Three-dimensional imaging of the forearm and hand: A comparison between two 3D imaging systems.

The conventional treatment for distal radius fractures typically involves immobilization of the injured extremity using a conventional forearm cast. These casts do cause all sorts of discomfort during wear and impose life-style restrictions on the wearer. Personalized 3D printed splints, designed using three-dimensional (3D) imaging systems, might overcome these problems. To obtain a patient specific splint, commercially available 3D camera systems are utilized to capture patient extremities, generating 3D models for splint design. This study investigates the feasibility of utilizing a new camera system (SPENTYS) to capture 3D surface scans of the forearm for the design of 3D printed splints. In a prospective observational cohort study involving 17 healthy participants, we conducted repeated 3D imaging using both the new (SPENTYS) and a reference system (3dMD) to assess intersystem accuracy and repeatability. The intersystem accuracy of the SPENTYS system was determined by comparison of the 3D surface scans with the reference system (3dMD). Comparison of consecutive images acquired per device determined the repeatability. Feasibility was measured with system usability score questionnaires distributed among professionals. The mean absolute difference between the two systems was 0.44 mm (SD:0.25). The mean absolute difference of the repeatability of the reference -and the SPENTYS system was respectively 0.40 mm (SD: 0.30) and 0.53 mm (SD: 0.25). Both repeatability and intersystem differences were within the self-reported 1 mm. The workflow was considered easy and effective, emphasizing the potential of this approach within a workflow to obtain patient specific splint.

Accuracy of augmented reality-guided needle placement for pulsed radiofrequency treatment of pudendal neuralgia: a pilot study on a phantom model.

Background: Pudendal neuralgia (PN) is a chronic neuropathy that causes pain, numbness, and dysfunction in the pelvic region. The current state-of-the-art treatment is pulsed radiofrequency (PRF) in which a needle is supposed to be placed close to the pudendal nerve for neuromodulation. Given the effective range of PRF of 5 mm, the accuracy of needle placement is important. This study aimed to investigate the potential of augmented reality guidance for improving the accuracy of needle placement in pulsed radiofrequency treatment for pudendal neuralgia. Methods: In this pilot study, eight subjects performed needle placements onto an in-house developed phantom model of the pelvis using AR guidance. AR guidance is provided using an in-house developed application on the HoloLens 2. The accuracy of needle placement was calculated based on the virtual 3D models of the needle and targeted phantom nerve, derived from CBCT scans. Results: The median Euclidean distance between the tip of the needle and the target is found to be 4.37 (IQR 5.16) mm, the median lateral distance is 3.25 (IQR 4.62) mm and the median depth distance is 1.94 (IQR 7.07) mm. Conclusion: In this study, the first method is described in which the accuracy of patient-specific needle placement using AR guidance is determined. This method could potentially improve the accuracy of PRF needle placement for pudendal neuralgia, resulting in improved treatment outcomes.

An open-source, three-dimensional growth model of the mandible.

The available reference data for the mandible and mandibular growth consists primarily of two-dimensional linear or angular measurements. The aim of this study was to create the first open-source, three-dimensional statistical shape model of the mandible that spans the complete growth period. Computed tomography scans of 678 mandibles from children and young adults between 0 and 22 years old were included in the model. The mandibles were segmented using a semi-automatic or automatic (artificial intelligence-based) segmentation method. Point correspondence among the samples was achieved by rigid registration, followed by non-rigid registration of a symmetrical template onto each sample. The registration process was validated with adequate results. Principal component analysis was used to gain insight in the variation within the dataset and to investigate age-related changes and sexual dimorphism. The presented growth model is accessible globally and free-of-charge for scientists, physicians and forensic investigators for any kind of purpose deemed suitable. The versatility of the model opens up new possibilities in the fields of oral and maxillofacial surgery, forensic sciences or biological anthropology. In clinical settings, the model may aid diagnostic decision-making, treatment planning and treatment evaluation.

Fully automated landmarking and facial segmentation on 3D photographs.

