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Pain, AcutePARVANCT06227039

Patient Augmented Reality and Vibratory Array Otorhinolaryngology Procedures

A study testing Vibroacoustic stimulation on, Augmented Reality on and Vibroacoustic stimulation off in people with Pain, Acute and Vocal Fold Polyp, run by University of Virginia at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

In-office procedures (IOPs) are a cost-effective, and safe alternative to many operating room procedure, with benefits such as reduced anesthesia risk. One of the major causes of failed in-office procedures or requirement of conversion to the operating room is poor patient tolerance. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Vibroacoustic stimulation on, Augmented Reality on and Vibroacoustic stimulation off
Could I receive a placebo?
No, everyone receives an active treatment
How many people
80 participants
Where
1 siteUnited States
Study dates
1 Oct 2022to 31 Dec 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Patients undergoing office-based laryngology procedure performed at home institution.

Who cannot join

  • None

Trial locations and contacts

1 site in 1 country.

James J Daniero, MD contact

4349242040

jjd5h@uvahealth.org

Elena Miller, MPH contact

4342433607

em8zk@uvahealth.org

United States1 site, 1 recruiting
  • UVA Fontaine Research Park Building 415

    Charlottesville, Virginia, 22903

    James Daniero, MD, 434-924-2040, jjd5h@uvahealth.org

    James Daniero, MD

    Recruiting

Other trials in United States

About this study

Official title: Using Augmented Reality With Vibroacoustic Stimulation to Improve the Patient Experience During In-Office Otorhinolaryngology Procedures

In-office procedures (IOPs) are a cost-effective, and safe alternative to many operating room procedure, with benefits such as reduced anesthesia risk. One of the major causes of failed in-office procedures or requirement of conversion to the operating room is poor patient tolerance. Vibration and augmented reality (AR) can be used as non-pharmacologic treatment options to treat patient anxiety and pain by using the physiology proposed by the gate-way theory of pain as well as distraction. This study seeks to compare anxiety and pain perception with patient reported survey data, as well as physiologic indicators of stress such as heart rate variability (HRV) within patients undergoing IOPs in a laryngology office with and without vibration and AR treatment.

Read the detailed description

In-office procedures (IOPs) represent a cost-effective and safe alternative to operating room procedures for a myriad of disease processes across medical and surgical specialties. IOPs are performed under local anesthetic without general anesthesia or sedation, resulting in faster and often safer procedures by eliminating risks associated with general anesthesia. IOPs are primarily limited by patient tolerance, as there is a lack of currently available non-pharmacologic treatment options for patient anxiety, stress, discomfort, and pain during these procedures.

The Gate Control Theory of Pain postulates that only a limited amount of simultaneous sensory stimuli can be processed by the central nervous system and therefore non-painful stimuli, such as vibration or virtual distraction (i.e. virtual or augmented reality), can eliminate or lessen the perception of concurrent painful stimuli. The use of these non-painful stimuli has been shown to have clinical utility in the setting of procedures such as percutaneous injections and wound dressing changes.

However, the coupling of multiple sensory distraction techniques has not been described for IOPs. Furthermore, no investigation of sensory distraction techniques to reduce patient discomfort within the field of otolaryngology has been conducted. The focus of the proposed project is to improve patient experience during IOPs by coupling a novel vibroacoustic stimulation device with original AR software applications.

In-office otolaryngology procedures specifically involve using a rigid endoscope or a flexible nasolarynogoscopy to visualize the inside of a patient nose, sinus, posterior oropharynx, and vocal cords. Using these imaging modalities, awake, in-office procedures can be performed. However, these procedures are often very uncomfortable and anxiety producing.

The goal of the study is to determine whether or not wearing an augmented reality headset with a novel game and vibroacoustic simulation device can help reduce anxiety and improve the patient experience of in-office otolaryngology procedures. The device consists of an augmented reality headset worn by the patient, a vibration device that is applied to the patient's neck to help reduce the sensation of the procedure, and a clicker that allows the patient to interact with the augmented reality game environment.

