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Wearable technologies provide users hands-free access to computer functions and are becoming increasingly popular on both the consumer market and in various industries. The medical industry has pioneered research and implementation of head-mounted wearable devices, such as Google Glass. Most of this research has focused on surgical interventions; however, other medical fields have begun to explore the potential of this technology to support both patients and clinicians.
Our aim was to systematically evaluate the feasibility, usability, and acceptability of using Google Glass in nonsurgical medical settings and to determine the benefits, limitations, and future directions of its application.
This review covers literature published between January 2013 and May 2017. Searches included PubMed MEDLINE, Embase, INSPEC (Ebsco), Cochrane Central Register of Controlled Trials (CENTRAL), IEEE Explore, Web of Science, Scopus, and Compendex. The search strategy sought all articles on Google Glass. Two reviewers independently screened titles and abstracts, assessed full-text articles, and extracted data from articles that met all predefined criteria. Any disagreements were resolved by discussion or consultation by the senior author. Included studies were original research articles that evaluated the feasibility, usability, or acceptability of Google Glass in nonsurgical medical settings. The preferred reporting results of systematic reviews and meta-analyses (PRISMA) guidelines were followed for reporting of results.
Of the 852 records examined, 51 met all predefined criteria, including patient-centered (n=21) and clinician-centered studies (n=30). Patient-centered studies explored the utility of Google Glass in supporting patients with motor impairments (n=8), visual impairments (n=5), developmental and psychiatric disorders (n=2), weight management concerns (n=3), allergies (n=1), or other health concerns (n=2). Clinician-centered studies explored the utility of Google Glass in student training (n=9), disaster relief (n=4), diagnostics (n=2), nursing (n=1), autopsy and postmortem examination (n=1), wound care (n=1), behavioral sciences (n=1), and various medical subspecialties, including, cardiology (n=3), radiology (n=3), neurology (n=1), anesthesiology (n=1), pulmonology (n=1), toxicology (n=1), and dermatology (n=1). Most of the studies were conducted in the United States (40/51, 78%), did not report specific age information for participants (38/51, 75%), had sample size <30 participants (29/51, 57%), and were pilot or feasibility studies (31/51, 61%). Most patient-centered studies (19/21, 90%) demonstrated feasibility with high satisfaction and acceptability among participants, despite a few technical challenges with the device. A number of clinician-centered studies (11/30, 37%) reported low to moderate satisfaction among participants, with the most promising results being in the area of student training. Studies varied in sample size, approach for implementation of Google Glass, and outcomes assessment.
The use of Google Glass in nonsurgical medical settings varied. More promising results regarding the feasibility, usability, and acceptability of using Google Glass were seen in patient-centered studies and student training settings. Further research evaluating the efficacy and cost-effectiveness of Google Glass as an intervention to improve important clinical outcomes is warranted.
Wearable technology is defined as any compact device, either in the form of a body sensor or head-mounted display, which provides a user information and allows user interaction via voice command or physical input [
Google Glass has distinguished itself from other head-mounted or heads-up wearable devices by providing users with a comfortable, unobtrusive, wireless platform that runs the Android operating system and displays virtual or augmented reality with little obstruction to normal vision [
Surgeons were among the first in the medical industry to incorporate Google Glass into their work. As a hands-free device that can react to voice commands, eye movements, and simple gestures, it is particularly attractive in environments where both hands are generally occupied with surgical tasks and maintaining sterility is of upmost importance [
While Google Glass is an exciting technology with a number of promising applications in medicine, it remains unclear which applications are most worth pursuing, what potential limitations are associated with its use, and the extent to which patients and clinicians might benefit from its use. The objectives of this review are to systematically evaluate the most recent evidence for the feasibility, usability, and acceptability of using Google Glass in nonsurgical settings, and determine its potential benefits, limitations, and future directions in these settings.
We followed the guidelines for the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) in the reporting of evidence across the studies we reviewed (
A librarian collaboratively developed the search strategies with the senior author (SB) and ran searches in the following databases in November 2015: PubMed MEDLINE, Embase, INSPEC (Ebsco), Cochrane Central Register of Controlled Trials (CENTRAL) on the Wiley platform, IEEE Explore, Web of Science, Scopus, and Compendex. An updated search of all databases was run in January 2017 to look for additional articles. Search strategies for all databases except MEDLINE were adapted from the PubMed MEDLINE strategy. All databases were searched back to 2013, when Google Glass was first released. No language limits were applied. The search strategy specified keywords related to Google Glass. We also reviewed the search strategies of previous studies to include additional terms. See
The inclusion criteria were as follows: (1) original research articles, (2) studies that were either randomized controlled trials, quasi-experimental studies, or pilot/feasibility studies (including single arm, pre-posttest), (3) Google Glass interventions, (4) nonsurgical study settings, and (5) clinical, usability, feasibility, and/or acceptability as primary or secondary outcome. The exclusion criteria included (1) technology-based interventions other than Google Glass, (2) surgical study settings, and (3) articles with more technical description of Google Glass but no clinical, usability, feasibility, and/or acceptability outcomes.
We used a standardized form for data extraction. Data items in the extraction form included the following: first author’s name, publication year, country, condition or disease focus of the study, purpose of the study, description of how Google Glass was used in the study as an intervention, participants’ age (when available), study design, study setting, duration of the study, and other study considerations. Two authors coded all included articles individually. Disagreements were resolved by discussion or by consultation with the senior author (SB), if needed. Quantitative and qualitative data analyses were conducted.