Three-dimensional facial stereophotogrammetry provides a detailed representation of craniofacial soft tissue without the use of ionizing radiation. While manual annotation of landmarks serves as the current gold standard for cephalometric analysis, it is a time-consuming process and is prone to human error. The aim in this study was to develop and evaluate an automated cephalometric annotation method using a deep learning-based approach. Ten landmarks were manually annotated on 2897 3D facial photographs. The automated landmarking workflow involved two successive DiffusionNet models. The dataset was randomly divided into a training and test dataset. The precision of the workflow was evaluated by calculating the Euclidean distances between the automated and manual landmarks and compared to the intra-observer and inter-observer variability of manual annotation and a semi-automated landmarking method. The workflow was successful in 98.6% of all test cases. The deep learning-based landmarking method achieved precise and consistent landmark annotation. The mean precision of 1.69 ± 1.15 mm was comparable to the inter-observer variability (1.31 ± 0.91 mm) of manual annotation. Automated landmark annotation on 3D photographs was achieved with the DiffusionNet-based approach. The proposed method allows quantitative analysis of large datasets and may be used in diagnosis, follow-up, and virtual surgical planning.

Augmented reality-The way forward in patient education for intracranial aneurysms? A qualitative exploration of views, expectations and preferences of patients suffering from an unruptured intracranial aneurysm regarding augmented reality in patient education.

Objectives: The goal of this project is to explore the views, expectations and preferences of patients with an unruptured intracranial aneurysm regarding the use of AR in patient education. Methods: To gain an in-depth understanding of the patients' perspective, a face-to-face interview study was conducted using an interview protocol with a predefined topic list. All interviews were audio-recorded and transcribed verbatim afterwards. Transcripts were analyzed using thematic content analyses. Coding was performed using Atlas.ti software. Results: Seventeen interviews were conducted. The views, expectations and preferences of patients regarding patient education with AR could be subdivided into 15 categories, which could be grouped into 4 general themes: 1) experiences with current patient education, 2) expectations of AR in patient education, 3) opportunities and limitations of AR, and 4) out-of-hospital use of an AR application. Patients' expectations were predominantly positive regarding improving patients' understanding of their medical situation and doctor-patient communication. Discusssion: This study suggests that patients with unruptured intracranial aneurysms are open to receive patient education regarding their disease with AR. Patients expect that AR models can help patients with intra-cranial aneurysms better understand their disease, treatment options and risks. Additionally, patients expect AR could improve doctor-patient communication.

Three Dimensional Printing as a Tool For Anatomical Training in Lung Surgery.

Objective: Pulmonary anatomy is challenging, due to the high variability and its three-dimensional (3D) shape. While demands in thoracic oncologic surgery are increasing, the transition from open to thoracoscopic surgery is hampering anatomical understanding. This study analyzed the value of a 3D printed lung model in understanding and teaching anatomy. Methods: A 3D pulmonary model was created and tested among different levels of proficiency: 10 experienced surgeons, 10 fellow surgeons and 10 junior residents. They were tested in interpretation of anatomy based on thoracic CT-scans, either using the 3D model or a 2D anatomical atlas. Accuracy of the given answers, time to complete the task and the self-reported level of certainty were scored in each group. Results: In the experienced surgeons group there was no difference in between the 2D-model or 3D-model with a high rate of correct answers in both groups, and no differences in time or certainty. Fellow surgeons highly benefitted from the 3D-model with an improved accuracy from 26.6% to 70.0% (p = 0.001). Time to complete the task was shorter (207 versus 122 s, p < 0.0001) and participants were more secure (median of 4 versus 3, p = 0.007). For junior residents time to complete the task was shorter, the level of certainty was higher, but there was no improvement in accuracy. Conclusions: 3D printing may benefit in understanding anatomical relations in the complex anatomy of the bronchiopulmonary tree, especially for surgeons in training and could benefit in teaching anatomy. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01807-x.

Skeletal structure of asymmetric mandibular prognathism and retrognathism.

BACKGROUND: This study aimed to compare the skeletal structures between mandibular prognathism and retrognathism among patients with facial asymmetry. RESULTS: Patients who had mandibular asymmetry with retrognathism (Group A) in The Netherlands were compared with those with deviated mandibular prognathism (Group B) in Korea. All the data were obtained from 3D-reformatted cone-beam computed tomography images from each institute. The right and left condylar heads were located more posteriorly, inferiorly, and medially in Group B than in Group A. The deviated side of Group A and the contralateral side of Group B showed similar condylar width and height, ramus-proper height, and ramus height. Interestingly, there were no inter-group differences in the ramus-proper heights. Asymmetric mandibular body length was the most significantly correlated with chin asymmetry in retrognathic asymmetry patients whereas asymmetric elongation of condylar process was the most important factor for chin asymmetry in deviated mandibular prognathism. CONCLUSION: Considering the 3D positional difference of gonion and large individual variations of frontal ramal inclination, significant structural deformation in deviated mandibular prognathism need to be considered in asymmetric prognathism patients. Therefore, Individually planned surgical procedures that also correct the malpositioning of the mandibular ramus are recommended especially in patients with asymmetric prognathism.

