Advanced Visualization Branch

AVB的目的是改善复杂慢性病患者的自我管理。我们使用的主要研究工具是沉浸式虚拟现实(IVR，VR)，它允许参与者体验熟悉的环境，并在高度受控的空间中进行自我管理活动，允许精确测量运动并评估认知和行为任务的努力。为此，我们开发了虚拟环境，描绘外行人熟悉的场景(住宅、杂货店)，并确保广泛的个人可以访问这些场景，包括那些数字经验有限的人，来自广泛的年龄范围、不同的背景，以及那些可能有一些认知或身体限制的人。现在我们已经演示了虚拟购物环境和界面适用于广泛的个人，我们将提交评估自我管理的特定方面的附加协议。 我们在10周的时间内完成了第一项研究，正在分析从研究中收集的数据，并正在准备报告和手稿，以传播调查结果。我们第一项研究的结果支持了我们的目标，即为广泛的参与者创造无障碍体验，即使是那些轻微残疾的人也是如此。这项研究的第二阶段被推迟到2022年秋季。第二阶段将探索参与者证明遵守饮食限制的能力，包括食物选择和遵守钠限制。我们已经有了一份想要参与的个人的等待名单。 对于结果评估，我们采用了认知负荷(VAS-Cognition)和任务负荷(NASA TLX)的标准测量。我们空出了观察指标，如执行任务的时间、IVR沉浸的持续时间和模拟器疾病评估，以评估参与者对IVR体验的可接受性。 我们应用相同的多功能沉浸式VR平台来创建第二个环境，以评估参与者在家庭环境中执行药物自我管理的能力。由于正确地将药丸放入药盒是一个复杂的认知过程，我们创建了一个简单版本的任务，以识别可能导致药丸分类错误的个人认知因素。我们目前的环境使我们能够确定个人是否能够在视觉上区分药片类型，与显示适当药片位置的日历相匹配，然后确定处理这些信息的速度。一部分参与者在议定书第一阶段期间完成了地堡任务。每个参与者都以最小的困难成功地学习并完成了任务。在我们的认知疲劳研究的第二阶段中，柱子任务将被用作表现减退的指标。这项任务和虚拟环境是评估影响药物管理的认知和环境因素的未来方案的起点。 我们的实验室致力于培训，包括接待两名毕业后实习生(Sara Flash和Allyson Ferguson)和一名暑期实习生(Nikhil PraDeep)。学员参与我们IVR环境设计和评估的所有阶段，并获得更多使用大数据和支持常见数据元素工作的经验。Sara Flash与我们的护士顾问Denise Goldsmith密切合作，评估在IRV空间的运动(在NIH展示的海报)，并基于从我们所有人项目中提取的数据完成了NIH的演示。我们在美国医学信息学协会年会上展示了海报，从而将VR融入生物医学信息学社区。我们的实习生都有使用我们所有研究人员工作台提出和回答问题的经验。这些数据为利用现有数据进行研究统计培训和科学介绍提供了一个平台。此外，我们的研究还包括支持NINR公共数据元素和倡议的数据，包括健康和PROMIS措施的社会决定因素。我们有兴趣通过合作扩展我们的研究，并正在探索与NIMHD和NIDA的选择。 我们目前的工作人员包括首席调查员、两名退学后受训人员和三名远程承包商，其中包括一名全职平面设计师、一名兼职工程师和一名兼职临床护士。我们的团队在不同的时区和不同的工作时间分布在全国各地。我们失去了首席科学家，也没能招到一名计算机工程师。我们已经暂时停止了让人类受试者参与我们的研究，一旦我们的人员配备完成，我们将立即恢复。我们将增加一名后备人才(威尔·汤普森)，以帮助下一阶段的研究方案，并增加我们的培训努力。尽管员工人数不多，但AVB已经推进了复杂的研究议程，并完成了沉浸式技术有潜力成为医疗领域有用工具的概念证明。我们预计明年我们的科学计划会加速进行。

The purpose of the AVB is to improve self-management among persons with complex chronic disease. The primary research instrument we use is immersive virtual reality (IVR, VR), which allows the participant to experience familiar environments and conduct self-management activities in a highly controlled space that allows for precise measurement of movement and assessment of the cognitive and behavioral task effort. To this aim, we develop virtual environments that depict scenes familiar to the lay person (homes, grocery stores) and insure that these are accessible to a broad range of individuals including those with limited digital experience, across a broad age-range, diverse backgrounds, and potentially those with some cognitive or physical limitation. Now that we have demonstrated that the virtual shopping environment and interface works for a broad range of individuals, we will submit additional protocols evaluating specific aspects of self-management. We completed our first study over a period of 10 weeks and are in the process of analyzing the data collected from the study and are in the process of preparing presentations and manuscripts to disseminate the findings. The results of our first study support our aims to create accessible experiences to a broad range of participants, even those with minor disabilities. Phase 2 of the study has been postponed to Fall, 2022. Phase 2 will explore participants abilities to demonstrate compliance with dietary restrictions, including food choice selection and compliance with sodium restrictions. We already have an extensive wait-list of individuals wanting to participate. For outcome assessment we employ standard measures of cognitive burden (VAS-Cognition) and task burden (NASA TLX). We empty observational measures such as time to perform tasks, duration of IVR immersion, and simulator sickness assessment to evaluate the acceptability of the IVR experience on participants. We applied the same multipurpose immersive VR platform to create a second environment to assess participants abilities to perform medication self management within the home environment. As correctly placing pills in a pillbox is a complex cognitive process, we have created a simple version of the task to identify individual cognitive factors that may contribute to errors in pill sorting. Our current environment enables us to determine if individuals can visually differentiate pill types, match to a calendar showing proper pill placement and then determining how quickly this information is processed. A subset of participants completed the pillbox task during phase 1 of the protocol. Each participant successfully learned and performed the task with minimal difficulty. The pillbox task will be used as a performance decrement indicator in phase 2 of our cognitive fatigue study. This task and virtual environment are a jumping off point for a future protocol evaluating the cognitive and environmental factors influencing medication management. Our lab has a strong commitment to training, including hosting two post-bac trainees (Sara Flash and Allyson Ferguson) and one summer intern (Nikhil Pradeep). Trainees participate in all phased of design and evaluation of our IVR environments, and gain additional experiences using big data, and supporting common data elements work. Sara Flash worked closely with our nurse consultant, Denise Goldsmith, to evaluate locomotion in IRV space (poster presented at NIH) and completed NIH presentations based on data extracted from the All of Us project. We presented posters at the American Medical Informatics Association annual meeting, thus integrating VR into the biomedical informatics community. Our trainees each have an experience proposing and answering questions using the All of Us Researchers workbench. The data provided a platform for training in research statistics using existing data and scientific presenting. Additionally, our studies have included data that supports NINR common data elements and initiatives including the social determinants of health and PROMIS measures. We are interested in extending our research through collaborations and are exploring options with NIMHD and NIDA. Our current staff includes the Principal Investigator, two post-bac trainees, and 3 remote contractors including a full-time graphic designer, a part-time engineer, and a part-time clinical nurse. Our team is geographically spread across the country in different time zones and varying work schedules. We lost our lead scientist and have been unsuccessful in recruiting a computer engineer. We have temporarily paused engaging human subjects in our research and will resume as soon as our staffing complement is complete. We will add an additional post-bac (Will Thompson) to aid in the next phase of research protocols and to increase our training efforts. Despite a small staff, under mostly remote telework, the AVB has moved forward with a complex research agenda and has completed proof of concept that immersive technology has potential to be a useful tool in the healthcare arena. We anticipate an acceleration of our scientific program over the next year.