The literature search identified 852 references (
Summary of studies using Google Glass as patient-centered interventions.
Source (country) | Health condition | Study design | Study setting | Google Glass (GG) use |
Anam et al, 2014 |
Ophthalmology – visual impairment | Pilot/feasibility study | Laboratory | Monitors and reports nonverbal social cues to user |
Garcia and Nahapetian, 2015 |
Ophthalmology – visual impairment | Pilot/feasibility study | Patient home | Analyzes environment and reports the information to user to help them navigate a room |
Pundlik et al, 2016 |
Ophthalmology – visual impairment | Pilot/feasibility study | Laboratory | Magnifies user’s vision while completing a series of tasks |
Hwang and Peli, 2016 |
Ophthalmology – advanced age-related macular degeneration | Case study | Laboratory | Warps the vision of participants in efforts to improve vision |
Tanuwidjaja et al, 2014 |
Ophthalmology – colorblindness | Pilot/feasibility study | Laboratory | Helps participants identify colors |
Lazewatsky et al, 2014 |
Motor impairment | Pilot/feasibility study | Laboratory | Helps participants guide the robot personal assistant |
Gips et al, 2015 |
Motor impairment | Pilot/feasibility study | Laboratory | Allows people to operate a computer with only eye or head movements |
Sinyukov et al, 2016 |
Motor impairment – Locked-In Syndrome | Pilot/feasibility study | Laboratory | Uses voice control function of GG to allow people to navigate an electric wheelchair in indoor environments |
Malu and Findlater, 2015 |
Motor impairment – upper body impairment | Pilot/feasibility study | Laboratory | Uses touchpad and visual display to perform tasks on a computer/ mobile phone |
McNaney et al, 2014 |
Motor impairment – Parkinson’s Disease | Pilot/feasibility study | Varying locations (patient home, in public) | Helps in daily interactions and common activities |
McNaney et al, 2015 |
Motor impairment – Parkinson’s Disease | Pilot/feasibility study | Varying locations (patient home, in public) | Monitors user’s speech volume and provides feedback |
Zhao et al, 2016 |
Motor impairment – Parkinson’s Disease | Pilot/feasibility study | Laboratory | Provides visual and auditory cues to modulate gait |
Pervaiz and Patel, 2014 |
Motor impairment – Dysarthria | Pilot/feasibility study | Assisted living facility | Helps people be aware of their volume, notifies them when to raise it, and provides feedback to clinicians so they can adjust therapy |
Miranda et al, 2014 |
Psychiatric/Developmental – Social Anxiety Disorder (SAD) | Quasi-experimental | Laboratory | Monitors symptoms of SAD through blinking habits |
Voss et al, 2016 |
Psychiatric/Developmental – Children with Autism Spectrum Disorder (ASD) | Pilot/feasibility study | Patient home | Uses the video feature to monitor everyday life |
Mirtchouk et al, 2016 |
Eating monitoring | Pilot/feasibility study | Laboratory | Records head motion while participants eat |
Rahman et al, 2015 |
Eating monitoring | Pilot/feasibility study | Laboratory | Records user’s eating and drinking habits through head movements |
Ye et al, 2015 |
Eating monitoring | Case study | Laboratory | Records head motion while participants eat |
Hernandez et al, 2014 |
Physiological measurements | Pilot/feasibility study | Laboratory | The accelerometer, gyroscope, and camera on GG are used to analyze the heart and respiration rate of user wearing the device |
Richer et al, 2015 |
Physiological measurements | Quasi-experimental study | Varying locations (patients’ everyday lives) | Serves as the “wearable extension” portion of the DailyHeart app |
Wiesner et al, 2015 |
Allergies | Pilot/feasibility study | Varying locations (drugstores selling cosmetic products) | Cross checks ingredients on cosmetic product package with a list of allergens created by the user in their online profile |
Flow of studies according to PRISMA guidelines.
Summary of studies using Google Glass as clinician-focused interventions.