Views on Augmented Reality, Virtual Reality, and 3D Printing in Modern Medicine and Education: A Qualitative Exploration of Expert Opinion.

Although an increased usage and development of 3D technologies is observed in healthcare over the last decades, full integration of these technologies remains challenging. The goal of this project is to qualitatively explore challenges, pearls, and pitfalls of AR/VR/3D printing applications usage in the medical field of a university medical center. Two rounds of face-to-face interviews were conducted using a semi-structured protocol. First an explorative round was held, interviewing medical specialists (8), PhD students (7), 3D technology specialists (5), and university teachers (3). In the second round, twenty employees in high executive functions of relevant departments were interviewed on seven statements that resulted from the first interviewing round. Data analysis was performed using direct content analyses. The first interviewing round resulted in challenges and opportunities in 3D technology usage that were grouped in 5 themes: aims of using AR/VR/3D printing (1), data acquisition (2), data management plans (3), software packages and segmentation tools (4), and output data and reaching end-user (5). The second interviewing round resulted in an overview of ideas and insights on centralization of knowledge, improving implementation of 3D technology in daily healthcare, reimbursement of 3D technologies, recommendations for further studies, and requirement of using certified software. An overview of challenges and opportunities of 3D technologies in healthcare was provided. Well-designed studies on clinical effectiveness, implementation and cost-effectiveness are warranted for further implementation into the clinical setting.

A learning curve in 3D virtual surgical planned orthognathic surgery.

OBJECTIVES: To assess the surgical accuracy of 3D virtual surgical planned orthognathic surgery and the influence of posterior impaction and magnitude of the planned movements on a possible learning curve. MATERIALS AND METHODS: This prospective cohort study included subjects who underwent bimaxillary surgery between 2016 and 2020 at the Department of Oral and Maxillofacial Surgery of the Radboud University Medical Center, Nijmegen. 3D virtual surgical planning (VSP) was performed with CBCT data and digitalized dentition data. By using voxel-based matching with pre- and postoperative CBCT data the maxillary movements were quantified in six degrees of freedom. The primary outcome variable, surgical accuracy, was defined as the difference between the planned and achieved maxillary movement. RESULTS: Based on 124 subjects, the surgical accuracy increased annually from 2016 to 2020 in terms of vertical translations (0.82 ± 0.28 mm; p = 0.038) and yaw rotations (0.68 ± 0.22°; p = 0.028). An increase in surgical accuracy was observed when combining all six degrees of freedom (p = 0.021) and specifically between 2016 and 2020 (p = 0.004). An unfavorable learning curve was seen with posterior impaction and with a greater magnitude of movements. CONCLUSION: The present study demonstrated a significant increase in surgical accuracy annually and therefore supports the presence of a learning curve. CLINICAL RELEVANCE: Cases with planned maxillary posterior impaction and/or a great magnitude of jaw movements should be transferred from the 3D VSP with extra care to obtain a satisfactory surgical accuracy.

Intraoral scanning of the edentulous jaw without additional markers: An in vivo validation study on scanning precision and registration of an intraoral scan with a cone-beam computed tomography scan.

Purpose: A fully digital approach to oral prosthodontic rehabilitation requires the possibility of combining (i.e., registering) digital documentation from different sources. This becomes more complex in an edentulous jaw, as fixed dental markers to perform reliable registration are lacking. This validation study aimed to evaluate the reproducibility of 1) intraoral scanning and 2) soft tissue-based registration of an intraoral scan with a cone-beam computed tomography (CBCT) scan for a fully edentulous upper jaw. Materials and Methods: Two observers independently performed intraoral scans of the upper jaw in 14 fully edentulous patients. The palatal vault of both surface models was aligned, and the inter-observer variability was assessed by calculating the mean inter-surface distance at the level of the alveolar crest. Additionally, a CBCT scan of all patients was obtained and a soft tissue surface model was generated using patient-specific gray values. This CBCT soft tissue model was registered with the intraoral scans of both observers, and the intraclass correlation coefficient (ICC) was calculated to evaluate the reproducibility of the registration method. Results: The mean inter-observer deviation when performing an intraoral scan of the fully edentulous upper jaw was 0.10 ± 0.09 mm. The inter-observer agreement for the soft tissue-based registration method was excellent (ICC=0.94; 95% confidence interval, 0.81-0.98). Conclusion: Even when teeth are lacking, intraoral scanning of the jaw and soft tissue-based registration of an intraoral scan with a CBCT scan can be performed with a high degree of precision.

