- COVID-19 has forced research labs around the world to shut their doors, halting the progress of many medical trials.
- Virtual reality (VR) could offer scientists a safe alternative for conducting potentially life-saving studies and trials.
- VR has already been used for research and training simulation and could revolutionize the way we gather, test and apply scientific knowledge.
In early March, the behavioural research lab I direct was running multiple research trials, ushering participants through hospital facilities, and coordinating closely through in-person meetings. Then COVID-19 forced research institutions worldwide to shut their doors. We suspended all studies, save for a few that became mission-critical. Now, as the global research community is looking for safe ways to resume trials amid the ongoing pandemic, one option looks particularly promising: virtual reality.
Although virtual reality (VR) has not been used broadly in medical research, it boasts a long history in specific areas. VR training simulations have become instrumental in developing and disseminating protocols for providing health care in the context of COVID-19. The efficacy of VR as a medical intervention has been widely studied in areas such as pain management and psychotherapy. For example, virtual reality has been successfully used in exposure therapy, during which patients are (virtually) presented with things they fear, thereby gradually reducing their phobias.
There are several examples of clinical studies that have distributed VR equipment to research participants’ homes, to investigate interventions such as balance training for patients with Parkinson's disease. Medical education researchers have also sent equipment to students, enabling them to participate together in virtual anatomy lessons. Such work has ironed out many procedural details involved in conducting VR-based, distributed medical research.
As researchers all over the world are struggling to find ways to reboot their studies, VR could be added to the armament of solutions. We have an opportunity and a need to leave the status quo behind and create more resilient and flexible ways of gathering evidence, testing our hypotheses and developing new products and technologies for better health.
While moving research into the virtual realm may sound like a radical change, it is in many ways a natural continuation of current trends. Many of us have already switched to virtual spaces in our everyday routines, pivoting to holding meetings, presentations, social gatherings, and even medical visits online. Regulatory agencies quickly paved the way for a mass transition to telehealth, a practice that was previously primarily used by innovators. Regulators for clinical trials followed suit and issued guidance for moving clinical trials from medical centers, out into digital terrain. And for their part, the research community is working to make distributed, virtual clinical trials a reality.
For example, a small study of oncology researchers noted that approximately 80% of teams surveyed were planning or moving toward telemedicine. Continuing to expand research innovation beyond the teleconference could allow for an even greater array of tests and measurements to be conducted virtually.
Leveraging VR for medical research and clinical trials is not just a backup solution when conventional labs are shut. It has many potential benefits in its own right. One obvious use is in research that involves tests in the person’s home, rather than the hospital or lab. Individuals’ home environments vary hugely. VR by its nature provides a consistent environment for every research participant. This becomes important as we consider the crucial influence of environmental context on biomarkers and on health. With VR, each patient could, for example, have their blood pressure assessed in the same calming virtual environment, every time.
VR also provides precise tracking of user behavior and movement. The resulting data could be used in research involving physical assessment, for example in rehabilitation. Existing VR research has also demonstrated that it can be a strong platform for social interaction and interpersonal connection. Many patients value and even begin participation in clinical trials because of their connection with research staff. VR could provide a personal touch that is now difficult to sustain in other ways.
Medical research studies are the means by which we accrue knowledge and develop new technologies for better, healthier lives. Investment in medical research has been growing in the United States, and is a broadly supported endeavor. While some necessary medical research continues in conventional labs, including into COVID-19 and its mitigation, many researchers will need to find ways of working in a pandemic-centric environment, and could welcome virtual solutions.
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Some barriers still stand in the way of widespread VR adoption. One concerns the equipment and the risk of transmission through contaminated surfaces. Cleaning and disinfection is of paramount importance at present, though given the typical length of clinical trials, a VR headset would likely be paired with a single user for some period of time. Protocols for safe use of VR headsets shared by multiple users are rapidly emerging.
The development of robust software tools for clinical research VR settings is a niche that is not yet clearly filled. The development of similar software systems for smart watches, activity trackers, and mobile phones has been crucial for integrating these technologies into the broader sphere of medical research.
Perhaps the biggest barrier, however, relates to accessibility. Estimates suggest that there are approximately 26 million VR headsets owned globally, but many of these may not be suitable for medical research. As low-cost hardware options increase, it will become more feasible for researchers or institutions to distribute the equipment to participants.
The other major accessibility considerations relate to internet access, technological skill and technical assistance. Participants must be supported in these areas if VR is to cover all eligible study populations. Typically, conducting medical research online expands its reach to more diverse socio-demographic groups. We must ensure that the introduction of VR methods does not counteract this trend.
A final area to watch relates to data privacy and ethics. There are broad privacy concerns relating to data gathered through VR as this information tends to be extensive and often identifiable. Medical and health research organizations, however, have substantial experience in data protection to safeguard sensitive information in the virtual space. In fact, we have emphasized this in a proposed model for industry adoption.
Given the danger of many physical spaces during the COVID-19 pandemic, VR is a natural solution to many new and exacerbated problems. VR has already improved the way we live, learn, play, and socialize. Although in the consumer space, adoption has not been strong as predicted, healthcare and medicine have always been areas where VR applications shine. We may need to build the infrastructure even as we are using it, but once its benefits and conveniences are established, medical research in virtual reality will likely be here to stay.