Source (country) | Health condition | Study design | Study setting | Google Glass (GG) use |
Gillis et al, 2015 |
Disaster relief | Pilot/feasibility study | Laboratory | Allows for audiovisual communication with each group of paramedics and the administrator; the virtual beacon component is used to eliminate the use for paper triage tags |
Carenzo et al, 2014 |
Disaster relief | Pilot/feasibility study | Local – Field hospital | Scans triage tags to provide their information, timestamp, and Global Positioning System (GPS) coordinates and relay the information back to the hospital |
Cicero et al, 2014 |
Disaster relief | Pilot/feasibility study | Local – Airport | Facilitates communication with telemedicine physician disaster expert who can confirm the triage decision of the intervention team, and determines time of triage for each patient |
Newaz and Eide, 2015 |
Disaster relief | Randomized control trial | Local – Neighborhood | Provides navigation and maps to first responders |
Paxton et al, 2015 |
Behavioral sciences | Randomized control trial | Laboratory | Uses PsyGlass app to facilitate the use of GG in behavioral, cognitive, and social research |
Pappachan et al, 2014 |
Diagnostics | Pilot/feasibility study | Hospital – Emergency department | Helps community health workers to identify certain disorders based on the patient demographics |
Pascale et al, 2015 |
Nursing – Peripheral detection | Pilot/feasibility study | Laboratory | Improves detection in the periphery |
Yuan et al, 2015 |
Neurology | Case study | Hospital – Neurology | Facilitates communication between physicians during a neurological examination |
Chaballout et al, 2016 |
Student training – health science students | Pilot/feasibility study | Classroom (university) | Presents a simulation in conjunction with real time performance of treatment on a manikin |
Drake-Brockman et al, 2016 |
Anesthesiology | Pilot/feasibility study | Hospital – Anesthesiology | Uses heads-up display to facilitate monitoring patient vitals while performing procedures |
Iversen et al, 2016 |
Student training – physiotherapy students | Randomized control trial | Classroom (large, private, non-profit research university) | Captures 1st-person view of a procedure and displays it for learning purposes |
Son et al, 2015 |
Student training – otolaryngology residents | Pilot/feasibility study | Hospital - Otolaryngology | Uses the video capabilities to record resident encounters with patients |
Spaedy et al, 2016 |
Radiology | Quasi-experimental | Hospital – Radiology | Takes images of and displays X-rays for physician interpretation |
Russel et al, 2014 |
Student training – medical students (radiology) | Randomized controlled trial | Instructional testing room (University of Kentucky, School of Medicine) | Provides live instruction from an expert via Google Hangout |
Wu et al, 2014 |
Student training – medical students and radiology residents | Randomized controlled trial | Classroom (University of Arizona College of Medicine – Phoenix) | Facilitates procedures by showing real-time ultrasound images on the heads-up display |
Widmer et al, 2014 |
Dermatology and Radiology | Exploratory study | Laboratory | Takes and analyzes images to facilitate interpretation and diagnostic decisions by presenting similar images to user |
Stetler et al, 2015 |
Cardiology | Quasi-experimental | Hospital – Cardiology | Captures images of the electrocardiogram (ECGs) and presents them on heads-up display to facilitate interpretation |
Duong et al, 2015 |
Cardiology | Exploratory study | Hospital – Cardiology | Records coronary angiograms were recorded to be reviewed on the heads-up display or transferred to a mobile phone |
Jeroudi et al, 2014 |
Cardiology | Exploratory study | Remote (location varied by physician reviewer) | Displays ECG images for interpretation |
Vallurupalli et al, 2013 |
Student training – medical students (cardiology) | Case study | Hospital – Cardiology (University of Arkansas for Medical Sciences, Division of Cardiology) | Facilitates collaboration between cardiology attending and resident in clinical training settings |
Benninger, 2015 |
Radiology | Pilot/feasibility study | Anatomy laboratory (Medical School) | Displays images captured by an ultrasound finger probe to teach medical students anatomy and simple interventions |
Vaughn et al, 2016 |
Student training – nursing students | Pilot/feasibility study | Classroom (Nursing School) | Presents a simulation in conjunction with real-time performance of treatment on a manikin |
Zahl et al, 2016 |
Student training – dental students | Exploratory study | Dental office | Records student SP station for later analysis |
Feng et al, 2015 |
Diagnostics – Human immunodeficiency virus (HIV) and cancer | Exploratory study | Laboratory | Takes rapid diagnostic tests (RDTs), images prostate specific antigen (PSA) tests, and images previously activated free PSA and total PSA RDTs |
Spencer et al, 2014 |
Pulmonology – airway assessment for burn victims | Case study | Hospital – Burn unit (Massachusetts General Hospital) | Facilitates assessment and management of the airway |
Tully et al, 2015 |
Student training – medical students (hospice) | Randomized controlled trial | University of Arizona, College of Medicine: Phoenix and local hospice organization | Records student standardized patient encounters for later analysis |
Albrecht et al, 2014 |
Pathology – autopsy and postmortem examinations | Pilot/feasibility study | Hospital – Autopsy laboratory | Takes pictures of body for documentation during examination |
Aldaz et al, 2015 |
Chronic wounds | Pilot/feasibility study | Hospital – Wound care (Stanford Hospital and Clinics) | Uses SnapCap software to facilitate hands-free digital imaging and the tagging and transfer of images to patient’s electronic medical record in chronic wound care assessments |
Chai et al, 2015 |
Toxicology | Pilot/feasibility study | Hospital – Emergency department (urban academic hospital) | Sends photographs and videos to the toxicology supervisors; acts as a platform for instruction of 2nd-year medical staff |
Chai et al, 2015 |
Dermatology | Pilot/feasibility study | Hospital – Emergency department (urban academic hospital) | Allows teledermatolgosists to complete a dermatology assessment via live video feed after in-person consultation by a resident |
Summary of Google Glass approach as patient-centered interventions.
