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Accepted for/Published in: JMIR Formative Research

Date Submitted: Sep 15, 2025
Open Peer Review Period: Sep 22, 2025 - Nov 17, 2025
Date Accepted: Jan 21, 2026
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Using a Wearable-Based Animated Patient Avatar to Improve Patients’ Perception of Vital Signs: Multicenter Computer-Based Study

Köhler J, Ebensperger M, Hunn CA, Delis A, Piekarski F, Massoth G, Raimann FJ, Zacharowski K, Tscholl DW, Roche TR

Using a Wearable-Based Animated Patient Avatar to Improve Patients’ Perception of Vital Signs: Multicenter Computer-Based Study

JMIR Form Res 2026;10:e84130

DOI: 10.2196/84130

PMID: 41818743

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Using a wearable-based animated patient avatar to improve patients’ perception of vital signs: A multicenter computer-based study

  • Johannes Köhler; 
  • Max Ebensperger; 
  • Cynthia A. Hunn; 
  • Achilles Delis; 
  • Florian Piekarski; 
  • Gregor Massoth; 
  • Florian J. Raimann; 
  • Kai Zacharowski; 
  • David W. Tscholl; 
  • Tadzio Raoul Roche

ABSTRACT

Background:

Visual Patient Avatar (VPA) is an innovative patient monitoring technology that translates numerical and waveform data into intuitive, avatar-based representations of patient conditions. Previous research indicates that this technology improves healthcare providers’ situation awareness compared to conventional monitoring methods. As patient-worn continuous vital sign monitoring continues to be developed, we introduce Visual Patient Wearable (VPW) to provide avatar-based visualization tailored to this application.

Objective:

The aim of this study was to evaluate whether a wearable-based animated patient avatar (VPW) can improve patients’ perception and recall of vital sign deviations compared to conventional monitoring methods, and to assess the usability and acceptance of this avatar-based visualization.

Methods:

This computer-based study included 67 patients from three academic hospitals in Central Europe. Participants were randomly assigned to the Visual Patient Wearable (VPW) or conventional monitoring group and viewed a standardized instructional video for their allocated method. They then completed four randomized clinical scenarios, each displayed for six seconds to simulate glance-based assessment. Accuracy in recalling vital sign deviations was measured, and VPW participants additionally rated the visualization using Likert scales.

Results:

VPW significantly improved the detection accuracy of vital sign deviations compared to standard monitoring layouts, from 47% [43, 50] to 63% [60, 67] p<0.001, with a risk ratio of 1.34 (95% confidence interval, 1.23, 1.47). Qualitative assessments indicated high levels of patient satisfaction across all six vital sign categories (4.04 [3.9 4.2] max. of 5 points) and strong positive notions in patients who had experienced VPA in their own anaesthetic care.

Conclusions:

This study showed VPW’s potential to enhance the early detection of vital sign deviations and to be well-received by potential users. The findings advocate for integrating avatar-based visualizations in continuous patient monitoring as adjunct tools. Patients considered the VPW as suitable for improving their awareness and strongly associated positive emotions with the avatar. Clinical Trial: Cantonal Ethics Commission of Zurich, Switzerland (Req-2024-00286), Bonn (2024-209-BO) and Frankfurt (2024-1759)


 Citation

Please cite as:

Köhler J, Ebensperger M, Hunn CA, Delis A, Piekarski F, Massoth G, Raimann FJ, Zacharowski K, Tscholl DW, Roche TR

Using a Wearable-Based Animated Patient Avatar to Improve Patients’ Perception of Vital Signs: Multicenter Computer-Based Study

JMIR Form Res 2026;10:e84130

DOI: 10.2196/84130

PMID: 41818743

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