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Trial registered on ANZCTR
Registration number
ACTRN12621000534886p
Ethics application status
Submitted, not yet approved
Date submitted
27/01/2021
Date registered
6/05/2021
Date last updated
6/05/2021
Date data sharing statement initially provided
6/05/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Integration of Virtual Reality as analgesia for office based flexible cystoscopy: a randomized prospective study
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Scientific title
Effect of Virtual Reality as analgesia for office based flexible cystoscopy on procedural discomfort: a randomized prospective study
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Secondary ID [1]
303273
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None
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Universal Trial Number (UTN)
U1111-1264-2733
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Pain
320464
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Cystoscopy
320465
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Condition category
Condition code
Renal and Urogenital
318349
318349
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0
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Other renal and urogenital disorders
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Surgery
318350
318350
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0
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Surgical techniques
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Anaesthesiology
318712
318712
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0
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Pain management
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Use of a virtual reality headset whilst undertaking office based flexible cystoscopy. Patients will wear a commercially available virtual reality headset for the duration of the procedure. They will receive a short tutorial on how to operate the headset prior to undergoing the procedure. Patient lie on a clinic bed whilst undergoing the procedure, in the outpatient clinic, which is standard practice. The procedure takes about 10 minutes. Patients will watch environmental scenery of a virtual savannah type scene with varied flora and fauna to provide distraction, with natural sounds of these played through the headset. Once the procedure is complete the patient will remove the headset. The headset will be cleaned.
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Intervention code [1]
319574
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Prevention
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Intervention code [2]
319575
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Treatment: Devices
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Comparator / control treatment
Standard practice of office based flexible cystoscopy. Patients are seen in the outpatient clinic to undergo flexible cystoscopy. The procedure is verbally explained to patients and any questions they have answered before proceeding. They are able to decline the procedure if they require. Patients will then lie on a clinic bed and expose their genitalia. The skin surrounding the external urethral meatus is cleaned with antiseptic solution, and the patient draped appropriately with sterile drapes.. Sterile anaesthetic gel is then applied to the urethra. The flexible cystoscope is then introduced through the urethra, with irrigation, into the bladder. The entire urethra and bladder is examined. The cystoscope is then removed which concludes the procedure. Patients will often have to pass urine afterwards due to instillation of fluid on entry. Patients in the control group will have the same procedural protocol, but with no virtual reality headset.
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain scores from office based flexible cystoscopy. This will be assessed with a study specific questionnaire which uses the visual analog scale for patients to record their responses.
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Assessment method [1]
326320
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Timepoint [1]
326320
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Prior to and Immediately after the procedure
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Primary outcome [2]
326648
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Anxiety scores from office based flexible cystoscopy. This will be assessed with a study specific questionnaire which uses the visual analog scale for patients to record their responses.
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Assessment method [2]
326648
0
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Timepoint [2]
326648
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Prior to and immediately after the procedure
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Primary outcome [3]
326649
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Overall satisfaction scores from office based flexible cystoscopy. This will be assessed with a study specific questionnaire which uses the visual analog scale for patients to record their responses.
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Assessment method [3]
326649
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Timepoint [3]
326649
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Prior to and immediately after the procedure
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Secondary outcome [1]
391052
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Response to virtual reality headset. This will be assessed with a study specific questionnaire which uses the visual analog scale for patients to record their responses.