Source (health condition) | Purpose | Intervention description |
Anam et al, 2014 |
To allow people with vision impairments gain the ability to determine non-verbal expressions | Expression is the type of feature addition that is being used |
It analyzes changes in facial expression and relays that information in the form of captured frames to user | ||
Helps user change their posture to better capture the facial expression | ||
Garcia and Nahapetian, 2015 |
To help guide people with visual impairments navigate indoor environments | Extract floor regions from images captured from GG to help guide the individual |
An app is installed in GG that starts the camera and sends image frames to the mobile phone | ||
An app is also installed that analyzes the floor plans and then sends it to the mobile phone through Bluetooth | ||
Images that are captured contain the walls, floor, and ceiling | ||
Pundlik et al, 2016 |
To use vision magnification to aid in the completion of tasks | Leverages zoom capabilities of GG |
Students are assigned tasks that involve the calculator and music player apps | ||
Performance on these tasks is measured | ||
Hwang and Peli, 2016 |
To augment the vision of the wearer so that they have improved vision | Vision enhancement tool is added to GG |
Participant wears GG which now warps the camera image to improve vision | ||
Images that the vision enhancement tool sees are then relayed to user in real-time | ||
Tanuwidjaja et al, 2014 |
To help people with colorblindness see color | Alters the way people perceive color |
Applied Chroma, which is an app that detects color and relays that information to the participant | ||
Implemented the Ishihara test, which tests for color vision deficiency | ||
Implemented the Blackboard test that determines if a person can distinguish between green and orange | ||
Lazewatsky et al, 2014 |
To show that GG can be used in conjunction with the PR2 robot to recognize people and objects and then manipulate the space around it | GG Bridge Node receives sensor data from GG and transmits it to Robots and Systems software (ROS) messages and publishes a coordinate frame for GG |
ROS works with face detection; GG software also uses face detection and person recognition | ||
Gips et al, 2015 |
To help people operate a computer with only eye or head movements | Noggin software was developed to allow user to move a cursor across the screen through head movements |
Noggin displays yes, no, and enter on the screen | ||
Noggin uses the gyroscope to monitor head movements | ||
GG Gab, another software, allows user to spell out a message | ||
Sinyukov et al, 2016 |
To help patients have better control over their wheelchairs | Patient uses the software installed on GG in conjunction with the motorized wheelchair |
GG monitors facial expressions of the patient | ||
GG’s audio monitoring is used to understand voice commands and then relay the instructions to the motorized wheelchair | ||
Malu and Findlater, 2015 |
To assess the accessibility of GG for individuals with upper body motor impairments | Using voice commands and the touchpad to go through day-to-day activities |
Touchpad on GG was on the right arm of the device and senses taps and swipes through voice commands | ||
Output is projected on the heads-up display | ||
Participants completed tasks using swipes and tasks function | ||
Participants then used a scale to rate the comport and ease of the touchpad and visual display | ||
McNaney et al, 2014 |
To help people with PD counteract their symptoms by allowing them to carry out the normal functions of a mobile phone using voice commands, cueing for freezing gait | GG was used to manage social cues and alert the user |
GG monitored movement and told the participant when they were freezing so that they could actively try to stop the behavior | ||
McNaney et al, 2015 |
To help monitor speech loudness issues and provide feedback to help with self-management | Developed the LApp app that monitors loudness |
Participants used the app for a set amount of time while carrying out a series of social interactions | ||
Indicating when the volume was inappropriate so the user could adjust to hit the target loudness | ||
Zhao et al, 2016 |
To provide visual and auditory cues to aid in the modulation of gait | GG was used to detect gait issues and improve them through cueing |
Audiovisual cues were used, including a metronome, flashing light, optic flow, and a control (no cue) | ||
Participants underwent a series of walking tasks and their gait was then analyzed for stability and freezing | ||
Pervaiz and Patel, 2014 |
To help patients monitor their low volume in order to self-regulate and to provide clinicians with feedback to adjust therapy | Developed the SpeedOmeter software that compares vocal loudness to ambient noise |
Provides feedback to user on their volume | ||
System provides usage and performance history for user | ||
Notifies patient of their volume so they can adjust | ||
Miranda et al, 2014 |
To assess the feasibility of using GG to monitor blinking rates in individuals with social anxiety disorder | Monitor blinking behaviors |
Used to gather data from the infrared (IR) sensor | ||
The app dealt with IR data gathering, data processing, and HTTP communication | ||
App processes the data and calculates when the user blinked | ||
Voss et al, 2016 |
To monitor life activities and allow for analysis of autism behaviors | Participant uses GG to record everyday behaviors |
Caregiver reviews system highlights and emotional moments so they are easily accessible for the reviewer | ||
Caregivers can tag parts of the video that are especially important and add comments to the video | ||
Mirtchouk et al, 2016 |
To accurately track an individual’s eating habits and provide feedback to help with self-regulation | GG sensor was used to detect head movement that was specific to eating |
Participants ate what they wanted and when they wanted and GG was supposed to detect when they were eating and for how long | ||
Participants were allowed to do other activities when eating their meals | ||
Rahman et al, 2015 |
To detect a person’s eating and drinking habits | Records a person’s eating and drinking habits through head movements |
Helps people with obesity and diabetes | ||
Developed the Glass Eating and Motion (GLEAM) dataset | ||
Participants ate, walked, and did other activities during the monitoring period | ||
Participants did not interact with GG but simply wore it | ||
GG sensors recorded movement | ||
Ye et al, 2015 |
To detail eating habits to help weight reduction | Collects images of the person’s day from their perspective every 30 seconds |
Amazon’s Mechanical Turk is a human computation platform that can determine eating behaviors and is used to identify when a person is eating | ||
Hernandez et al, 2014 |
To measure heart rate and breaths per minute | Participant would wear GG, and GG’s accelerometer, gyroscope, and camera were used to find user’s pulse and respiratory rates |
The recording was done in several different positions including, sitting, standing, and lying down | ||
Richer et al, 2015 |
To use the DailyHeart app to monitor ECGs | GG presents ECG signals to user in everyday life |
Signals are processed in real-time and classify the user’s heart beats | ||
It will store data in an internal database | ||
Wiesner et al, 2015 |
To give consumers information of possible allergens in cosmetic products | An app is developed for GG whose purpose is to scan products |
User scans the product in the store and the GG app identifies the product | ||
User has uploaded the information of their specific allergies and the app compares the ingredients to the user’s profile | ||
GG indicates whether the user should buy the product and why |
Summary of Google Glass approach as clinician-centered interventions.
