Piloting the Use of Patient-Specific Cardiac Models as a Novel Tool to Facilitate Communication During Cinical Consultations

Abstract

This pilot study aimed to assess the impact of using patient-specific three-dimensional (3D) models of congenital heart disease (CHD) during consultations with adolescent patients. Adolescent CHD patients (n = 20, age 15-18 years, 15 male) were asked to complete two questionnaires during a cardiology transition clinic at a specialist centre. The first questionnaire was completed just before routine consultation with the cardiologist, the second just after the consultation. During the consultation, each patient was presented with a 3D full heart model realised from their medical imaging data. The model was used by the cardiologist to point to main features of the CHD. Outcome measures included rating of health status, confidence in explaining their condition to others, name and features of their CHD (as a surrogate for CHD knowledge), impact of CHD on their lifestyle, satisfaction with previous/current visits, positive/negative features of the 3D model, and open-ended feedback. Significant improvements were registered in confidence in explaining their condition to others (p = 0.008), knowledge of CHD (p < 0.001) and patients' satisfaction (p = 0.005). Descriptions of CHD and impact on lifestyle were more eloquent after seeing a 3D model. The majority of participants reported that models helped their understanding and improved their visit, with a non-negligible 30% of participants indicating that the model made them feel more anxious about their condition. Content analysis of open-ended feedback revealed an overall positive attitude of the participants toward 3D models. Clinical translation of 3D models of CHD for communication purposes warrants further exploration in larger studies.

Keywords: 3D printing; Communication; Congenital heart disease; Rapid prototyping; Transition clinic.

Fig. 1

Example of 3D whole heart models manufactured by means of 3D printing, showing a normal heart from a healthy control for comparison purposes (a); a model of transposition of the great arteries repaired with arterial switch operation with Lecompte manoeuvre (b); a model of repaired tetralogy of Fallot (c)

Fig. 2

Statistically significant changes were observed in confidence (a), knowledge (b) and satisfaction (c) amongst participants comparing responses before (“Pre”) and after (“Post”) their consultation. Note for a 1 = Not at all confident – 5 = Very confident; for b each point represents a point in knowledge, as marked according to the correct name of primary diagnosis, correctly identified keywords and correct use of diagrams; for c1 = Very dissatisfied – 5 = Very satisfied. The red lines indicate average score

Fig. 3

Summary of participants’ level of agreement to different statements on 3D models