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EXPANSE: A novel narrative serious game for the behavioral assessment of cognitive abilities.

ABSTRACT: EFs are a set of processes that supports many cognitive domains as goal setting, monitoring, planning, and cognitive-behavioural flexible control. Currently, many standardized paper-and-pencil tests or scales are used to assess EFs. These tests are easy to administer, score, and interpret but present some limitations in terms of generalizability of behaviours in real life. More recently, Information and Communication Technology has provided a higher ecological validity in the EFs assessment. In order to increase the ecological validity, we have developed a serious game (SG), named EXPANSE, which aim was to compare the participants' game performance (latency times, and correct answers) with the results obtained in the traditional tasks and scales. 354 healthy subjects participated to the study and the findings showed significant correlations among standard tasks and the serious game. The exploratory nature of the present study, on one hand, highlighted that SG could be an additional behavioral tool to assess EFs and, on the other, we need further investigations, including clinical populations, for better defining the game sensitivity toward EF components. Finally, the results show that serious games are a promising technology for the evaluation of real cognitive behavior along with traditional evaluation.

SUBMITTER: Chicchi Giglioli IA

PROVIDER: S-EPMC6226175 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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EXPANSE: A novel narrative serious game for the behavioral assessment of cognitive abilities.

Chicchi Giglioli Irene Alice IA de Juan Ripoll Carla C Parra Elena E Alcañiz Raya Mariano M

PloS one 20181109 11

EFs are a set of processes that supports many cognitive domains as goal setting, monitoring, planning, and cognitive-behavioural flexible control. Currently, many standardized paper-and-pencil tests or scales are used to assess EFs. These tests are easy to administer, score, and interpret but present some limitations in terms of generalizability of behaviours in real life. More recently, Information and Communication Technology has provided a higher ecological validity in the EFs assessment. In ...[more]

PMID: 30412614

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Project description:BackgroundRhythm perception and production are related to phonological awareness and reading performance, and rhythmic deficits have been reported in dyslexia. In addition, rhythm-based interventions can improve cognitive function, and there is consistent evidence suggesting that they are an efficient tool for training reading skills in dyslexia.ObjectiveThis paper describes a rhythmic training protocol for children with dyslexia provided through a serious game (SG) called Mila-Learn and the methodology used to test its usability.MethodsWe computed Mila-Learn, an SG that makes training remotely accessible and consistently reproducible and follows an educative agenda using Unity (Unity Technologies). The SG's development was informed by 2 studies conducted during the French COVID-19 lockdowns. Study 1 was a feasibility study evaluating the autonomous use of Mila-Learn with 2500 children with reading deficits. Data were analyzed from a subsample of 525 children who spontaneously played at least 15 (median 42) games. Study 2, following the same real-life setting as study 1, evaluated the usability of an enhanced version of Mila-Learn over 6 months in a sample of 3337 children. The analysis was carried out in 98 children with available diagnoses.ResultsBenefiting from study 1 feedback, we improved Mila-Learn to enhance motivation and learning by adding specific features, including customization, storylines, humor, and increasing difficulty. Linear mixed models showed that performance improved over time. The scores were better for older children (P<.001), children with attention-deficit/hyperactivity disorder (P<.001), and children with dyslexia (P<.001). Performance improved significantly faster in children with attention-deficit/hyperactivity disorder (β=.06; t3754=3.91; P<.001) and slower in children with dyslexia (β=-.06; t3816=-5.08; P<.001).ConclusionsGiven these encouraging results, future work will focus on the clinical evaluation of Mila-Learn through a large double-blind randomized controlled trial comparing Mila-Learn and a placebo game.

Project description:BackgroundSerious games for health are increasingly being used to address health outcomes in patients with chronic illnesses. These studies vary in their study designs, patient populations, frameworks, outcome variables, and degree of specificity of the serious game intervention.ObjectiveThis scoping review aims to clarify the conceptual features of the existing research related to serious games designed to improve cognitive and behavioral outcomes in adults with chronic illness.MethodsWe applied the Preferred Reporting Items of Systematic Reviews and Meta-Analysis for scoping reviews (PRISMA-ScR) methodology, including an a priori research question. We searched 4 electronic databases to identify articles published through November 2019. Inclusion criteria encompassed (1) adults 18 years or older; (2) patients with a diagnosis of chronic illness; (3) a serious game intervention; and (4) defined patient outcomes that assess patients' behavioral, cognitive, or health outcomes.ResultsOf the 3305 articles identified, 38 were included in the review. We charted and analyzed the theoretical frameworks, key concepts, and outcome variables of these studies with summaries of features across articles. The majority of studies used a randomized controlled trial design (23/38, 61%), included a custom serious game intervention (22/38, 58%), and lacked a theoretical framework (25/38, 66%). Common outcome variables included quality of life (16/38, 42%), mood (15/38, 39%), cognitive function (13/38, 34%), symptoms (12/38, 32%), and physical activity (9/38, 24%). Key differences between studies included whether or not serious games aimed to train versus teach patients, be widely accessible versus tailored interventions, or replace versus complement current treatments.ConclusionsThis scoping review defines the current landscape of research in serious games for health research targeting behavioral and cognitive outcomes in adults with chronic disease. Studies have addressed a variety of patient populations and diverse patient outcomes. Researchers wanting to build on the current research should integrate theoretical frameworks into the design of the intervention and trial to more clearly articulate the active ingredients and mechanisms of serious games.

Project description:IntroductionAssessment of episodic memory is traditionally used to evaluate potential cognitive impairments in senior adults. The present article discusses the capabilities of Episodix, a game to assess the aforementioned cognitive area, as a valid tool to discriminate among mild cognitive impairment (MCI), Alzheimer's disease (AD) and healthy individuals (HC); that is, it studies the game's psychometric validity study to assess cognitive impairment.Materials and methodsAfter a preliminary study, a new pilot study, statistically significant for the Galician population, was carried out from a cross-sectional sample of senior adults as target users. A total of 64 individuals (28 HC, 16 MCI, 20 AD) completed the experiment from an initial sample of 74. Participants were administered a collection of classical pen-and-paper tests and interacted with the games developed. A total of six machine learning classification techniques were applied and four relevant performance metrics were computed to assess the classification power of the tool according to participants' cognitive status.ResultsAccording to the classification performance metrics computed, the best classification result is obtained using the Extra Trees Classifier (F1 = 0.97 and Cohen's kappa coefficient = 0.97). Precision and recall values are also high, above 0.9 for all cognitive groups. Moreover, according to the standard interpretation of Cohen's kappa index, classification is almost perfect (i.e., 0.81-1.00) for the complete dataset for all algorithms.LimitationsWeaknesses (e.g., accessibility, sample size or speed of stimuli) detected during the preliminary study were addressed and solved. Nevertheless, additional research is needed to improve the resolution of the game for the identification of specific cognitive impairments, as well as to achieve a complete validation of the psychometric properties of the digital game.ConclusionPromising results obtained about psychometric validity of Episodix, represent a relevant step ahead towards the introduction of serious games and machine learning in regular clinical practice for detecting MCI or AD. However, more research is needed to explore the introduction of item response theory in this game and to obtain the required normative data for clinical validity.

Dataset Information

EXPANSE: A novel narrative serious game for the behavioral assessment of cognitive abilities.

Publications

EXPANSE: A novel narrative serious game for the behavioral assessment of cognitive abilities.

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