Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jul 27, 2025
Date Accepted: Aug 24, 2026
Digital-Twin-Assisted Risk Disclosure in Adults Undergoing Elective Bronchoscopy: Multicenter Randomized Controlled Trial
ABSTRACT
Background:
A detailed text-based pre-bronchoscopy explanation of the risks can increase patient anxiety, which may have a detrimental effect on patient overall experience. Thus, this study aimed to evaluate the effect of a digital-twin-based bronchoscopy simulator-assisted risk disclosure on pre-bronchoscopy anxiety and post-operative satisfaction.
Objective:
To evaluate the effect of a digital-twin-based bronchoscopy simulator-assisted risk disclosure on pre-bronchoscopy anxiety and post-operative satisfaction.
Methods:
This prospective multicenter randomized controlled trial was conducted from June to July 2024 in China. Participants aged ≥18 years scheduled for elective local anesthesia bronchoscopy were randomly allocated to either the digital-twin informed-consent group (a written risk-information sheet and a visualization of the bronchoscopy procedure via a digital-twin-based bronchoscopy simulator that uses the patients’ chest CT data) or the conventional informed-consent group (a written risk-information sheet and oral risk disclosure). The primary outcome was the proportion of patients achieving the minimal clinically important difference (MCID) in anxiety levels measured using Visual Analogue Scale (VAS) score and Modified Amsterdam Pre-Operative Anxiety and Information Scale (APAIS) score. Satisfaction was also assessed.
Results:
A total of 122 patients were randomized to the digital-twin informed-consent group (n=61) and the conventional informed-consent group (n=61). Patients in digital-twin informed-consent group had significantly greater reduction in anxiety levels than those in conventional informed-consent group on both VAS (proportion achieving MCID: 49.18% vs 6.56%, P<0.001) and APAIS (54.10% vs 9.84%, P<0.001). Post-bronchoscopy satisfaction was only slightly but significantly higher in the digital-twin informed-consent group.
Conclusions:
Pre-bronchoscopy risk disclosure assisted with a digital-twin-based bronchoscopy simulator yielded significantly lower pre-bronchoscopy anxiety and higher post-bronchoscopy satisfaction than conventional methods. Clinical Trial: Trial Registration: ClinicalTrials.gov (NCT06441149).
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