Informatics in Medicine Unlocked (Jan 2022)
Development and evaluation of serious games for diagnosis and cognitive improvement of patients with mild cognitive impairment: A study protocol
Abstract
Introduction: Early diagnosis of cognitive impairment and improving cognitive function of patients with mild cognitive impairment (MCI) are of particular importance for preventing Alzheimer's disease (AD). Health-oriented serious games (SGs) could be innovative tools for evaluating and improving cognitive status. In this study, a SG will be developed to evaluate and improve cognitive status of patients with MCI based on different cognitive aspects of mini-mental state examination (MMSE) and Addenbrooke's cognitive examination-revised version (ACE-R). Furthermore, the SG will be validated and assessed in diagnosing and improving the cognitive status of patients with MCI. Material and methods: This qualitative and quantitative study includes four steps. In the first step, the literature is reviewed systematically. In the second step, game stories and scenarios are designed for the proposed game series based on the results of step 1 in collaboration with the clinical experts. Then, a game will be designed for the different cognitive aspects of MMSE and ACE-R. The third step includes the technical design and development of the game and usability evaluation. 60 participants in two healthy or patient (who are at the MCI stage) groups will be selected using convenience and purposive sampling methods based on inclusion and exclusion criteria. In the fourth step, evaluation of the serious game for patients with MCI is performed. We will conduct correlation analysis to evaluate the degree of coordination between the game and the cognitive test results. Moreover, we will evaluate the effect of the game on improving cognitive status through a before-after study. Results: The correlation between the game and MMSE/ACE-R results will be calculated. Furthermore, the MMSE/ACE-R mean difference before and after playing the game will be examined. The results of machine learning algorithms and indicators such as sensitivity and specificity to evaluate the effectiveness of the game in disease diagnosis will also be reported. Conclusion: Medical staff who intend to use SGs for diagnosing MCI can choose the game based on the results of correlation between different games and aspects of psychological tests. Moreover, examining the impact of each game on the cognitive status could help therapists choose games that could improve the cognitive status of people with MCI. The results could also be useful for technical designers who intend to design suitable games for the patients with MCI.
