Using the Patient Augmented Reality and Vibratory Array (PARVA) to Improve Patient Experience During In-office Laryngology Procedures; Disparities in Female Pain Perception and its Implications for the Diagnosis and Treatment of Endometriosis

Gonzalez, Lauren, School of Engineering and Applied Science, University of Virginia
Baritaud, Catherine, EN-Engineering and Society, University of Virginia
Barker, Shannon, EN-Biomed Engr Dept, University of Virginia
Allen, Timothy, EN-Biomed Engr Dept, University of Virginia

A growing number of in-office procedures (IOPs) are taking the place of traditional operating room (OR) surgeries. For patients, this means lower costs, shorter wait times, and fewer risks, but without the general anesthesia that accompanies OR procedures, patients are more likely to experience significant discomfort. Thus, there is a need for non-pharmaceutical pain management techniques that address procedural anxiety and discomfort. The technical project involves the development and testing of a medical device that seeks to reduce these complaints. Accordingly, the sociotechnical research aims to highlight disparities in the way patient pain is assessed and treated and examine the implications these disparities have for diagnosis and treatment within the field of obstetrics and gynecology (OB/GYN). Together, the tightly coupled topics seek to approach pain management from both a physiological and societal perspective to identify shortcomings in how the medical field traditionally assesses and treats pain.
The technical report details the research, development, and validation of the Patient Augmented Reality and Vibratory Array (PARVA). The device is made up of two components that are designed to distract and ease the anxieties of patients during common laryngology IOPs: a wearable vibratory array and an augmented reality experience. To test the success of the device, the project team has received Institutional Review Board approval to conduct a patient study. The study involves a patient experience survey coupled with an analysis of the patient’s heart rate variability during the procedure.
After several iterations, the team has completed a final device prototype that meets the specifications designated at the beginning of the semester. Initial feedback from patients and practitioners indicates that most stakeholders believe the device will effectively reduce procedural discomfort. The formal patient study will take place after the undergraduate team graduates.
The response to the growth in IOPs has been generally positive as it allows patients to retain the autonomy that is lost when undergoing general anesthesia for OR procedures. However, the ability for patients to express pain and discomfort during procedures has exposed disparities in the way practitioners respond to that pain. The sociotechnical research deploys Bijker’s Social Construction of Technology framework to investigate the response to the diagnosis and treatment of pain in the OB/GYN specialty.
The findings suggest that the lack of objective pain assessment tools leaves the field vulnerable to physician biases that underestimate patients’ pain on the basis of gender, race, and obesity. A lack of women in biomedical research, both as primary investigators and clinical research participants, translates to women’s pain going largely unaddressed in terms of diagnosis and treatment technologies. The consequences, demonstrated by a case study of endometriosis patients, are that many women suffer with pain that they believe or have been convinced is normal when, in reality, it is an indication that something is wrong. Addressing stigmas surrounding women’s health is crucial to increasing research interest and funding, promoting patient self-advocacy, and reducing physician biases.
As new technologies, like the PARVA, emerge to address needs in pain management, considerations should be made for how they may hinder or promote a patient’s ability to communicate pain. Pain management should not serve as a substitute for treating the causes of pain. Thus, it is important to eliminate taboos as a barrier to developing diagnostic tools and treatments for women’s disorders.

BS (Bachelor of Science)
patient experience, in-office procedures, endometriosis, pain perception

School of Engineering and Applied Science
Bachelor of Science in Biomedical Engineering
Technical Advisors: Timothy Allen, Shannon Barker
STS Advisor: Catherine Baritaud
Technical Team Members: Kathryn Costanzo, Lauren Gonzalez, Marissa Marine

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