a smartphone and to explore telementoring capabilities	GG was used to broadcast livestream of injectable ILR, LINQ implantation in a 20-year old woman presenting with presyncope-associated palpitations
Liebert et al, 2016 (minimally invasive procedures) [22]	To assess the feasibility of GG for real-time wireless vital sign monitoring during surgery	Control group used a standard bedside digital monitor; experimental group tested GG in combination with a standard vital sign monitor; 2 scenarios: thoracostomy tube placement and bronchoscopy; all subjects from one group switched to the other for the second scenario to test the other technique
Spencer et al, 2014 (minimally invasive procedures) [23]	To explore whether GG could be effective in recording airway management to improve education demonstrations	GG recorded airway assessment and tracheal intubation of a patient with a malocclusion of the mandible; also recorded a direct laryngoscopy of another patient
Wu et al, 2014 (minimally invasive procedures) [24]	To determine whether medical practitioners at various levels of training could use GG to perform an ultrasound-guided procedure	Experimental group: used GG to perform an ultrasound-guided central line; control group: used traditional ultrasound machine during the procedure; video recordings of practitioners’ eye and hand movements were analyzed to assess distractibility
Vorraber et al, 2014 (minimally invasive procedures) [25]	To test whether GG can enhance clinical care by providing doctors with vital sign monitoring information continuously and directly within their field of view during various procedures	Physicians used GG as vital sign monitor to perform a percutaneous transluminal angioplasty in 3 patients; participants were interviewed before and after the procedure
Kantor, 2015 (surgical oncology) [26]	To assess the use of GG in Mohs surgery and cutaneous reconstruction	120 Mohs surgery patients were evaluated by physicians wearing GG; patient medical records and history were obtained using GG; calculated rate of patient acceptance of GG
Zhang et al, 2016 (surgical oncology) [41]	To develop and test a GG system to integrate fluorescence and ultrasound image acquisition to determine sites of near-infrared emitting optical agent uptake	GG used in combination with a camera for fluorescence imaging, 12 LEDs, and an M5 ultrasound probe; phantom was created as a simulation to test feasibility of GG system; GG used to detect fluorescent ICG uptake by lymph nodes; first site where this occurs is the SLN, which normally indicates tumor site; 30 core needle biopsies conducted on the phantom; done to test accuracy of GG’s fluorescence/ ultrasound imaging in isolating tumor site under 3 scenarios: (1) GG with dual-mode (fluorescence and ultrasound) imaging, (2) GG with fluorescence imaging alone, and (3) no GG; tested GG’s dual-mode fluorescence & ultrasound-guided detection of SLN, core needle biopsy, and SLN excision in an ex vivo breast resection specimen
Muensterer et al, 2014 (pediatric surgery) [27]	To explore potential uses for GG in surgical environments and assess the quality of its functions (eg, Web searches, videoconferencing)	GG worn daily for 4 consecutive weeks by one of research study authors; a diary was kept on all pros, cons, and observations; evaluated the ergonomics, battery life, audiovisual quality, functionality, lag time, connectivity, applications, acceptance, and data privacy issues associated with GG
Drake-Brockman et al, 2016 (pediatric anesthesiology) [42]	To assess the effectiveness of GG as a patient monitoring device in a pediatric anesthetic setting	Developed a program for GG consisting of 3 parts: (1) AnaeVis: runs on GG to display patient vitals, (2) AnaeHQ: runs on laptop to collect information from patient monitoring devices, and (3) AnaeComm: allows integration of computer and GG; anesthesiologist wore GG in the OR and answered follow-up survey
Moshtaghi et al, 2015 (otolaryngology) [28]	To explore the use of GG in otolaryngologic surgery and its role in surgical education and communication	A neurotologist, head and neck surgeon, and a general otolaryngologist used GG in various otolaryngologic procedures; GG also used to communicate to another remote physician for consultation during the surgery; used program, Pristine, in conjunction with GG to stream video of the surgery to a pathologist and aid in a margin analysis
Rahimy & Garg, 2015 (ophthalmology) [29]	To assess the intraoperative use of GG in scleral buckling surgery	GG recorded several steps of scleral buckling surgery
Sinkin et al, 2016 (plastic surgery) [30]	To assess the comfort of GG use during plastic surgery, level of gaze diversion from the operative field, and quality of intraoperative photography	Residents and surgeons used GG over a 7-month period, taking pictures and videos intraoperatively using voice and wink commands; videos and photos were downloaded and reviewed postoperatively; surveys conducted to assess comfort, ease of use, and quality of images
Aldaz et al, 2015 (chronic wound care) [34]	To compare the effectiveness of GG running on the SnapCap app vs iPhone using Epic Haiku in image capture	Part 1a: GG SnapCap vs iPhone-based Epic Haiku apps and took pictures of wound on a mannequin for comparison; Part 1b: follow-up questionnaire on nurse’s preferences for (1) current SnapCap system features, (2) app preferences for SnapCap vs Epic Haiku, and (3) for the preference for future SnapCap features; Part 2: examined preference for GG’s speech-to-text wound annotation
Baldwin et al, 2016 (organ transplant surgery) [31]	To test GG in a donor organ harvest	Examined GG in live collaboration between an organ retrieval team and home surgeons to assess GG’s ability to stream intraoperative video of the organ harvest
Gupta et al, 2016 (emergency department-surgical consultations) [33]	To assess GG’s asynchronous, near-real-time recording, uploading, and viewing of visual media capabilities in facilitating remote surgical consults from the emergency department	4 physician assistants assessed patients by photographing significant findings and recording videos and laboratory imaging results using GG; images were then uploaded to a secure server and accessed remotely by a surgeon; surgeon was then able to utilize the data to determine wither changes to the existing clinical management were necessary; changes in surgeon’s confidence post GG assessment about the management plan were also evaluated through a questionnaire

^aCVC: central venous catheter; ECG: electrocardiogram; EMG: electromyography; EMR: electronic medical record; GG: Google Glass; HRFU: Hernia Repair for the Underserved; ICG: indocyanine green; ILR: implantable loop recorder; IPP: inflatable penile prosthesis; OR: operating room; SDR: selective dorsal rhizotomy; SLN=sentinel lymph node; TTC: time-to-task completion; VIPAAR: Virtual Interactive Presence and Augmented Reality.