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Assessment method [1]
391052
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Timepoint [1]
391052
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Immediately after the procedure
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Eligibility
Key inclusion criteria
Undergoing flexible cystoscopy in the Urology outpatient clinic at Dunedin Hospital
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Patients with vision impairment or significant cognitive impairment.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
A Sample size has been calculated from existing studies data to be able to detect a statistically significant difference of 1 cm on the visual analog scale. Depending on the distribution of the data, a statistical calculation will be made to calculate the P value of the difference between the two groups. It is likely that the data will be normally distrubted so an ordinary t test could be used.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
28/05/2021
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Actual
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Date of last participant enrolment
Anticipated
1/02/2022
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Actual
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Date of last data collection
Anticipated
1/02/2022
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
23413
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New Zealand
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State/province [1]
23413
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Otago
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Funding & Sponsors
Funding source category [1]
307683
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Government body
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Name [1]
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Southern District Health Board
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Address [1]
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Dunedin Hospital, 201 Great King Street, Dunedin 9011, New Zealand
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Country [1]
307683
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New Zealand
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Primary sponsor type
University
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Name
University Of Otago
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Address
201 Great King Street, Dunedin 9011, New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
308382
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Government body
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Name [1]
308382
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Southern District Health Board
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Address [1]
308382
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201 Great King Street, Dunedin 9011, New Zealand
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Country [1]
308382
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New Zealand
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Ethics approval
Ethics application status
Submitted, not yet approved
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Ethics committee name [1]
307719
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Southern Health and Disability Ethics Committee, New Zealand
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Ethics committee address [1]
307719
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133 Molesworth Street, Thorndon, Wellington 6011
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Ethics committee country [1]
307719
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New Zealand
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Date submitted for ethics approval [1]
307719
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25/02/2021
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Approval date [1]
307719
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Ethics approval number [1]
307719
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Summary
Brief summary
Virtual reality has made an impact in areas of acute and chronic pain as an adjunct to standard analgesia regimes. Research has already shown benefit in areas of paediatric procedures, burn wound debridements and endoscopic gynaecological procedures to manage acute procedural pain. It appears subjective pain scores and anxiety levels may be reduced with this non-pharmacological approach This has not been introduced within the scope of urology procedures. Flexible cystoscopy is commonly carried out in the outpatient clinic under local anaesthetic. There wide variation in patients experience with this procedure, with a large number tolerating it poorly, which can also detract from the accuracy of the procedure. Integrating Virtual reality as an analgesia for office based flexible cystoscopy may improve patient satisfaction outcomes, and reduce numbers of patients requiring cystoscopy under General Anaesthesia. Aim: To determine if virtual reality technology will act as an analgesic aid to improve patient satisfaction following outpatient flexible cystoscopy. Method: This will be a single-centre, randomized prospective cohort study conducted within the Urology Department of Dunedin Hospital. Eligible participants will be patients who present for flexible cystoscopy in the outpatient setting. Patients with vision impairment or significant cognitive impairment will be excluded. Recruitment will be from the outpatient clinic over a 12-month period. Estimated sample size 200 patients. Patients will be consented then randomly allocated to Virtual Reality (VR) intervention group or control group. Routine flexible cystoscopy under local anaesthetic will take place with no procedural change in the way samples are collected in both groups. However, the intervention group will wear a VR headset with distraction environment VR software. They will then watch a VR movie for the duration of the procedure. Prior to the procedure in each group, Patients will complete a standardized questionnaire about their expectations of the procedure. This will include questions relating to pain, anxiety and overall expectation. After the procedure, patients will complete the same questionnaire investigating their pain, anxiety, VR response (if applicable) and overall satisfaction. The primary outcome will be patients’ pain, anxiety and overall satisfaction scores. This will be collected on standardized questionnaires as guided by similar international studies. Data will then be analysed to see if there is correlation between VR and primary outcome scores. All data collection will be anonymous with no identifiable information collected. No further follow up is required.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
108262
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Dr Thomas Clarkson
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Address
108262
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Southern District Health Board, Dunedin Hospital, 201 Great King Street, Dunedin 9011
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Country
108262
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New Zealand
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Phone
108262
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+64 27 387 3124
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Fax
108262
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Email
108262
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[email protected]
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Contact person for public queries
Name
108263
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Thomas Clarkson
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Address
108263
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Southern District Health Board, Dunedin Hospital, 201 Great King Street, Dunedin 9011
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Country
108263
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New Zealand
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Phone
108263
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+64 3 434 0999
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Fax
108263
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Email
108263
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[email protected]
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Contact person for scientific queries
Name
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Thomas Clarkson
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Address
108264
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Southern District Health Board, Dunedin Hospital, 201 Great King Street, Dunedin 9011
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Country
108264
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New Zealand
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Phone
108264
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+64 3 434 0999
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Fax
108264
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Email
108264
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
10362
Study protocol
[email protected]
Can be obtained from Investigator on request - con...
[
More Details
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381301-(Uploaded-05-05-2021-19-41-26)-Study-related document.docx
10363
Informed consent form
[email protected]
Hard copies provided to participants when enrollin...
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381301-(Uploaded-02-05-2021-18-01-19)-Study-related document.doc
10807
Ethical approval
[email protected]
Can be obtained from study team on request, contac...
[
More Details
]
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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