An augmented reality platform to reduce post-operative and chronic opioid use in pediatric cancer

增强现实平台可减少儿科癌症术后和长期阿片类药物的使用

• 批准号: 10416115
• 负责人: Juan Pablo Cata
• 金额: $ 91.54万
• 依托单位: ALTALITY, INC.
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10416115
• 关键词: augmented; reality; platform; reduce; post

PROJECT SUMMARY/ABSTRACT Pediatric opioid use is a public health crisis. In children, prescription opioids are the primary source of non- medical abuse as well as opioid-associated hospitalizations and deaths. Early opioid use in childhood is a known “gateway” to adulthood dependence and substance abuse disorders. Despite years of research, opioids remain the most commonly prescribed pain medication for children with cancer. These children experience pain from the time of diagnosis into adulthood as survivors, primarily from the treatment for their cancer. The majority of pediatric cancer patients have persistent opioid use in the months following major surgery to cure or to treat their disease. More concerning, studies in childhood cancer survivors show that major surgery increases risk of new-onset and chronic opioid use. The high costs and lack of scalability of traditional distraction-based medical devices for managing pain, such as virtual reality headsets, limit their clinical impact and commercial potential. As cancer patients are often immunocompromised, risk from infectious disease transmission from sharing devices is an additional, possibly life-threatening, concern. Mobile augmented reality applications eliminate these limitations, representing a cost-effective, safe and commercially viable adjunctive tool for pain management in critically ill children. Our goal is to reduce long-term opioid use in children with cancer undergoing major surgery by distracting them from their pain with a scavenger hunt-style mobile AR game while they are recovering in the hospital. To achieve this goal, we have collaborated with pediatric oncologists, anesthesiologists and pain specialists at the MD Anderson Cancer Center and the Baylor College of Medicine (Texas Children’s Hospital). In Phase I, we will demonstrate the feasibility of investigating the ARISE (Augmented Reality Incorporating Spatial Enhancement) game for reducing opioid consumption in the inpatient postoperative wards. In Phase II, we will evaluate the efficacy of the game to reduce immediate and long-term postoperative opioid use in children with cancer undergoing major treatment-related surgery in a multi-site randomized controlled clinical trial (AURORA trial: Augmented Reality for Opioid Reduction in Childhood Cancer). To our knowledge, this is the first RCT to investigate mobile augmented reality for opioid reduction in pediatric cancer patients or for postoperative opioid reduction in any pediatric population. As the majority of children with cancer are expected to survive long-term, the benefits of reducing and preventing chronic opioid use in this high-risk, refractory pain population will last over the lifetime of a child.

项目摘要/摘要 小儿阿片类药物使用是一种公共卫生危机。在儿童中，处方阿片类药物是非 - 医学虐待以及阿片类药物相关的住院和死亡。童年早期使用阿片类药物是 已知的“门户”对成年依赖性和药物滥用障碍。尽管研究了多年，阿片类药物 仍然是癌症儿童最常见的处方止痛药。这些孩子经历 从诊断之时到成年后的疼痛，主要是由于其癌症治疗的疼痛。这 大多数儿科癌症患者在大手术治愈或 治疗他们的疾病。关于儿童癌症生存的研究更加令人担忧，表明大手术 增加新发和慢性阿片类药物的风险。传统的高成本和缺乏可扩展性 基于分心的医疗设备来管理疼痛，例如虚拟现实耳机，限制其临床影响 和商业潜力。由于癌症患者经常受到免疫功能的影响，因此传染病的风险 从共享设备中传输是一种额外的威胁生命，关注的问题。 移动增强现实应用程序消除了这些限制，代表了成本效益，安全和 重症儿童疼痛管理的商业上可行的辅助工具。我们的目标是减少长期 在癌症儿童接受大术手术的儿童中使用的绿核酸，通过用A分散他们的疼痛。 在医院康复时，寻宝狩猎风格的移动AR游戏。为了实现这一目标，我们有 与儿科肿瘤学家，麻醉学家和痛苦专家合作 中心和贝勒医学院（得克萨斯州儿童医院）。在第一阶段，我们将证明 调查出现的可行性（增强现实，结合了空间增强）游戏 减少住院术后病房中阿片类药物的消耗。在第二阶段，我们将评估 该游戏减少正在接受癌症儿童的术后阿片类药物的立即和长期使用 在多站点随机对照临床试验中，与治疗相关的主要手术（Aurora试验：增强 儿童癌症减少阿片类药物的现实）。据我们所知，这是第一个调查移动的RCT 增加了小儿癌症患者阿片类药物减少的现实或任何术后阿片类药物减少 小儿种群。由于预计大多数癌症儿童将长期生存，因此 在这种高风险，难治性的疼痛人群中，减少和预防慢性阿片类药物的使用将持续一生 一个孩子。