Source (health condition) | Purpose | Intervention description |
Gillis et al, 2015 |
To provide a hands-free way for doctors to be updated on the status and needed-care levels of critical-care patients | Developed a mesh network that covered a set area to allow communication between users and the hospital |
Users wore GG and could communicate with each other across the lake | ||
Users were then able to use the information they were getting in the field, record it, and relay it back to the hospital | ||
Carenzo et al, 2014 |
To aid in nontechnical skills in the management of disasters and mass casualty incidents | Used an app to GG to guide a Simple Triage and Rapid Treatment Triage visually |
Focused heavily on casualty identification, therefore the facial recognition capabilities for GG were used | ||
Visual information was then relayed to a secondary location for others to monitor | ||
Cicero et al, 2014 |
To streamline the triage system and then also offer consultations from an expert physician to those onsite | Paramedics used GG to communicate with an offsite physician disaster expert |
They assigned triage levels to victims using the SMART Triage System | ||
Offsite physician had an audio-video interface with paramedics so they could be observed in the offsite location | ||
Newaz and Eide, 2015 |
To provide direction to first responders in a new area | One group used GG as a tool for navigation |
The other group used a different device to navigate an unfamiliar neighborhood | ||
The route was preset on GG or the other device | ||
Paxton et al, 2015 |
To determine how interpersonal dynamics in conversation are affected by the environment | The app PsyGlass was created for GG |
The students wore GG and were presented with a series of red or blue lights as well as audio stimuli | ||
They had a conversation with the experimenter and their head movements were recorded through the GG accelerometer | ||
Pappachan et al, 2014 |
To assist community health workers to more efficiently diagnose patients | Uses Rafiki, a GG software that calculates age and gender and other characteristics to diagnose a patient |
Correlates between diseases, symptoms, and patients to determine the problem | ||
Pascale et al, 2015 |
To help clinicians, such as nurses, pay attention to multiple patients while away from their station | Provided stimuli in the periphery of the nurses |
GG was used to detect and notify the nurses when something was presented in their peripheral vision | ||
Yuan et al, 2015 |
To make a neurological examination as accurate as possible through collaboration | A woman that suffered a right-sided dysphagia and asthenia was in the emergency department with a suspected stroke |
A local physician lacking neurological knowledge used GG to establish a teleconsult with a remote specialist who guided the physician in evaluating the patient | ||
Chaballout et al, 2016 |
To teach health care students to respond to respiratory distress | Students watched a video while wearing GG |
Video showed a patient in respiratory distress | ||
Students then performed a procedure to aid respiratory distress on a manikin in front of them | ||
Drake-Brockman et al, 2016 |
To allow anesthesiologists to monitor vitals of patients during procedures | AnaeVis was developed to run on GG, which provides visualization of patient monitoring data |
Anesthetists wore the device while treating the patient and the signals were shown and recorded | ||
Iversen et al, 2015 |
To record 1st-person view of procedures demonstrated by instructors to relay to students for training purposes | Faculty member wore GG during the performance of clinical skills |
Video of clinical skill performance was then shown to students for the purpose of teaching | ||
Son et al, 2015 |
To improve otolaryngology resident training by capturing 1st-person recordings of clinic encounters for later evaluation | Residents were recorded in an outpatient clinic by patients |
Patients were then given a survey to complete that rated their satisfaction level with their visit | ||
Video information was evaluated by two different parties and a review was given back to residents | ||
Spaedy et al, 2016 |
To improve the efficiency of remote chest X-ray interpretation | Fellows reviewed 12 chest X-rays with 23 major findings by viewing the image on GG, viewing an image taken by GG on a mobile device, and viewing the original X-ray on a desktop computer |
One point was given for each major finding | ||
Russel et al, 2014 |
To determine if GG could provide telementoring instruction in bedside ultrasonography | Students wore GG and received real-time telementoring education |
Telementoring was done by an expert at a different location | ||
Students’ goal was to obtain best parasternal long axis cardiac imaging using a portable GE Vscan | ||
Wu et al, 2014 |
To minimize the amount of distraction caused by monitors during ultrasounds | Medical practitioner wore the GG during the ultrasound procedure |
GG screen projected images and video to the wearer | ||
Practitioner’s hand movements and eye movement were recorded to see if there was improvement | ||
Widmer et al, 2014 |
To improve diagnostics in dermatology and cardiology | Participants would wear GG during a consultation |
ParaDISE app was developed to be a medical image retrieval system | ||
GG’s visual and photo taking capabilities were utilized and then the photograph was sent into the interface and could be matched with similar images | ||
Those similar images were then sent to the wearer | ||
Stetler et al, 2015 |
To capture and facilitate the interpretation of ECGs | ECGs were selected that had important findings |
GG zoom capabilities were used to identify each finding | ||
Every time a participant identified a finding they received one point | ||
ECGs were captured using the video function of GG | ||
Duong et al, 2015 |
To facilitate the interpretation of coronary angiograms | GG’s video function was used to record angiograms with specific findings |
Students were then told to try to determine each of the findings in the angiograms | ||
Jeroudi et al, 2014 |
To facilitate the interpretation of ECGs | Physicians wore GG and looked at the ECG image on the screen |
Physicians wore GG and viewed a photograph of the ECG taken using GG and then viewed on a mobile device | ||
Results were then compared to other methods of viewing ECGs | ||
Vallurupalli et al, 2013, |
To improve resident training by streaming the view of residents during simulations to attending physicians for consultation | Residents wore GG while working through four scenarios in cardiovascular practice |
Live video of the scenarios taken by GG was streamed to a mobile phone or personal computer used by the attending physician | ||
Benninger, 2015 |
To facilitate teaching anatomy to medical students | Students familiarized themselves with GG for 10-30 minutes using a program called MiniGames |