Location and motion of vaginal pessaries in situ in women with successful and unsuccessful pessary treatment for pelvic organ prolapse.

INTRODUCTION AND HYPOTHESIS: The objective was to compare the location and motion of pessaries between women with pelvic organ prolapse (POP) with a successful (fitting) and unsuccessful (non-fitting) pessary treatment on dynamic magnetic resonance imaging (dMRI). METHODS: A cross-sectional exploratory study of 15 women who underwent a mid-sagittal dMRI of the pelvic floor at rest, during contraction and during Valsalva with three different types of pessaries. The coordinates of the pessaries cross section, inferior pubic point (IPP) and sacrococcygeal junction (SCJ) were obtained and the location (position, orientation) and the motion (translation and rotation) were calculated. Differences between the groups and between the pessaries within the groups were compared. RESULTS: Nine women with a fitting pessary and 6 women with a non-fitting pessary were selected. In the non-fitting group, the pessaries were positioned more caudally and rotated more in clockwise direction and descended more, but not significantly, during Valsalva compared with the fitting group. The Falk pessary was positioned more anteriorly in the fitting group and more cranially in the non-fitting group compared with the ring and ring with support pessary. CONCLUSIONS: A non-fitting pessary was positioned more caudally at rest; on Valsalva, it rotated more clockwise and moved more caudally, suggesting that the dynamic characteristics of the pessary might play an important role in its effectiveness. Findings of this study serve as a basis for the development of new pessary designs.

Automatic grading of patients with a unilateral facial paralysis based on the Sunnybrook Facial Grading System - A deep learning study based on a convolutional neural network.

PURPOSE: In order to assess the severity and the progression of a unilateral peripheral facial palsy the Sunnybrook Facial Grading System (SFGS) is a well-established grading system due to its clinical relevance, sensitivity, and robust measuring method. However, training is required in order to achieve a high inter-rater reliability. This study investigated the automated grading of facial palsy patients based on the SFGS using a convolutional neural network. METHODS: A total of 116 patients with a unilateral peripheral facial palsy and 9 healthy subjects were recorded performing the Sunnybrook poses. A separate model was trained for each of the 13 elements of the SFGS and then used to calculate the Sunnybrook subscores and composite score. The performance of the automated grading system was compared to three clinicians experienced in the grading of a facial palsy. RESULTS: The inter-rater reliability of the convolutional neural network was within the range of human observers, with an average intra-class correlation coefficient of 0.87 for the composite Sunnybrook score, 0.45 for the resting symmetry subscore, 0.89 for the symmetry of voluntary movement subscore, and 0.77 for the synkinesis subscore. CONCLUSIONS: This study showed the potential of the automated SFGS to be implemented in a clinical setting. The automated grading system adhered to the original SFGS, which makes the implementation and interpretation of the automated grading more straightforward. The automated system can be implemented in numerous settings such as online consults in an e-Health environment, since the model used 2D images captured from a video recording.

Development and validation of the patient-reported "Facial Function Scale" for facioscapulohumeral muscular dystrophy.

PURPOSE: Facial weakness and its functional consequences are an often underappreciated clinical feature of facioscapulohumeral muscular dystrophy (FSHD) by healthcare professionals and researchers. This is at least in part due to the fact that there are few adequate clinical outcome measures available. METHODS: We developed the Facial Function Scale, a Rasch-built questionnaire on the functional disabilities relating to facial weakness in FSHD. A preliminary 33-item questionnaire was created based on semi-structured interviews with 16 FSHD patients and completed by 119 patients. For reliability studies, 73 patients completed it again after a two-week interval. Data were subjected to semi-automated Rasch analysis to select the most appropriate item set to fit model expectations. RESULTS: This resulted in a 25-item unidimensional, linear-weighted questionnaire with high internal consistency (person separation index = 0.92) and test-retest reliability (patients' locations ICC = 0.98 and items' locations ICC = 0.99). Good external construct validity scores were obtained through correlation with the Communicative Participation Item Bank questionnaire, examiner-reported Facial Weakness Score and facial weakness subscale of the FSHD evaluation score (respectively r = 0.733, r = -0.566, and r = 0.441, all p < 0.001). CONCLUSIONS: This study provides a linear-weighted, clinimetrically sound, patient-reported outcome measure on the functional disabilities relating to facial weakness in FSHD, to enable further research on this relevant topic.Implications for rehabilitationFacial weakness and its functional consequences are an often underappreciated clinical feature of facioscapulohumeral muscular dystrophy (FSHD), both in symptomatic treatment and in research.To enable the development and testing of therapeutic symptomatic interventions for facial weakness, clinical outcome measures are required.This study provides a linear-weighted, clinimetrically sound, patient-reported outcome measure on the functional disabilities relating to facial weakness in FSHD patients.

