@article{le_du_new_2023,

title = {A New Option for Pain Prevention Using a Therapeutic Virtual Reality Solution for Bone Marrow Biopsy (REVEH Trial): Open-Label, Randomized, Multicenter, Phase 3 Study},

author = {K. Le Du and A. -L. Septans and F. Maloisel and H. Vanquaethem and A. Schmitt and M. Le Goff and A. Clavert and M. Zinger and H. Bourgeois and O. Dupuis and F. Denis and S. Bouchard},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85148250546&doi=10.2196%2f38619&partnerID=40&md5=e27bfbd3d4c42f8850daf70bdf60b384},

doi = {10.2196/38619},

issn = {14388871 (ISSN)},

year  = {2023},

date = {2023-01-01},

journal = {Journal of Medical Internet Research},

volume = {25},

abstract = {Background: Evidence regarding the analgesic effect of distraction through immersion in virtual reality (VR) for care-induced pain has been documented in several phase 2 trials, but comparison with standard treatments in large, randomized studies is needed. Objective: In this open-label, multicenter, randomized, phase 3 trial, we evaluated the safety and efficacy of a novel VR therapy solution for distraction in the context of bone marrow biopsy. Methods: Bliss is a VR software with 4 imaginary interactive environments in 3 dimensions with binaural sound (head-mounted display). Efficacy regarding pain intensity was evaluated using a visual analog scale (VAS; score from 0 to 10) immediately after the biopsy. Secondary end points were anxiety and tolerance. Modified intention-to-treat analysis was performed. Results: Overall, 126 patients with previously documented untreated or suspected malignant hemopathy between September 6, 2018, and May 18, 2020, were randomly assigned in a 1:1 ratio to receive pain prevention with a mixture of nitrous oxide/oxygen (MEOPA; n=63) or VR (n=63) before and during the bone marrow biopsy. We excluded 8 patients from the final analysis (3 in the MEOPA group and 5 in the VR group). All patients received local anesthesia (lidocaine) before biopsy. Follow-up was limited to 1 month after the biopsy. Participants' median age was 65.5 (range 18-87) years, and 54.2% (64/118) of patients were male. The average pain intensity was 3.5 (SD 2.6, 95% CI -1.6 to 8.6) for the MEOPA group and 3.0 (SD 2.4, 95% CI -1.7 to 7.7) for the VR group, without any significant differences in age, sex, center, and hemopathy (P=.26). Concerning anxiety, 67.5% (79/117; fear of pain questionnaire) of the patients were afraid before the biopsy, and anxiety scores were moderate to very high in 26.3% (30/114; revised Spielberger State-Trait Anxiety Inventory questionnaire) of the patients before the biopsy and 9.0% (10/114) after the biopsy for all patients, without a significant difference between the 2 groups (P=.83). Immersion in VR was well tolerated by the majority (54/57, 95%) of patients in the VR group. Conclusions: The intensity of pain did not significantly differ between both arms. VR was well tolerated, and the satisfaction of patients, nurses, and physicians was very high. VR could be an alternative treatment in case of contraindication or intolerance to MEOPA. © 2023 Journal of Medical Internet Research. All rights reserved.},

note = {Publisher: JMIR Publications Inc.},

keywords = {80 and over, Adolescent, adult, aged, alprazolam, Anxiety, article, Biopsy, blood pressure measurement, Bone Marrow, bone marrow biopsy, clinical trial, controlled study, demographics, digital health, digital therapeutics, Distraction, Effectiveness, efficacy, eHealth, female, follow up, head-mounted display, hematologic disease, human, human tissue, Humans, hypertension, imagery, imaginary, imagination, Immersive environment, Intention to Treat Analysis, interactive environment, leukemia, lidocaine, local anesthesia, lymphoma, major clinical study, male, medical procedure, Meopa, Middle Aged, monoclonal immunoglobulinemia, multicenter study, myelodysplastic syndrome, myeloma, myeloproliferative disorder, myeloproliferative neoplasm, nitrous oxide plus oxygen, open study, Pain, pain intensity, pain measurement, paracetamol, phase 3 clinical trial, prospective study, questionnaire, randomized controlled trial, RCT, relaxation training, safety, satisfaction, solid malignant neoplasm, State Trait Anxiety Inventory, very elderly, virtual reality, visual analog scale, VR, Young Adult},

