. 2022 Nov 30;30(1):109–122. doi: 10.1177/15533506221143235

Table 4.

Surgeon-Related Outcomes: Summary of Results Following Preoperative Planning With iVR, Arranged by Study Design.

Study	Study Design	Description of Outcome Measurement	Comparator	Findings favour iVR or control
Impact on Surgical Strategy (n = 12)
Parkhomenko et al., 2019²⁵	Historical control trial	Participants asked postoperatively if iVR altered the operative approach	CT alone	Equivalent
Xie et al., 2021³⁴	Historical control trial	Participants asked pre-operatively to rate agreement with statement that iVR altered surgical plan	CT alone	iVR
Sampogna et al., 2017²⁷	Prospective study	Participants rated whether interventions changed surgical strategy compared to 2D imaging	3D printing, 3D reconstructions of CT or MRI displayed on 2D screens	Equivalent
Sugiyama et al., 2021³⁰	Prospective study	Participants asked preoperatively to rate if iVR impacted major and minor surgical decisions	None	iVR
Zawy Alsofy et al., 2021a³⁷	Prospective study	Participants asked to choose surgical approach after viewing 2D imaging, then re-surveyed after viewing iVR	CT and MRI alone	iVR
Zawy Alsofy et al., 2021b³⁸	Prospective study	Participants asked to choose surgical approach after viewing 2D imaging, then re-surveyed after viewing iVR	CT or MRI alone	iVR
Zawy Alsofy et al., 2021c³⁹	Prospective study + case report	Participants asked to choose surgical approach after viewing 2D imaging, then re-surveyed after viewing iVR	MRI alone	iVR
Zawy Alsofy et al., 2020a⁴⁰	Prospective study	Participants asked to choose surgical approach after viewing 2D imaging, then re-surveyed after viewing iVR	MRI alone	iVR
Zawy Alsofy et al., 2020b⁴¹	Prospective study	Participants asked to choose surgical approach after viewing 2D imaging, then re-surveyed after viewing iVR	CTA alone	iVR
Zawy Alsofy et al., 2019⁴²	Prospective Study	Participants asked to choose surgical approach after viewing 2D imaging, then re-surveyed after viewing iVR	CT alone	iVR
Sadeghi et al., 2020²⁶	Cross-sectional	Qualitative description of experiences	None	iVR
Yan et al., 2020³⁶	Case series	Qualitative description of experiences	None	ND
Visualization of Anatomy (n = 12)
Parkhomenko et al., 2019²⁵	Historical control trial	Participants surveyed pre- and postoperatively to self-rate understanding of patient and pathology anatomy	CT alone	iVR
Xie et al., 2021³⁴	Historical control trial	Participants surveyed pre- and postoperatively to compare anatomy understanding with iVR vs CT	CT alone	iVR
Sugiyama et al., 2021³⁰	Prospective study	Participants surveyed preoperatively to determine if iVR increased understanding of patient anatomy, and their illustrations of patient anatomy were compared with actual surgical videos	None	iVR
Zawy Alsofy et al., 2021b³⁸	Prospective study	Participants asked to rate sufficiency of anatomic structure detection after viewing 2D imaging, then resurveyed after viewing iVR	CT or MRI alone	iVR
Zawy Alsofy et al., 2021c³⁹	Prospective study + case report	Participants asked to identify pathology after viewing 2D imaging, then resurveyed after viewing iVR	MRI alone	iVR
Zawy Alsofy et al., 2020b⁴¹	Prospective study	Participants asked to rate sufficiency of anatomic structure detection after viewing 2D imaging, then resurveyed after viewing iVR	CTA alone	iVR
Sampogna et al., 2017²⁷	Prospective study	Participants were surveyed to compare comprehension of anatomy compared to 2D imaging	3D printing, 3D reconstructions of CT or MRI displayed on 2D screens	Equivalent
Sadeghi et al., 2020²⁶	Cross-sectional	Participants surveyed postoperatively to see if iVR allowed for more accurate anatomy review compared to conventional CT, and qualitative description of experiences	None	iVR
Timonen et al., 2020³¹	Cross-sectional (cadaveric)	Participants rated anatomic visualization and understanding using a survey	CT alone	iVR
Croci et al., 2020²⁰	Case series	Qualitative description of experiences	None	ND
Ong et al., 2018²⁴	Case series	Qualitative description of experiences	None	ND
Yan et al., 2020³⁶	Case series	Qualitative description of experiences	None	ND
Validity and Reliability (n = 2)
Timonen et al., 2020³¹	Cross-sectional (cadaveric)	Participants asked to subjectively rate face validity and content validity. Reliability and criterion validity were established by comparing virtual with physical cadaveric measurements	CT alone	iVR
Sadeghi et al., 2020²⁶	Cross-sectional	Criterion validity was established by comparing virtual with intraoperative measurements	None	ND
Impact on Surgeon Confidence (n = 3)
Parkhomenko et al., 2019²⁵	Historical control trial	Participants asked preoperatively if iVR improved understanding and confidence for surgery	CT alone	iVR
Xie et al., 2021³⁴	Historical control trial	Participants asked preoperatively to rate confidence in understanding patient anatomy	CT alone	iVR
Yan et al., 2020³⁶	Case series	Qualitative description of experiences	None	ND
Feasibility (Quantitative; n = 4)
Kenngott et al., 2021²³	Cross-sectional	Participants asked to rate iVR’s potential for clinical use, and to predict number of years until daily clinical use	None	Equivalent
Sadeghi et al., 2020²⁶	Cross-sectional	Participants asked postoperatively to rate agreement with statements on future use of VR	None	iVR
Timonen et al., 2020³¹	Cross-sectional (cadaveric)	Participants asked to rate feasibility of inclusion into clinical surgical planning	CT alone	Equivalent
Vertemati et al., 2019³³	Cross-sectional	Participants asked to rate iVR ease of use (feasibility)	None	iVR

Abbreviations: CT = computerized tomography; iVR = immersive virtual reality; ND = not determinable (cannot determine superiority of one intervention) MRI = magnetic resonance imaging; RCT = randomized controlled trial; VR = virtual reality.