Effectiveness of extended reality technologies in cardiopulmonary resuscitation training: a bayesian network meta-analysis
High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network me...
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| Published in | BMC emergency medicine Vol. 25; no. 1; pp. 94 - 11 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
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England
BioMed Central Ltd
07.06.2025
BioMed Central BMC |
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| Online Access | Get full text |
| ISSN | 1471-227X 1471-227X |
| DOI | 10.1186/s12873-025-01256-2 |
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| Abstract | High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods.
A Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models.
11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected.
XR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact.
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| AbstractList | High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods.
A Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models.
11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected.
XR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact.
Not applicable. Abstract Background High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods. Methods A Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models. Results 11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected. Conclusions XR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact. Clinical trial number Not applicable. BackgroundHigh-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods.MethodsA Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models.Results11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected.ConclusionsXR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact.Clinical trial numberNot applicable. High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods.BACKGROUNDHigh-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods.A Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models.METHODSA Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models.11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected.RESULTS11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected.XR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact.CONCLUSIONSXR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact.Not applicable.CLINICAL TRIAL NUMBERNot applicable. Background High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods. Methods A Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models. Results 11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected. Conclusions XR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact. Clinical trial number Not applicable. Keywords: Cardiopulmonary resuscitation training, Extended reality, Augmented reality, Virtual reality, Mixed reality High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR), Virtual Reality (VR), and Mixed Reality (MR), provide immersive and interactive training, potentially enhancing CPR outcomes. This network meta-analysis compared the effectiveness of XR-based CPR training to traditional face-to-face methods. A Bayesian network meta-analysis was conducted following PRISMA guidelines. We systematically searched PubMed, Cochrane Library, Web of Science, EMBASE, and CNKI for randomized controlled trials (RCTs) comparing XR-based and traditional CPR training. Primary outcomes included chest compression depth and rate; secondary outcomes assessed full chest wall recoil. The CINeMA tool (GRADE framework) was used to assess evidence quality. Statistical analyses were performed using Stata 15 SE and ADDIS software with random-effects models. 11 RCTs (1,190 participants) were included. MR showed the improvement in chest compression depth (SMD = 10.96; 95% CI, 0.95 to 20.82) compared to VR and traditional methods. For full chest wall recoil, AR outperformed VR (SMD = 48.57; 95% CI, 19.56 to 79.75) and traditional methods (SMD = 52.95; 95% CI, 25.94 to 80.48). However, no significant differences were observed for chest compression rate. SUCRA rankings placed MR as most effective for compression depth (87.4%) and AR for full chest wall recoil (99.1%). Evidence quality was moderate to high, with minor downgrades for imprecision. No publication bias was detected. XR technologies, particularly MR and AR, significantly improve chest compression depth and full chest wall recoil in comparing with face to face CRP training, offering a flexible and engaging approach to CPR training. Further studies are needed to evaluate long-term skill retention and real-world impact. |
| ArticleNumber | 94 |
| Audience | Academic |
| Author | Wang, Xiaokai Li, Xiangmin Yin, Xinbo Huang, Guoqing |
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| Keywords | Extended reality Cardiopulmonary resuscitation training Mixed reality Augmented reality Virtual reality |
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| Snippet | High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented Reality (AR),... Background High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented... BackgroundHigh-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including Augmented... Abstract Background High-quality cardiopulmonary resuscitation (CPR) is critical to cardiac arrest patients. Extended Reality (XR) technologies, including... |
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| SubjectTerms | Analysis Augmented Reality Bayes Theorem Bayesian analysis Cardiopulmonary resuscitation Cardiopulmonary Resuscitation - education Cardiopulmonary resuscitation training Chest Clinical trials Compression Computer applications CPR CPR (First aid) Evidence Extended reality Humans Lifesaving Mathematical models Meta-analysis Mixed reality Randomized Controlled Trials as Topic Software Statistical analysis Training Virtual Reality |
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| Title | Effectiveness of extended reality technologies in cardiopulmonary resuscitation training: a bayesian network meta-analysis |
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