The Impact of Virtual Reality on Pain and Anxiety during Ultrasound Guided Breast Biopsies

Over 1.6 million patients undergo an image-guided biopsy to obtain a breast tissue diagnosis in the United States annually. Prior studies report that women anticipate these biopsies to be painful. Local anesthesia has been the mainstay for pain management during image-guided biopsies for decades, and most patients report significantly lower pain levels with local anesthesia. However, despite local analgesia, a common accompaniment of pain during these procedures is anxiety. Studies investigating the factors contributing to patient anxiety relating to a percutaneous breast biopsy report a multitude of factors, including patient concerns over biopsy results, level of education, age of the patient, communication with radiologists, information available, and the number of relatives with breast cancer. The purpose of this study was to investigate the efficacy of immersive VR in combination with conventional pharmacological treatment for mitigating pain and anxiety experienced during ultrasound-guided breast biopsies compared to conventional pharmacological treatment alone in the outpatient setting.

​

Extended Reality-Based Art Therapy and Cognitive Behavioral Therapy for Opioid Use Disorder and Recovery 

Opioid abuse and related overdoses, characterized as the "US opioid epidemic," are one of the nation's leading causes of injury deaths. In December 2021, opioid overdose deaths reached a record high in the US, with over 290 daily deaths. While opioid misuse has significantly increased over the years, digital health and technology-based tools for managing opioid cravings, recovery, and relapse have not kept pace. This calls for an urgent need to design and develop adjunct programs and tools beyond conventional therapies that are accessible, affordable, and convenient for those recovering from Opioid Use Disorder (OUD). This research intends to address the critical public health challenge of the opioid epidemic by integrating Art Therapy and Cognitive Behavioral Therapy with Extended Reality (XR) technologies to develop a digital tool that is convenient, affordable, and accessible to OUD patients. This research will be carried out by a diverse faculty and practitioners with expertise in immersive technologies, human-computer interaction, psychotherapy, behavioral health, and addiction services. 

​

A Data-Driven Modeling Approach to Allocating Resources in Emergency Departments

Over 145 million people visit US Emergency Departments (ED) annually. The diverse nature and overwhelming volume of patient visits make the ED one of the most complicated settings in healthcare to study. ED overcrowding is a recognized worldwide public health problem, and its negative impacts include an increased patient length of stay, medical errors, patients left without being seen, ambulance diversions, and health system finances. The critical research task is to understand how to identify “optimized” policies that reduce onboarding time, reduce the length of stay, and increase throughput with minimum investment. The research team will identify and collect patient-level and system-level data to support data-driven analytical modeling of GMH ED operations. With these data, the team will build a simulation/optimization model of the ED representing patient care pathways, system capacities, and operational policies.

​

Team-Based, Risk-Adjusted Staffing during a Pandemic: An Agent-Based Approach

Since the World Health Organization declared the novel coronavirus disease a pandemic, more than 30 million cases of infections and 950,000 deaths have been reported across the world. Specialty physicians are now working as frontline workers due to hospital overcrowding and a lack of providers, and this places them as a high-risk target of the epidemic. Within these specialties, anesthesiologists are one of the most vulnerable groups as they come in close contact with the patient's airway. An agent-based simulation model was developed to test various staffing policies, and we demonstrate the benefits of a restricted, no-mixing shift policy, which segregates the anesthesiologists as groups and assigns them to a shift within a single hospital.

​

Biofeedback Enhanced Adaptive Virtual Reality to Mitigate Surgical Pain and Anxiety

Pain and anxiety are common accompaniments of surgery, and opioids have been the mainstay of pain management for decades. Approximately 80% of the patients undergoing surgery leave the hospital with an opioid prescription. Moreover, patients receiving an opioid prescription after short-stay surgeries have a 44% increased risk of long-term opioid use, and about one in 16 surgical patients becomes a long-term user. We aimed to develop a virtual reality experience based on Attention Restoration Theory and integrate the user's heart rate variability biofeedback to create an adaptive environment to mitigate preoperative anxiety and postoperative pain.

​

Virtual Reality to Mitigate Pain and Anxiety in an Operative Setting

Research demonstrates that ten percent of the population becomes addicted to opioids from exposure to narcotics in the operative setting. The abuse and addiction to these drugs have placed the US at the center of an “opioid epidemic.” A variety of programs and interventions are being explored to treat the pain associated with surgery while minimizing or eliminating the need for opioids. Our goal was to assess the efficacy of virtual reality in mitigating surgical pain and anxiety among patients undergoing total knee arthroplasty.

​

Virtual Reality to Mitigate Anxiety among AYA Cancer Patients

Studies have reported that adolescent and young adult (AYA) patients are specifically vulnerable to distress because of the intersection of disease and age. Compared to older cancer patients, AYA cancer patients indicate a more negative psychosocial outcome. Recent studies have focused on improving the quality of life of AYA patients by providing adjunctive non-pharmacological interventions. Our longitudinal study analyzed the efficacy of VR in the AYA population and sought to understand their preferences in virtual environments.

​

Stress and Burnout among Attending and Resident Physicians in the Emergency Department

Emergency department physicians work in complex care settings with frequent exposure to stressful conditions. Burnout among physicians is increasing each year, and one of the most prone groups is emergency medicine providers. This research sought to understand if a difference in stress levels and burnout rate exists between attending and resident physicians working in an academic Level 1 trauma center emergency department on the same shift. Stress levels were estimated using physiological measures, including heart rate variability and electrodermal activity. Burnout scores and workload index were collected using the Maslach Burnout Inventory-Human Services Survey, and the NASA-TLX survey.