Patients who are undergoing in-office laryngology procedures (procedures on their vocal cords) will be randomized into a control group augmented reality (AR) group, vibration group, and combined AR and vibration group. The control group will wear a sham augmented reality head set during the procedure. The AR group will have a game played on the head set to distract them during the procedure. The patient will interact with the game use a hand held clicker.

Each participant will answer a survey before and after the procedure assessing their anxiety. Each participant will also wear a one-lead EKG to measure their heart rate through the procedure. The subjective and physiological level will be compared between the two groups

Being tested
Vibroacoustic stimulation on, Augmented Reality on, Vibroacoustic stimulation off, Augmented reality off
Medical subject headings
Acute Pain, Vocal Cord Paralysis, Laryngeal Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Vibroacoustic stimulation onOther

    Mechanical stimulus is provided to the patient through a vibroacoustic device via vibration around the neck.

  • Augmented Reality onOther

    Visual stimulus is provided through augmented reality glasses in the form of a game.

  • Vibroacoustic stimulation offOther

    Vibroacoustic device is worn but turned off.

  • Augmented reality offOther

    Augmented reality glasses are worn but turned off.

Study groups in NCT06227039
Study groupRoleWhat they receive
No treatmentNo interventionThis arm will be the current standard of care
VibroacousticExperimentalThis arm will use the vibroacoustic device to provide a mechanical stimulus to the patient as treatment to reduce pain and anxiety. Augmented reality glasses will be worn but will be turned off.
Receives: Other: Vibroacoustic stimulation on; Other: Augmented reality off
Augmented RealityExperimentalThis arm will use the augmented reality game to provide a visual stimulus to the patient as treatment to reduce pain and anxiety. Vibroacoustic device will be worn but will be turned off.
Receives: Other: Augmented Reality on; Other: Vibroacoustic stimulation off
Combination vibroacoustic and augmented realityExperimentalThis arm will use both the augmented reality game and vibroacoustic device to provide a visual stimulus to the patient as treatment to reduce pain and anxiety.
Receives: Other: Vibroacoustic stimulation on; Other: Augmented Reality on

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Max pain experienced

    Visual analog scale rating of max perceived pain during procedure

    Measured: measured post-treatment (1 hr).

  2. Average pain experienced

    Visual analog scale rating of average perceived pain during procedure

    Measured: measured post-treatment (1 hr).

  3. Pain nervousness experienced

    Visual analog scale rating of how nervous about pain patient was during procedure

    Measured: measured post-treatment (1 hr).

  4. Time spent thinking about pain

    Visual analog scale rating of percent of time spent thinking about pain during procedure

    Measured: measured post-treatment (1 hr).

  5. Change in heart rate variability during procedure

    Difference between heart rate variability during procedure compared with pre-procedure

    Measured: calculated post-treatment (1 hr).

  6. Change in maximum heart rate

    Difference between maximum heart rate during procedure compared with pre-procedure

    Measured: calculated post-treatment (1 hr).

  7. Change in average heart rate

    Difference between average heart rate during procedure compared with pre-procedure

    Measured: calculated post-treatment (1 hr).

Secondary outcomes (3)
  1. Change is STAI score

    Measure change in Stait-Trait anxiety inventory State 5 question score pre and post-procedure.

    Measured: calculated post-procedure (1 hr).

  2. Pain catastrophizing score

    Pain catastrophizing score

    Measured: calculated pre-procedure (1 hr).

  3. Patient satisfaction

    Likert scale rating of satisfaction of treatment group

    Measured: measured post-treatment (1 hr).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jan 2024
  2. Study start1 Oct 2022
  3. Primary completion31 Dec 2024 (estimated)
  4. Study completion31 Dec 2024 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
80 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06227039
Sponsor's protocol ID
HSR210111
Acronym
PARVA
Status last verified
Jan 2024
First submitted
17 Jan 2024
Last updated
26 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: There is no intention to share individual participant data with other researchers.

Publications

  • McCarthy M. US health-care system faces cost and insurance crises. Rising costs, growing numbers of uninsured, and quality gaps trouble world's most expensive health-care system. Lancet. 2003 Aug 2;362(9381):375. doi: 10.1016/s0140-6736(03)14057-3. No abstract available.