pubstate = {published},

tppubtype = {article}

}

@article{plouffe-demers_facial_2022,

title = {Facial Expression of Pain: Sex Differences in the Discrimination of Varying Intensities},

author = {M. -P. Plouffe-Demers and C. Saumure and D. Fiset and S. Cormier and C. Blais},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85138214204&doi=10.1037%2femo0001156&partnerID=40&md5=d5063c7ab05722c16694952ac5d53027},

doi = {10.1037/emo0001156},

issn = {15283542 (ISSN)},

year  = {2022},

date = {2022-01-01},

journal = {Emotion},

volume = {23},

number = {5},

pages = {1254–1266},

abstract = {It has been proposed that women are better than men at recognizing emotions and pain experienced by others. They have also been shown to be more sensitive to variations in pain expressions. The objective of the present study was to explore the perceptual basis of these sexual differences by comparing the visual information used by men and women to discriminate between different intensities of pain facial expressions. Using the data-driven Bubbles method, we were able to corroborate the woman advantage in the discrimination of pain intensities that did not appear to be explained by variations in empathic tendencies. In terms of visual strategies, our results do not indicate any qualitative differences in the facial regions used by men and women. However, they suggest that women rely on larger regions of the face that seems to completely mediate their advantage. This utilization of larger clusters could indicate either that women integrate simultaneously and more efficiently information coming from different areas of the face or that they are more flexible in the utilization of the information present in these clusters. Women would then opt for a more holistic or flexible processing of the facial information, while men would rely on a specific yet rigid integration strategy. © 2022 American Psychological Association},

note = {Publisher: American Psychological Association},

keywords = {adult, article, controlled study, data-driven methods, effect size, Empathy, Facial Expression, facial expressions, female, human, human experiment, information processing, male, normal human, Pain, pain intensity, qualitative research, sample size, sex difference, sex differences, vision, visual acuity, visual information, Visual Perception},

pubstate = {published},

tppubtype = {article}

}

@article{dumoulin_are_2020,

title = {Are cognitive load and focus of attention differentially involved in pain management: An experimental study using a cold pressor test and virtual reality},

author = {S. Dumoulin and S. Bouchard and C. Loranger and P. Quintana and V. Gougeon and K. L. Lavoie},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85090185237&doi=10.2147%2fJPR.S238766&partnerID=40&md5=38278e890412e4529b0a740f4a6a881e},

doi = {10.2147/JPR.S238766},

issn = {11787090 (ISSN)},

year  = {2020},

date = {2020-01-01},

journal = {Journal of Pain Research},

volume = {13},

pages = {2213–2222},

abstract = {Objective: The aim of this study is to assess whether distraction (lack of attentional focus) and attention (cognitive load) are differentially involved in the analgesic effect of virtual reality (VR) immersions during a cold pressor test (CPT). Methods: Thirty-one participants were randomly assigned to four experimental conditions (high and low cognitive load, attention with or without a reminder of the pain stimuli) and performed three CPTs. Pain was assessed based on the duration of the CPT (pain tolerance), a visual analog rating scale of perceived pain intensity during the CPT and the subjective pain scale of the Short form McGill Pain Questionnaire (SF-MPQ). Results: The statistical analyses revealed that VR immersions were associated with less pain compared to the baseline (all p <0.001), but for the experimental manipulations, only the conditions where there was an increase in cognitive load (ie, from low cognitive load at Immersion 1 to high cognitive load at Immersion 2) were effective for increasing pain tolerance (significant Time X Conditions interaction). The interactions were not significant for pain intensity assessed with the VAS or the SF-MPQ. Conclusion: The results suggest that increases in cognitive load play an important role in the analgesic effect of VR immersion, although the combination of attentional focus and cognitive load may be important. Suggestions are given for designing a replication study. © 2020 Dumoulin et al.},

note = {Publisher: Dove Medical Press Ltd},

keywords = {adult, analgesia, analgesic activity, article, attention, clinical article, Cognitive load, cold pressor test, controlled study, CPT, Distraction, experimental study, female, human, immersion, male, McGill Pain Questionnaire, Pain, pain intensity, pain threshold, randomized controlled trial, rating scale, replication study, virtual reality},

pubstate = {published},

tppubtype = {article}

}