Extended Reality Analgesia Evidence Reviews Often Lack Sufficient Intervention Detail

Background: Evidence synthesis projects such as systematic reviews and meta-analyses are defined by the focal research question addressed through assemblage and analysis of all relevant literature. In complex intervention domains such as medical extended reality (MXR), there are a plethora of intervention factors that could be included in research questions, which define study inclusion criteria and, in turn, shape the generalizability of results. This article quantifies how recently published evidence syntheses of MXR interventions for pain management characterize the primary studies they assess.

Method: Inclusion criteria for analysis consisted of English-language scoping reviews, systematic reviews, and meta-analyses, published in 2021-2023, that evaluated MXR-based interventions for pain management in any setting. We employed quantitative content analysis to assess characterization of intervention features.

Results: Of the 61 synthesis publications that met inclusion criteria, 29 (48%) included only minimal description of MXR intervention content, 14 (23%) included substantial content descriptions, and the remainder did not describe intervention content within synthesized studies. Hardware details were reported for 15 (25%) of publications in a minimal way, 28 (46%) in a substantial way, and not reported in 18 (30%) of syntheses. Among the 39 papers that included a meta-analysis, 10 (25%) explicitly evaluated the role of intervention features in intervention efficacy.

Conclusion: Findings suggest considerable variability in the characterization of intervention elements (content and hardware), which can limit accurate conclusions about the generalizability of synthesis findings. Accordingly, we make recommendations to guide future evidence syntheses in the MXR domain.