    PubMed 12907006
  • Rice T, Rosenau P, Unruh LY, Barnes AJ, Saltman RB, van Ginneken E. United States of America: health system review. Health Syst Transit. 2013;15(3):1-431.

    PubMed 24025796
  • Hoffer EP. The American Health Care System Is Broken. Part 7: How Can We Fix It? Am J Med. 2019 Dec;132(12):1381-1385. doi: 10.1016/j.amjmed.2019.10.003. Epub 2019 Oct 24.

    PubMed 31668898
  • Young S, Shapiro FE, Urman RD. Office-based surgery and patient outcomes. Curr Opin Anaesthesiol. 2018 Dec;31(6):707-712. doi: 10.1097/ACO.0000000000000655.

    PubMed 30148715
  • Saini AT, Citardi MJ, Yao WC, Luong AU. Office-Based Sinus Surgery. Otolaryngol Clin North Am. 2019 Jun;52(3):473-483. doi: 10.1016/j.otc.2019.02.003. Epub 2019 Mar 22.

    PubMed 30905564
  • Shah PD. Patient Safety and Quality for Office-Based Procedures in Otolaryngology. Otolaryngol Clin North Am. 2019 Feb;52(1):89-102. doi: 10.1016/j.otc.2018.08.015. Epub 2018 Sep 22.

    PubMed 30249445
  • Braz J, Solorzano C, Wang X, Basbaum AI. Transmitting pain and itch messages: a contemporary view of the spinal cord circuits that generate gate control. Neuron. 2014 May 7;82(3):522-36. doi: 10.1016/j.neuron.2014.01.018.

    PubMed 24811377
  • Treede RD. Gain control mechanisms in the nociceptive system. Pain. 2016 Jun;157(6):1199-1204. doi: 10.1097/j.pain.0000000000000499.

    PubMed 26817644
  • Zhang Y, Liu S, Zhang YQ, Goulding M, Wang YQ, Ma Q. Timing Mechanisms Underlying Gate Control by Feedforward Inhibition. Neuron. 2018 Sep 5;99(5):941-955.e4. doi: 10.1016/j.neuron.2018.07.026. Epub 2018 Aug 16.

    PubMed 30122375
  • Smith KC, Comite SL, Balasubramanian S, Carver A, Liu JF. Vibration anesthesia: a noninvasive method of reducing discomfort prior to dermatologic procedures. Dermatol Online J. 2004 Oct 15;10(2):1.

    PubMed 15530291
  • Mally P, Czyz CN, Chan NJ, Wulc AE. Vibration anesthesia for the reduction of pain with facial dermal filler injections. Aesthetic Plast Surg. 2014 Apr;38(2):413-8. doi: 10.1007/s00266-013-0264-4. Epub 2014 Jan 24.

    PubMed 24464122
  • Sharma P, Czyz CN, Wulc AE. Investigating the efficacy of vibration anesthesia to reduce pain from cosmetic botulinum toxin injections. Aesthet Surg J. 2011 Nov;31(8):966-71. doi: 10.1177/1090820X11422809. Epub 2011 Oct 14.

    PubMed 22001341
  • Legrain V, Damme SV, Eccleston C, Davis KD, Seminowicz DA, Crombez G. A neurocognitive model of attention to pain: behavioral and neuroimaging evidence. Pain. 2009 Aug;144(3):230-232. doi: 10.1016/j.pain.2009.03.020. Epub 2009 Apr 18. No abstract available.

    PubMed 19376654

Questions about this trial

What is this clinical trial studying?

A study testing Vibroacoustic stimulation on, Augmented Reality on and Vibroacoustic stimulation off in people with Pain, Acute and Vocal Fold Polyp, run by University of Virginia at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 26 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact James J Daniero, MD (4349242040, jjd5h@uvahealth.org), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Max pain experienced (time frame: measured post-treatment (1 hr).). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06227039, which also lists 13 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Jan 2024.

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