Students were then given tutorials in groups of 3-5 while using GG with a finger probe to identify neuromuscular and organ structures and spaces in the limbs and cavities | ||
Students were tested during 7 separate laboratory examinations over 1 year to identify the same structures and practice procedures | ||
Vaughn et al, 2016 |
To increase the perception of realism in nursing student simulations | Students were allowed 10 minutes to familiarize themselves with GG before the intervention |
Students were then given the patient report and started the simulation in which GG projected a video of an acute asthma exacerbation scenario | ||
1-2 Certified Healthcare Simulation Experts evaluated students’ performance | ||
Zahl et al, 2016 |
To facilitate self- and peer-assessment of standardized patient (SP) interactions for dental students | 3rd-year dental students volunteered to record their SP encounter using GG while a traditional static camera simultaneously recorded |
All GG and static camera videos were later reviewed during Behavioral Patient Management small group discussions | ||
Students rated how effective each type of video was for assessing communication skills | ||
Feng et al, 2015 |
To improve the efficiency of immunochromatographic diagnostic test analysis | One or more RDTs, either HIV (qualitative) or PSA (quantitative), labeled with QR codes were imaged using GG |
Images were automatically transmitted to a digital server that located all RDTs and produced a quantitative diagnostic result, which was reported to user | ||
Spencer et al, 2014 |
To facilitate airway assessment of burn patients requiring surgery | GG was worn by physicians during two cases of burn patients requiring airway assessment |
Documentation of procedure by GG was evaluated after the intervention | ||
Tully et al, 2015 |
To facilitate medical student self-evaluation after end-of-life SP encounters | 2nd-year medical students participated in end-of-life SP encounters where the SP was wearing GG to record the encounter |
Students then reviewed GG and traditional videos | ||
Albrecht et al, 2014 |
To evaluate the feasibility of using GG in a forensics setting | Two physicians wore GG during 4 autopsy and postmortem examinations and took images using both GG and a traditional digital single lens reflex (DSLR) camera |
Six forensic examiners evaluated the images for quality | ||
Aldaz et al, 2015 |
To facilitate photo documentation of chronic wounds for long-term care | Wound care nurses used SnapCap software on GG to take images, tag, and transfer them to patient electronic medical records |
Image quality and ease of use were evaluated | ||
Chai et al, 2015 |
To facilitate toxicology teleconsultation in the emergency department | Emergency medicine residents wore GG while evaluating poisoned patients |
Real-time video of physician findings was transmitted to toxicology fellows and attendings for evaluation | ||
Chai et al, 2014 |
To facilitate dermatology teleconsultation in the emergency department | Patients first had a standard dermatology consultation (phone call and sometimes a static photo of the rash) with a dermatology resident |
Patients were then evaluated by the dermatology chief resident through a real-time video filmed by the patient (wearing GG) and viewed by the physician on a tablet |
Feasibility and acceptability of Google Glass as patient-centered interventions.
Source (health condition) | User satisfaction results |
Anam et al, 2014 |
Participants completed 5-point Likert scale on usability of the Expression system (a score of 5=the best): Learnability ‒ median 4.1, interquartile range (IQR) 0.7; Informativeness ‒ median 4.5, IQR 1.0; Usability ‒ median 4.6, IQR 0.7; User Satisfaction ‒ median 4.5, IQR 1.0; Willing to Use ‒ median 3.7, IQR 0.7. The relatively low score for “Willing to Use” can be attributed to perceived uncertainty in social acceptability of wearing a device such as GG. |
Tanuwidjaja et al, 2014 |
4/6 participants reported they found Chroma system useful in performing study tasks and would find it useful in everyday life. Two participants expressed concerns about system lag time in switching between modes. One participant did not find the system helpful because his vision test scores worsened when using Chroma. |
Malu and Findlater, 2015 |
Participants rated system features on a 5-point scale (1=very easy/comfortable to 5=very difficult/uncomfortable): Visual Display ‒ comfort median 2, mean 2.2, SD 1.2; ease median 2, mean 2.2, SD 1.2; Touchpad Gestures ‒ comfort median 3, mean 3, SD 2.2; ease median 2, mean 2.7, SD 1.9; Voice Commands ‒ ease median 1, mean 1.7, SD 1.2. For the reciprocal tapping task, most (N=8) found the large touchpad easiest to use, and most (N=7) found the large touchpad to be most physically comfortable. |
McNaney et al, 2014 |
Study exit interviews identified some concerns with usability of and patient satisfaction with GG. Some felt wearing GG in public drew unwanted attention, and 3/4 participants reported they would not wear GG in certain settings due to safety concerns. All participants experienced frustration when certain features, such as voice recognition and navigation, were difficult to use in everyday life or did not work. However, when the features were working properly, user satisfaction was high. GG enabled some to do things others without PD can do on mobile phones. Overall, reactions to GG were positive and showed appreciation for how GG could be used to help those with PD. |
McNaney et al, 2015 |
Study exit interviews revealed mixed reactions to LApp program, with some finding significant improvement in and confidence with their speech volume and others reporting the program performance was inconsistent. Additional frustrations were related to GG’s short battery life and difficulties navigating the touchpad because of PD-related tremors. |
Zhao et al, 2016 |
Most users found GG easy or very easy to use (N=7/11) and the instructions on screen clear or very clear to read (9/12). One user particularly liked the bone-conducting headphone because the metronome was less audible to others around. Some participants disliked GG’s placement of the visual display in the upper right corner (n=3) and suggested images be projected binocularly (n=1) or more focally (n=2) in the visual field. They suggested verbal instructions (n=9), rhythmic music (n=2), and postural feedback (n=1) as additional cues for the app and that cues be provided only when needed (n=2). |
Voss et al, 2016 |
Review of videos of participants using GG system at home showed that children reported positive experiences with the activities at home and stated they viewed the system as a toy. However, the device heated up to uncomfortable levels if worn too long. |
Richer et al, 2015 |
Participants completed a qualitative assessment of their experience using |
Feasibility and acceptability of Google Glass as clinician-centered interventions.
