Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Augmented Reality (AR) is a technology that integrates digital information with the user's real-world environment. It offers a new approach for treatments and education in medicine. AR aids in surgery planning, patient treatment and helps explaining complex medical situations to patients and their relatives. Objective: This systematic and bibliographic Review offers an overview of the development of Applications in AR with a medical use case within the time range from 03/2012 to 06/2017. This work can aid as a guide to literature and is categorizing the publications in the field of AR research. Methods: In total 1309 publications from PubMed and Scopus between 03/2012 and 06/2017 have been manually analyzed and categorized based upon a pre-defined taxonomy. 340 duplicates were removed and of the remaining 969 publications, 631 publications have been excluded, i.e. due to wrong classification or unavailable technical data. The remaining 338 publications were original research on AR. An assessment of the maturity of projects has been conducted to the remaining publications using Technology Readiness Levels (TRL). To provide a comprehensive process of inclusion and exclusion, the authors adopted the PRISMA statement. Results: The results show an increasing trend in publications on AR used in medicine. There is no relevant number of clinical trials on the effect of AR in medicine. Domains that make use of display technologies seem to be more researched than other medical fields. The TRL show that AR technology is following a rough bell curve around the levels 4 to 7. Current AR technology is more often applied in treatment scenarios than in training. The appendix contains an interactive table to search and filter through the reviewed publications. Conclusions: This work discusses the applicability and future development of augmented and mixed reality technologies such as wearable computers and AR devices. It offers an overview of current technology and a base for researchers interested in developing AR applications in medicine. The field of AR is well researched, and there is a positive trend, but it is in an early stage in medicine and not widely adopted in clinical practice. It still lacks clinical studies proving the effectiveness of applied AR technologies.

In an unprecedented rate data in the life sciences is generated and stored in many different databases. An ever increasing part of this data is human health data and therefore falls under data protected by legal regulations. As part of the BioMedBridges project, which created infrastructures that connect more than 10 ESFRI research infrastructures (RI), the legal and ethical prerequisites of data sharing were examined employing a novel and pragmatic approach. We employed concepts from computer science to create legal requirement clusters that enable legal interoperability between databases for the areas of data protection, data security, Intellectual Property (IP) and security of biosample data. We analysed and extracted access rules and constraints from all data providers (databases) involved in the building of data bridges covering many of Europe’s most important databases. These requirement clusters were applied to five usage scenarios representing the data flow in different data bridges: Image bridge, Phenotype data bridge, Personalised medicine data bridge, Structural data bridge, and Biosample data bridge. A matrix was built to relate the important concepts from data protection regulations (e.g. pseudonymisation, identifyability, access control, consent management) with the results of the requirement clusters. An interactive user interface for querying the matrix for requirements necessary for compliant data sharing was created. To guide researchers without the need for legal expert knowledge through legal requirements, an interactive tool, the Legal Assessment Tool (LAT), was developed. LAT provides researchers interactively with a selection process to characterise the involved types of data and databases and provides suitable requirements and recommendations for concrete data access and sharing situations. The results provided by LAT are based on an analysis of the data access and sharing conditions for different kinds of data of major databases in Europe. Data sharing for research purposes must be opened for human health data and LAT is one of the means to achieve this aim. In summary, LAT provides requirements in an interactive way for compliant data access and sharing with appropriate safeguards, restrictions and responsibilities by introducing a culture of responsibility and data governance when dealing with human data.

Background/Objectives: This systematic and bibliographic review examines publications in the field of dementia and video game research from 2004 to 2023. The main objective is to assess developments and trends in video game technology for dementia care and detection. Methods: The PubMed database was the primary source for publications. PRISMA guidelines were applied to structure this review. Ten variables were defined, investigated, and split into three main categories: bibliographic, medical, and technical. Results: The results were synthesized using a quantitative approach to reduce bias through interpretation. Of 209 initial results, 77 publications have been included in the investigation. More studies focus on rehabilitation over assessment and detection of dementia. Clinical trials are typically conducted with limited participants. The most populated trials rarely enrol over 300 subjects. On average, around 38 subjects were enrolled in the trials. These studies are commonly supervised by a trainer or technology specialist, suggesting a technology gap in familiarity in the trial demographic. Conclusions: Most interventions assessed were custom-designed applications with a specific outcome, focusing on physical activity and cognitive exercises. As the first of its kind, this publication focuses on the technical aspects of applied technologies and development methods. Using video games to treat and detect patients with cognitive impairments like dementia can benefit healthcare professionals, caretakers, and patients.

Background: This review investigates the use of virtual and augmented reality games in dementia care. It provides an insight into the last 13 years of research, including the earliest publications on this topic, and takes a systematic and bibliographic approach. Methods: We sourced research publications from three different scientific databases (PubMed, Scopus, and APA PsycInfo) for this publication. We chose the PRISMA approach and categorized the studies according to the publisher. A set of 12 variables was defined across three categories (bibliographic, medical, and technical). Results: Of the 389 identified articles, 36 met the inclusion and exclusion criteria. After a phase of pilot studies mainly being conducted, the number of publications increased by four times but decreased again in 2023. Dominating were pilot and feasibility studies; 8 out of the 36 trials were RCTs. The median trial population was 24, and the protocols were performed for an average of 10 weeks, with two 40-min sessions a week. Simulator sickness was reported but not by the majority of participants. A total of 59% of the studies used fully immersive 3D-VR systems. We identified only three publications that provided high immersion quality. These findings indicate the positive effects of using virtual and augmented reality systems on participants’ cognitive function and mood. Conclusions: This publication focuses on the technical aspects of the applied technologies and immersion levels of the patients. Using augmented and virtual reality methods to improve the quality of life and physical interaction of dementia patients shows the potential to enhance cognitive functioning in this population, but further investigation and multicenter RCTs are needed. There are strong indications that this research branch has high potential to benefit both caretakers and patients.