VR Therapies for IBD
AI-Enhanced Virtual Reality Cognitive Behavioral Therapy to Reduce Anxiety and Improve Quality of Life in Patients With Inflammatory Bowel Disease: A Multicenter Pilot and Feasibility Study
Panoramica dello studio
Stato
Condizioni
Intervento / Trattamento
Descrizione dettagliata
In this pilot randomized controlled trial (RCT), the investigators aim to test the feasibility and preliminary clinical impact of a novel virtual reality (VR) cognitive behavioral therapy (CBT) program supported by artificial intelligence (AI) vs. distraction VR control among patients with IBD and anxiety.
The investigators will conduct this pilot RCT with 76 participants with with IBD and anxiety to achieve the following aims: Aim 1-Establish the feasibility of using an 8-week VR/AI CBT program among patients with IBD and anxiety; Aim 2-Acquire preliminary data assessing the clinical impact of an 8-week VR/AI CBT program vs. distraction VR control among patients with IBD with anxiety.; Aim 3-Acquire exploratory data assessing the biomarker impact of an 8-week VR/AI CBT program vs. distraction VR control among IBD patients with anxiety.
Participants will be randomized 1:1 to each study arm via the REDCap randomization module with allocation tables created by PASS. Block randomization will be used with random permuted block sizes of 6, 8, or 10, accounting for 20% additional subjects from the original sample size to allow for dropouts. The investigators will stratify randomization by sex to ensure balance in each arm. The investigators will also stratify randomization by current use of psychotropic or mental health medications/ prior psychotherapy to maintain balance.
Assessments will be performed at baseline and bi-weekly during the 8-week study period; this is a common treatment length for VR trials. While IBD is a chronic disease, the investigators must first assess the potential efficacy of the 8-week intervention in this pilot trial before evaluating durability in a definitive efficacy RCT.
Tipo di studio
Iscrizione (Stimato)
Fase
- Non applicabile
Contatti e Sedi
Contatto studio
- Nome: Samuel Eberlein, MSHS
- Numero di telefono: 310-423-6721
- Email: Samuel.Eberlein@cshs.org
Backup dei contatti dello studio
- Nome: Karisma K Suchak, MD, MSHS
- Numero di telefono: 310-423-0714
- Email: karisma.suchak@cshs.org
Luoghi di studio
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California
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Los Angeles, California, Stati Uniti, 90048
- Cedars-Sinai Medical Center
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Contatto:
- Samuel Eberlein, MSHS
- Numero di telefono: 310-423-6721
- Email: Samuel.Eberlein@cshs.org
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Contatto:
- Karisma K Suchak, MD, MSHS
- Numero di telefono: 310-423-0714
- Email: karisma.suchak@cshs.org
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Investigatore principale:
- Brennan Spiegel, MD, MSHS
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Illinois
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Chicago, Illinois, Stati Uniti, 60637
- University of Chicago
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Investigatore principale:
- David Rubin, MD
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Contatto:
- Alexandra McDermott
- Numero di telefono: 847-409-0284
- Email: Alexandra.Mcdermott@bsd.uchicago.edu
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Criteri di partecipazione
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
Inclusion Criteria:
- Stated willingness to comply with all study procedures, VR therapy regimen, and availability for the duration of the study
- Age of 18 years or older
- Confirmed diagnosis of IBD with concurrent anxiety, defined as a GAD-7 score of ≥10
- Ability to read and write in English (VR/AI CBT program is currently only available in English)
- Access to an internet-enabled device (android or iOS smartphone, or personal laptop or desktop computer) to complete surveys and has access to internet and email complete baseline and assessment surveys.
Exclusion Criteria:
- Have a condition that interferes with the safe use of VR usage, such as history of seizures, facial injuries precluding headset placement, significant visual or hearing impairment that impacts ability to see the VR images or follow audio instructions
- Have cognitive impairments that would affect protocol participation.
- Currently engaged in psychotherapy (Patients who are taking medications for anxiety or have previously engaged in psychotherapy but are not currently in therapy will remain eligible).
- Have had an IBD related surgery (including perianal surgery) within the past 6 months or anticipated in the next 6 months
- Anticipated to change their IBD inflammatory treatment during the study period.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Triplicare
Armi e interventi
Gruppo di partecipanti / Arm |
Intervento / Trattamento |
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Sperimentale: VR/AI CBT
The VR/AI CBT program will be delivered through the Meta Quest 2 device and is self-administered and includes a network of environments arranged in a virtual clinic that participants experience at home though a protocolized, 8-week program.
Depending on the module, experiences within the program last between 10-20 minutes.
Participants will be prompted to regularly use the headset each week over the 8-week study period.
The VR modules are reinforced with regularly scheduled messages and CBT exercises delivered by a webapp that is available on any smartphone or computer.
The program progressively builds new skills and culminates in transitioning from using VR to applying the skills learned in VR to everyday life.
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8-week protocolized VR/AI CBT program
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Comparatore fittizio: Distraction VR
Participants in the distraction VR group will receive the same Meta Quest 2 device but will only have access to a distraction-based VR therapy program that includes 2D nature videos (e.g., relaxing on a beach, swimming with dolphins).
Similar to the VR/AI CBT arm, people in the distraction VR group will be prompted to regularly use the headset each week for the 8-week treatment period.
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Distraction-based VR program with 2D nature videos to be used for 8-weeks for 10-20 minutes per week.
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Cosa sta misurando lo studio?
