3D telemedicine outperforms 2D telemedicine : a randomized crossover trial in reconstructive plastic surgery

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Lo, Steven and Britto, Andrea and Spina, Thiago and Graham, Catriona and Young, David and Rose, Anna and O’Dowd, Chris and Miller, Gillian and Shepperd, Mike and Cutler, Ben and Fowers, Spencer (2025) 3D telemedicine outperforms 2D telemedicine : a randomized crossover trial in reconstructive plastic surgery. Plastic and Reconstructive Surgery. ISSN 1529-4242 (https://doi.org/10.1097/PRS.0000000000012524)

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Abstract

One of the key barriers to adoption of Telemedicine remains patients’ preference for in-person consultations. To address this, an immersive 3D telemedicine system was co-developed with patients in order to improve the realism, quality and patient experience of remote consultations, and the benefits assessed in this randomised trial. Methods: 80 patients at Canniesburn Plastic Surgery Unit, UK, were recruited to a randomized crossover trial of 3D versus 2D Telemedicine consultations, from 2022 to 2023. Primary outcome was ‘presence’ using the Presence scale, which measured how closely a remote consultation resembled an in-person consultation. Secondary outcomes included included the validated Telehealth Usability Questionnaire (TUQ), Mental Effort Rating Scale and satisfaction scales. Results: ‘Presence’ score for 3D Telemedicine was significantly higher than 2D (p<0.001). Secondary outcomes were superior for 3D, including TUQ (p<0.001), Mental Effort (p<0.001) and satisfaction (p<0.001). Age, deprivation, education, gender and technology familiarity were not associated with any outcome measures, indicating inclusivity of the 3D technology. Subjective interviews indicated that 3D telemedicine – by virtue of allowing annotation and drawing on the patients’ own 3D model - aided understanding of complex surgery, allowing a more personalized medicine approach in the consent process. Conclusion: 3D Telemedicine improves the realism, interaction quality and experience of remote consultations relative to 2D Telemedicine, with significantly higher ‘presence’ and Telehealth Usability Questionnaire scores. Critically, as 3D Telemedicine more closely mimics reality, this may help overcome barriers to adoption related to patients’ preference for in-person consultations.

ORCID iDs

Lo, Steven, Britto, Andrea, Spina, Thiago, Graham, Catriona, Young, David ORCID logoORCID: https://orcid.org/0000-0002-3652-0513, Rose, Anna, O’Dowd, Chris, Miller, Gillian, Shepperd, Mike, Cutler, Ben and Fowers, Spencer;
CORE (COnnecting REpositories)