Entry Point Variation in the Osseous Fixation Pathway of the Anterior Column of the Pelvis-A Three-Dimensional Analysis.

Fractures of the superior pubic ramus can be treated with screw insertion into the osseous fixation pathway (OFP) of the anterior column (AC). The entry point determines whether the screw exits the OFP prematurely. This can be harmful when it enters the hip joint or damages soft tissues inside the lesser pelvis. The exact entry point varies between patients and can be difficult to ascertain on fluoroscopy during surgery. The aim of this study was to determine variation in the location of the entry point. A retrospective single center study was performed at a level 1 trauma center in the Netherlands. Nineteen adult patients were included with an undisplaced fracture of the superior pubic ramus on computer tomography (CT)-scan. Virtual three-dimensional (3D) models of the pelvises were created. Multiple screws were placed per AC and the models were superimposed. A total of 157 screws were placed, of which 109 did not exit the OFP prematurely. A universally reproducible entry point could not be identified. A typical crescent shaped region of entry points did exist and was located more laterally in females when compared to males. Three-dimensional virtual surgery planning can be helpful to identify the ideal entry points in each case.

3D stereophotogrammetry in children and adolescents with Scleroderma En Coup De Sabre/Parry-Romberg Syndrome: Description of a novel method for monitoring disease progression.

Background: The diagnosis of Scleroderma En Coup de Sabre (ECDS)/Parry Romberg Syndrome (PRS) is mainly based on characteristic clinical findings. Methods to objectively monitor the course of the disease in a standardized way are lacking. Objectives: This descriptive, retrospective, single centre cohort study aims to describe the contribution of 3D photographs in the assessment of the degree of facial asymmetry changes over time in growing children and adolescents with ECDS and PRS. Methods: Six patients diagnosed with ECDS/PRS, with a follow-up period of at least 24 months and at least three 3D photographs were included. Mirroring these 3D photographs was automatically performed using surface-based matching to generate a colour-coded distance map, illustrating the inter-surface distance and thereby asymmetry between the original and mirrored 3D photographs. The percentage of absolute distances between the original and mirrored 3D photograph were calculated. Results: In two patients, impressive decreases in the percentages of absolute distance levels over time were found, whereas the other patients did not show progression of asymmetry over time. Conclusion: This study shows the potential of 3D stereophotogrammetry as an objective tool to measure disease activity over time in patients with ECDS/PRS.

A semi-automatic three-dimensional technique using a regionalized facial template enables facial growth assessment in healthy children from 1.5 to 5.0 years of age.

Objectives: To develop a semi-automatic technique to evaluate normative facial growth in healthy children between the age of 1.5 and 5.0 years using three-dimensional stereophotogrammetric images. Materials and Methods: Three-dimensional facial images of healthy children at 1.5, 2.0, 2.5, 3.0, 4.0 and 5.0 years of age were collected and positioned based on a reference frame. A general face template was used to extract the face and its separate regions from the full stereophotogrammetric image. Furthermore, this template was used to create a uniform distributed mesh, which could be directly compared to other meshes. Average faces were created for each age group and mean growth was determined between consecutive groups for the full face and its separate regions. Finally, the results were tested for intra- and inter-operator performance. Results: The highest growth velocity was present in the first period between 1.5 and 2.0 years of age with an average of 1.50 mm (±0.54 mm) per six months. After 2.0 years, facial growth velocity declined to only a third at the age of 5.0 years. Intra- and inter-operator variability was small and not significant. Conclusions: The results show that this technique can be used for objective clinical evaluation of facial growth. Example normative facial averages and the corresponding facial growth between the age 1.5 and 5.0 years are shown. Clinical Relevance: This technique can be used to collect and process facial data for objective clinical evaluation of facial growth in the individual patient. Furthermore, these data can be used as normative data in future comparative studies.