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Generalized Anxiety Disorder-7 (GAD-7)
Lasso di tempo: Bi-weekly; Baseline through Week 8
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The GAD-7 is a 7-item scale for screening and assessing the severity of generalized anxiety disorder.
It has a 2-week recall period and is scored on a 0-21 scale-0-4: minimal anxiety; 5-9: mild; 10-14: moderate; 15-21 severe.
It has high reliability and criterion validity across many clinical contexts.
The minimal clinically important difference (MCID) is 4 points.
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Bi-weekly; Baseline through Week 8
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System Usability Scale (SUS)
Lasso di tempo: Week 8
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The SUS is a validated, widely-used ten-item Likert scale giving a global view of assessments of usability, with each item rated on a scale of 0 to 5. Higher scores indicate greater usability.
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Week 8
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Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Short Inflammatory Bowel Disease Questionnaire (SIBD-Q)
Lasso di tempo: Baseline, Week 4, and Week 8
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The SIBDQ is a 10-item, disease-targeted Health-Related Quality of Life (HRQoL) measure that evaluates 4 domains: bowel symptoms, systemic symptoms, emotional function, and social function. Each item is rated on a 7-point Likert scale, with total scores ranging from 10 to 70, higher scores indicate a better HRQoL and fewer IBD symptoms. The SIBDQ has been validated to detect meaningful changes in HRQoL in an outpatient setting. The full version IBDQ, has been validated for its excellent internal consistency, test-retest reliability, and construct validity, distinguishing between active disease and remission, as well as convergent and divergent validity. The IBDQ is widely validated in clinical trials and real-world settings, making it a robust tool for assessing changes in HRQoL. |
Baseline, Week 4, and Week 8
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Patient Reported Outcome 2 (PRO2 for Ulcerative Colitis)
Lasso di tempo: Baseline, Week 4, and Week 8
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The PRO-2 is a simplified PRO measure used to assess Ulcerative Colitis (UC) activity.
The PRO-2 focuses on rectal bleeding (ranging from 0-3; higher score indicates worse severity of bleeding) and average daily stool frequency.
This tool provides a quick and reliable assessment of patient-reported disease activity.
The PRO-2 has been validated against clinical markers of disease activity, such as endoscopic findings and biomarkers, and is sensitive to detecting changes in UC symptoms.Total PRO-2 scores range from 0 to 6, with higher scores indicating worse ulcerative colitis symptom severity.
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Baseline, Week 4, and Week 8
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Patient Reported Outcome 3 (PRO3 for Crohn's Disease)
Lasso di tempo: Baseline, Week 4, and Week 8
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The PRO-3 is a simplified PRO measures used to assess Crohn's Disease activity.
The PRO-3 evaluates: abdominal pain (ranging from 0-3 with higher scores indicating worse abdominal pain), stool frequency (number of liquid or soft stools per day), and general well-being (5-point scale ranging from 0-4, higher score indicates worse general well-being).
The PRO-3 has been validated against clinical markers of disease activity, such as endoscopic findings and biomarkers, and is sensitive to detecting changes in Crohn's Disease symptoms.
Higher overall PRO-3 scores indicate worse Crohn's disease symptom severity.
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Baseline, Week 4, and Week 8
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29-item Patient Reported Outcomes Measurement System v2.1(PROMIS-29)
Lasso di tempo: Baseline, Week 4, and Week 8
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The PROMIS-29 is a validated 29-item questionnaire to assess general Health-Related Quality of Life (HRQoL) and treatment response in individuals with IBD. The assessment includes questions in each of the following domains: physical function, anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, pain interference, and pain intensity. 28 of the items use a 5-point Likert response scale that is T-scored, 1-5 with higher T-scores representing more of the domain measured (higher physical function/ability to participate in social roles and activities= better; higher anxiety/depression/fatigue/sleep disturbance/ pain interference=worse). Pain intensity uses a numeric rating scale, 0 to 10 with higher scores indicating greater pain intensity. |
Baseline, Week 4, and Week 8
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Visceral Sensitivity Index (VSI)
Lasso di tempo: Baseline, Week 4, and Week 8
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GI symptom-specific anxiety as measured by the VSI.
The VSI is 15 items, rated on 6-point Likert scale ranging from 1 (strongly agree) to 6 (strongly disagree).
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Baseline, Week 4, and Week 8
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Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
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Serum C-Reactive Protein (CRP)
Lasso di tempo: Baseline and Week 8
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A blood test that measures for systemic inflammation.
CRP is a protein made by the liver, and increases when there is inflammation in the body.
This biomarker is routinely used in clinical settings to monitor IBD activity and predict relapses.
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Baseline and Week 8
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Fecal Calprotectin (fCal)
Lasso di tempo: Baseline and Week 8
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A stool sample that measures for gastrointestinal inflammation.
fCal is released by neutrophils in the intestine during inflammation.
This biomarker is routinely used in clinical settings to monitor IBD activity and predict relapses.
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Baseline and Week 8
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Collaboratori e investigatori
Sponsor
Collaboratori
Investigatori
- Investigatore principale: David Rubin, MD, University of Chicago
- Investigatore principale: Brennan Spiegel, MD, MSHS, Cedars-Sinai Medical Center
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Primo Inserito (Effettivo)
Aggiornamenti dei record di studio
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Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
- STUDY00004302
- 1R01DK144719-01 (Sovvenzione/contratto NIH degli Stati Uniti)
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