Figure 6 Effects of IVR-based interventions on depression (Exclusion of 1 study).
3.2.3 | Fatigue meta-analysis
Three studies16-18 describing the effect of IVR on fatigue in breast cancer patients included a total of 179 study participants, and the results showed a statistically significant combined effect size for the IVR-based intervention compared to the control group [I2 =93%, SMD=-1.94, 95% CI=(-3.18,-0.71),P=0.002](Figure 7). Sensitivity analyses were performed using a literature-by-literature approach, and when Reynolds et al.17 ’s study, the heterogeneity disappeared (I2 =0%), and meta-analysis using a fixed-effects model showed that the difference was statistically significant [SMD=-2.53,95% CI=(-2.98,-2.08),P<0.00001](Figure 8). The heterogeneity may be related to the measurement tool, the intervention period and the location of the intervention.