A Virtual Reality Education Experience Improves Colonoscopy Preparation and Detection Rates

Colonoscopy technology concept
Investigators assessed the efficacy of a virtual reality educational video at improving bowel preparation among patients scheduled for colonoscopies.

Better bowel preparation, improved compliance, and higher polyp and adenoma detection rates were observed among patients who watched a virtual reality (VR) educational video prior to colonoscopy. These findings were published in JAMA Network Open.

This prospective, single-blinded, randomized, single-center clinical trial was conducted at Peking Union Medical College Hospital in China between 2018 and 2020. Patients (N=346) undergoing colonoscopy were randomly assigned in a 1:1 ratio to receive conventional education plus VR (n=173) or conventional education alone (n=173) on colonoscopy preparation. Compliance, preparation, satisfaction, and detection rates were assessed.

The VR and control cohorts were aged mean 52.6 (SD, 11.4) and 50.5 (SD, 12.5) years, 48.6% and 50.3% were women, 29.5% and 27.7% reported long-term laxative use, 19.1% and 24.3% constipation, 19.1% and 20.2% diarrhea, 20.8% and 24.3% mucosanguineous feces, and 15.0% and 13.9% a history of abdominal operations, respectively.

Better Bowel Preparation Scores (BBPS) were higher among the VR cohort overall (mean, 7.61 vs 7.04; P =.002). Stratified by location, BBPS was improved in the ascending (mean, 2.29 vs 1.97; P <.001) and descending (mean, 2.66 vs 2.45; P =.001) colon among VR recipients. No difference was observed between groups for the transverse colon (P =.09).

A total of 118 polyps, 94 adenomas, 5 cancers, and 2 serrated adenomas were detected. Detection rates of polyps (41.9% vs 26.7%; P =.003) and adenomas (32.6% vs 22.1%; P =.03) were superior among the VR cohort. There were no differences in cancer or serrated adenoma detection rates.

VR recipients indicated they had increased satisfaction (mean, 8.68 vs 8.16; P =.01) and sleep quality scores (mean, 7.60 vs 7.08; P=.04); a higher compliance rate was also observed for the VR group (68.8% vs 50.3%; P <.001). No effect on willingness to accept subsequent colonoscopy was reported.

This study may not be generalizable, as this patient population had a relatively high level of education and economic status.

These data indicate that an educational VR tool may improve preparation and detection rates among patients undergoing colonoscopy.


Chen G, Zhao Y, Xie F, et al. Educating outpatients for bowel preparation before colonoscopy using conventional methods vs virtual reality videos plus conventional methods: a randomized clinical trial. JAMA Netw Open. 2021;4(11):e2135576. doi:10.1001/jamanetworkopen.2021.35576