TY - JOUR
T1 - Deterioration rates in Virtual Reality Therapy
T2 - An individual patient data level meta-analysis
AU - Fernández-Álvarez, Javier
AU - Rozental, Alexander
AU - Carlbring, Per
AU - Colombo, Desirée
AU - Riva, Giuseppe
AU - Anderson, Page L.
AU - Baños, Rosa María
AU - Benbow, Amanda A.
AU - Bouchard, Stéphane
AU - Bretón-López, Juana María
AU - Cárdenas, Georgina
AU - Difede, Jo Ann
AU - Emmelkamp, Paul
AU - García-Palacios, Azucena
AU - Guillén, Verónica
AU - Hoffman, Hunter
AU - Kampann, Isabel
AU - Moldovan, Ramona
AU - Mühlberger, Andreas
AU - North, Max
AU - Pauli, Paul
AU - Peñate Castro, Wenceslao
AU - Quero, Soledad
AU - Tortella-Feliu, Miquel
AU - Wyka, Kataryzna
AU - Botella, Cristina
PY - 2019/1
Y1 - 2019/1
N2 - Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31–1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.
AB - Ample evidence supports the use of Virtual Reality (VR) for anxiety disorders. Nonetheless, currently there is no evidence about moderators or potential negative effects of VR treatment strategies. An Individual Patient Data (IPD) approach was employed with 15 retrieved datasets. The current study sample was composed of 810 patients. Randomized control trials (RCTs) for each primary outcome measure were performed, in addition to moderator analyses of the socio-demographic variables. Deterioration rates were 14 patients (4.0%) in VR, 8 (2.8%) in active control conditions, and 27 (15%) in the WL condition. With regard to receiving treatment, patients in a waiting list control condition had greater odds of deteriorating than in the two active conditions, odds ratios (ORs) 4.87, 95% confidence interval (CI) [0.05, 0.67]. In the case of the socio-demographic variables, none of them were associated with higher or lower odds of deterioration, with the exception of marital status in the WL condition; married people presented a significantly lower probability of deterioration, OR 0.19, 95% CI [0.05, 0.67]. Finally, when comparing pooled effects of VR versus all control conditions, the OR was 0.61 (95% CI 0.31–1.23) in favor of VR, although this result was not statistically significant. This study provides evidence about the deterioration rates of a therapeutic VR approach, showing that the number of deteriorated patients coincides with other therapeutic approaches, and that deterioration is less likely to occur, compared to patients in WL control groups.
KW - Anxiety disorders
KW - Deterioration rates
KW - Individual patient data analysis
KW - Virtual reality
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UR - http://www.scopus.com/inward/citedby.url?scp=85050381788&partnerID=8YFLogxK
U2 - 10.1016/j.janxdis.2018.06.005
DO - 10.1016/j.janxdis.2018.06.005
M3 - Article
C2 - 30057346
AN - SCOPUS:85050381788
VL - 61
SP - 3
EP - 17
JO - Journal of Anxiety Disorders
JF - Journal of Anxiety Disorders
SN - 0887-6185
ER -