Study designs of evaluations included in the review
The inclusion criteria were not defined in terms of study design.
Specific interventions included in the review
Studies of any form of VR or AV distraction were eligible for inclusion. The equipment used in primary studies of VR included head mounted display, motion sensing system with and without sound effects, liquid crystal display (LCD) glasses and various specified virtual environments. Studies of AV distraction used LCDs with and without sound and various specified virtual environments. Control treatments, where these existed, mostly consisted of no distraction.
Participants included in the review
Studies of participants of any age were eligible for inclusion. The included studies were undertaken in patients with a variety of conditions who were undergoing various procedures, as well as healthy volunteers in a laboratory who had pain induced by a tourniquet or cold pressure. The former included: burns patients undergoing wound debridement; dental patients; patients with cancer who were undergoing subcutaneous venous port access or lumbar punctures; a patient with cerebral palsy undergoing physiotherapy; patients undergoing gastric laboratory procedures; and patients with leg ulcers. Where reported, the participants were aged from 7 to 81 years. Several studies were in patients who had reported difficulty in dealing with pain.
Outcomes assessed in the review
Studies that explicitly assessed pain were eligible for inclusion. The included studies assessed pain using a variety of methods: visual analogue scales (VAS), Likert scale, Stress Symptom Rating Questionnaire, Fear of Pain Questionnaire, Dental Fear Survey, Children's Hospital of Eastern Ontario Pain Scale and Multidimensional Anxiety Scale for Children. The review also assessed anxiety, patient satisfaction and nausea.
How were decisions on the relevance of primary studies made?
The authors did not state how the studies were selected for the review, or how many reviewers performed the selection.