Source (health condition) | User satisfaction results |
Cicero et al, 2014 |
First responders using GG completed a survey assessment after the intervention, and their responses supported the idea that GG does not make a significant improvement in disaster triage. |
Yuan et al, 2015 |
Local physicians found that holding a mobile phone to provide the consulting specialist live images on GG was inconvenient. |
Teleneurohospitalists using GG did not feel the system allows for patient evaluation similar to what would be achieved in-person. | |
Chaballout et al, 2016 |
Participants were asked to complete 2 post-intervention surveys, a 13-item Student Satisfaction and Self-Confidence in Learning Scale and a 20-item Simulation Design Scale (scale for both measures was 1=strongly disagree to 5=strongly agree). Most students recommended continued use of GG in clinical simulations (N=10/12). They also reported high mean scores on the simulations’s design and satisfaction with the simulation to promote learning and self-confidence in learning. |
Simulation Design Scale (mean [SD]): Objectives and information ‒ 4.65 (0.18); Support ‒ 4.85 (0.04); Problem solving ‒ 4.53 (0.30); Feedback/guided reflection ‒ 4.85 (0.14); Fidelity (realism) ‒ 4.67 (0.12) | |
Student Satisfaction and Self-Confidence with Learning (mean [SD]): Satisfaction with current learning ‒ 4.67 (0.13); Self-confidence in learning ‒ 4.35 (0.60). | |
Drake-Brockman et al, 2016 |
Anesthetists participating in the intervention were asked to complete a survey including a Likert scale and freeform questions: 78% would use GG again, 58% would recommend GG to colleagues, 21% felt GG improved patient management, 90% reported GG was comfortable to wear, 86% reported that information presented on GG was easy to read, 56% would wear GG in view of patients, 75% felt positive about using GG in the operating room environment, 82.5% reported that wearing GG did not distract from patient management. |
Iversen et al, 2015 |
Students who used GG in the study answered questions about the technology after the intervention. 67% (26/39) of students evaluated GG video quality as not acceptable (score of ≤2 on the Likert scale), and 59% (23/39) of students reported using GG did not enhance their learning experience. |
Spaedy et al, 2016 |
Participants responded to a 5-point Likert scale about the quality of GG images and their confidence about their interpretation. When viewing images through GG, 87% (13/15) were dissatisfied with the image and unsure that such a small display would be able to provide the necessary level of detail. 80% (12/15) were impressed with image clarity taken via GG and viewed on the mobile device. |
Wu et al, 2014 |
Participants who used GG responded to a post-exercise survey. 87% reported GG was comfortable to use for ultrasound guidance. 88% reported they would be likely to use ultrasound visualization through GG as opposed to traditional monitors (18% very likely, 35% moderately likely, 35% somewhat likely). 78% indicated they would “very likely” be interested in future research studies involving GG in medical simulation and education. |
Stetler et al, 2015 |
Physicians responded to a 5-point user-experience Likert scale after the intervention. 58% (7/12) were satisfied with GG image quality of ECGs. 50% (6/12) were confident in their interpretation when using GG. |
Duong et al, 2015 |
Participants responded to a post-study survey regarding their satisfaction with image quality and comfort making clinical recommendations. 10% (1/10) were “neutral” regarding quality and giving recommendations. 60% (6/10) of physicians were “somewhat satisfied” and would be “somewhat comfortable” giving recommendations. 30% (3/10) were “very satisfied” and would be “very comfortable” giving recommendations. |
Jeroudi et al, 2014 |
Participants completed subjective ratings on a 5-point Likert scale regarding image quality and their confidence of ECG interpretation. 75% (9/12) were dissatisfied with the ECG image quality when viewing via GG. 83% (10/12) were not confident in their interpretation when viewing via GG. 58% (7/12) were neutral about ECG images taken by GG and viewed on mobile phones. 58% (7/12) were more confident in their interpretation when viewing the GG image on a mobile phone than when viewing via GG. |
Benninger, 2015 |
Participants responded to a 5-point Likert scale questionnaire. Did they enjoy the exposure to technology applying the triple feedback method? Average score 4.6. Would they prefer more time with the technology? Average score 4.8 |
Vaughn et al, 2016 |
After the intervention, students responded to 2 surveys, the Simulation Design Scale and the Self-Confidence in Learning Scale (both 5-point scales from 1=strongly disagree to 5=strongly agree), to assess their perception of GG in the simulation: Independent problem-solving was facilitated, 4.75 (0.45); Resembled a real-life situation, 4.75 (0.45); Teaching methods were helpful and effective, 4.67 (0.65); Teaching materials were motivating and helpful, 4.58 (0.90); Confidence in mastering simulation content: 4.42 (0.51); Develops skills/knowledge applicable to a clinical setting, 4.83 (0.39) |
Zahl et al, 2016 |