Reproducibility of Manual Transfer of the Clinical Natural Head Position: Influence on the Soft Tissue and Hard Tissue Position of 3-Dimensional Virtual Surgical Planning.

PURPOSE: The purpose of this study was to assess the reproducibility of manually transferring the clinical natural head position (NHP) to the 3-dimensional (3D) virtual surgical planning and its subsequent influence on the soft tissue and maxillary hard tissue position. METHODS: A retrospective cohort study was set up. The study population consisted of subjects who underwent bimaxillary osteotomies between 2016 and 2020 at the Department of Oral and Maxillofacial Surgery in Radboud University Medical Centre (Nijmegen, the Netherlands). Cone beam computed tomography scans, dentition data, and clinical photographs were acquired 4 weeks before surgery. Two attempts (NHP1 and NHP2) were performed by a single examiner to manually transfer the NHP. 3D transformation matrices were used to quantify the transferred NHP in 3 degrees of freedom (pitch, roll, and yaw). Landmarks and surface-based matching were used to quantify the influence on the soft tissue and hard tissue positions in 6 degrees of freedom. The primary outcome variable was the reproducibility of manually aligning the NHP. The secondary and tertiary outcome variables were the effect of the reproducibility of the manually aligned NHP on the soft tissue and hard tissue displacements in the 3D virtual surgical planning. RESULTS: The study population consisted of 109 subjects: 37 males (33.9%) and 72 females (66.1%) with a mean age of 29.1 ± 10.3 years (range, 17.0 to 59.0). The manual transfer of pitch alignment (2.24 ± 1.64°; 95% confidence interval [CI], 1.93 to 2.55) was significantly less reproducible than the roll (0.56 ± 0.44°; 95% CI, 0.48 to 0.64; P < .001) and yaw (0.67 ± 0.92°; 95% CI, 0.50 to 0.85; P < .001). Subsequently, this alignment error influenced the position of the maxilla (incisal point) and soft tissue menton by 0.85 ± 0.86 mm and 1.01 ± 1.00 mm vertically and 0.78 ± 1.10 mm and 0.80 ± 1.18 mm sagittally. CONCLUSIONS: The present study demonstrated that the manual transfer of the NHP from the clinical situation to the virtual environment influenced the soft tissue and hard tissue position and that a more reproducible method of transferring the clinical NHP is recommended.

Static and Motion Facial Analysis for Craniofacial Assessment and Diagnosing Diseases.

Deviation from a normal facial shape and symmetry can arise from numerous sources, including physical injury and congenital birth defects. Such abnormalities can have important aesthetic and functional consequences. Furthermore, in clinical genetics distinctive facial appearances are often associated with clinical or genetic diagnoses; the recognition of a characteristic facial appearance can substantially narrow the search space of potential diagnoses for the clinician. Unusual patterns of facial movement and expression can indicate disturbances to normal mechanical functioning or emotional affect. Computational analyses of static and moving 2D and 3D images can serve clinicians and researchers by detecting and describing facial structural, mechanical, and affective abnormalities objectively. In this review we survey traditional and emerging methods of facial analysis, including statistical shape modeling, syndrome classification, modeling clinical face phenotype spaces, and analysis of facial motion and affect.

The role and effectiveness of augmented reality in patient education: A systematic review of the literature.

OBJECTIVES: To provide an overview of the existing research concerning the use and effects of AR in patient education. METHODS: Following PRISMA guidelines four electronic databases were systematically searched. INCLUSION CRITERIA: empirical studies using any type of AR intervention in patient education across all medical specialties. Quality assessment of the retrieved literature was carried out. RESULTS: Ten papers, comprising 788 patients, were identified and included (Randomized controlled trial (RCT)(n = 3), non-randomized controlled trial (n = 3), before-and-after study (n = 3), and qualitative survey (n = 1)). Retrieved literature showed itself to be highly heterogeneous. The studied population included patients suffering from a diverse spectrum of chronic diseases (e.g., prostate cancer, diabetes mellitus, multiple sclerosis, epilepsy). Quantitative results indicated that the use of AR had a positive effect on knowledge retention and patient satisfaction. Qualitative findings suggested that patients liked the technology and felt comfortable with its use for educational purposes. The quality of the retrieved results was shown to be moderate to low. CONCLUSION: The limited evidence of this topic suggests the possible potential of AR in patient education. PRACTICE IMPLICATION: More research, using high-quality study designs and more evidence-based interventions, is needed to fully appreciate the value of AR on patient education.