# Requirements for mHealth and Augmented Reality Apps for Patient Education Regarding Colorectal Cancer Surgery: Focus Group Study

## TL;DR

This study explores how mobile and augmented reality apps can better educate colorectal cancer patients about their surgery, focusing on what patients and doctors need from these tools.

## Contribution

The study identifies specific requirements for mHealth and AR apps based on patient and physician input, emphasizing personalized and interactive visualizations.

## Key findings

- Patients prefer interactive 3D and AR visualizations for detailed, personalized information throughout their treatment journey.
- Physicians favor simpler 2D images that integrate easily into their workflow.
- AR is seen as a supplementary tool for general anatomical and surgical overviews.

## Abstract

The purpose of preoperative informed consent is to provide patients with comprehensive information about their treatment, including risks and alternatives, to enable informed decision-making. However, studies have shown that patients are often unable to understand or remember important information. Mobile health (mHealth) and augmented reality (AR) apps have been identified as promising solutions to improve patient education and knowledge retention.

This study aims to identify the essential requirements for an mHealth app to support informed decision-making for patients with colorectal cancer, with a specific focus on the potential of AR for visualization. This research explores the patient and physician perspectives on these requirements, particularly regarding information delivery and visualization to guide app design.

A qualitative focus group study was conducted with groups of mostly patients with colorectal cancer and a physician’s group. Topics related to patient education were discussed, guided by a semistructured interview guide covering personal experience; information content; context of use; and acceptance and presentation of content, which included presenting various visualizations in 2D, 3D, and AR. The interviews were transcribed and analyzed using qualitative content analysis.

We conducted 4 focus groups with patients (n=23) and 1 focus group with physicians (n=7), for a total of 30 participants. Relevant informational content for the app and its presentation was identified. Patients consistently expressed a desire for personalized, detailed, and visual information about their condition and treatment tailored to their specific case throughout the treatment journey, so they could prepare for the informed consent discussion after diagnosis, prepare for treatment, access guidance and track progress during hospitalization, and access information and resources during recovery after treatment. Patients demonstrated a strong preference for interactive 3D visualizations, while physicians favored simpler 2D images that could be easily integrated into their existing workflow. AR visualizations were seen as a potential tool to provide a general overview of anatomy and surgical approaches but more as a novelty feature and a supplement to more traditional visualizations.

An ideal patient education app combines comprehensive content with interactive, customizable visualizations like 3D models and AR and should be accessible throughout a patient’s treatment journey. This study highlights the need for a patient-centered design that balances detailed information with ease of understanding and considering different preferences for visualization modalities and levels of detail.