Students responded to 4 open- and closed-text items about using GG and static video for self- and peer-assessment. Students’ reported mean score was higher for GG recordings (84.61) than static video (79.74). Students reported that verbal communication was more easily assessed by reviewing GG video (23.87) than static video (22.17); paraverbal communication was more easily assessed by reviewing GG video (24.26) than static video (21.51); and nonverbal communication was more easily assessed by reviewing static video (19.78) than GG video (17.09). |
Tully et al, 2015 |
Students responded to a 5-point Likert scale on how distracting they found GG during the intervention. 23% (7/30) reported a “positive, nondistracting experience.” 37% (11/30) reported a “positive, initially distracting experience.” 17% (5/30) reported a “neutral experience.” 10% (3/30) reported a “negative experience.” After reviewing the videos filmed with GG, 70% (16/30) believed that GG is worth including in the clinical skills training program. |
Albrecht et al, 2014 |
Both participants agreed that GG was comfortable to wear but required more physical effort to capture images than a DSLR camera. |
Chai et al, 2015 |
Study participants completed a survey immediately after the consult about their experience viewing a teleconsult through GG: 94% (17/18) were confident in the toxidrome after GG consultation as compared to 56% (10/18) who were confident after phone consultation. |
Chai et al, 2014 |
All participants responded to a survey on acceptability of GG after their consultation. 93.5% (29/31) were overall satisfied with the video consultation. 22.6% (7/31) preferred care provided through mobile video communication technology over a standard face-to-face clinic visit. 74.2% (23/31) preferred care provided through mobile video communication technology over standard emergency department telephone consultation. 93.3% (28/31) would recommend the video consultation to others. 96.8% (28/30) felt comfortable that privacy was protected during the video encounter. 96.8% (30/31) were confident in the video equipment used. |
In recent years, wearable devices such as wrist-worn accelerometers and head-mounted devices have become increasingly popular for their applications to everyday life as well as to various industries. While Google Glass, one of the more well-known head-mounted wearable devices, has yet to successfully break into the consumer market, various industries are eager to harness its potential in their fields. Medicine is one such industry; however, far greater attention has been paid to surgical applications than to nonsurgical ones. In this systematic review, we assessed existing evidence of the usability, benefits, and limitations of Google Glass to support both patients and clinicians in nonsurgical medical settings. Overall, the evidence was somewhat limited by a small number of studies fitting all inclusion criteria, small sample sizes, and other methodological considerations, particularly for statistical analysis. We included 51 studies that met our pre-set inclusion criteria, with the majority of studies describing clinician-centered interventions. There was a wide range of health conditions and uses of Google Glass. While information regarding age of participants was limited, the studies that did include age information were conducted with adults and none within pediatric populations. Many were conducted in laboratory, hospital, and student training settings, which indicates potential of university-affiliated teaching hospitals to integrate wearable technologies to make clinicians more efficient and provide clinical support to patients.
Unlike our systematic review, other recent reviews of the use of wearable technology in medicine included other heads-up devices besides Google Glass and did not distinguish between surgical and nonsurgical interventions [
A recent systematic review of medical applications of Google Glass in both surgical and nonsurgical settings found more globally positive support for the technology’s use in these settings [
Our systematic review has a number of strengths. First, our review was conducted following the recommendations and guidelines for rigorous systematic reviews methodology [
Our systematic review of the literature has some potential methodological limitations. First, similar to other systematic reviews, although our search criteria were comprehensive, we could have missed some relevant articles [
Results regarding the feasibility, usability, and acceptability of Google Glass in nonsurgical medical settings were extremely varied, with more positive results being reported for patient-centered studies and student training settings. Further investigation with rigorous research designs evaluating the efficacy and cost-effectiveness of these more successful interventions in supporting patients and clinicians is warranted. These efforts would be beneficial in informing the base of evidence on the use of wearable devices, such as Google Glass, in medicine.
PRISMA checklist.
Search strategies.
Summary of the technical results of the patient-centered studies.
Summary of the technical results of the clinician-centered studies.
autism spectrum disorder
electrocardiogram
Google Glass
Parkinson’s Disease
rapid diagnostic test
social anxiety disorder
standardized patient
We thank Ms Linda O’Dwyer (Galter Health Sciences Library, Northwestern University Feinberg School of Medicine, Chicago, IL) for her support with the literature search. We also thank Ms Ayana Ceaser (Northwestern University Weinberg College of Arts and Sciences, Evanston, IL) for her help with data extraction.
None declared.