Ontology definition and construction, and epistemological adequacy for systems interoperability: a practitioner analysis.

Ontology development is considered to be a useful approach to the design and implementation of interoperable systems. This literature review and commentary examines the current state of knowledge in this field with particular reference to processes involved in assuring epistemological adequacy. It takes the perspective of the information systems practitioner keen to adopt a systematic approach to in-house ontology design, taking into consideration previously published work. The study arises from author involvement in an integration/interoperability project on systems that support Scottish Common Housing Registers in which, ultimately, ontological modelling was not deployed. Issues concerning the agreement of meaning, and the implications for the creation of interoperable systems, are discussed. The extent to which those theories, methods and frameworks provide practitioners with a usable set of tools is explored, and examples of practical applications of ontological modelling are noted. The findings from the review of the literature demonstrate a number of difficulties faced by information systems practitioners keen to develop and deploy domain ontologies. A major problem is deciding which broad approach to take: to rely on automatic ontology construction techniques, or to rely on key words and domain experts to develop ontologies

Assessing the psychometric properties of the digital behavior change intervention engagement scale in users of an app for reducing alcohol consumption:Evaluation study

Background: The level and type of engagement with digital behavior change interventions (DBCIs) are likely to influence their effectiveness, but validated self-report measures of engagement are lacking. The DBCI Engagement Scale was designed to assess behavioral (ie, amount, depth of use) and experiential (ie, attention, interest, enjoyment) dimensions of engagement. Objective: We aimed to assess the psychometric properties of the DBCI Engagement Scale in users of a smartphone app for reducing alcohol consumption. Methods: Participants (N=147) were UK-based, adult, excessive drinkers recruited via an online research platform. Participants downloaded the Drink Less app and completed the scale immediately after their first login in exchange for a financial reward. Criterion variables included the objectively recorded amount of use, depth of use, and subsequent login. Five types of validity (ie, construct, criterion, predictive, incremental, divergent) were examined in exploratory factor, correlational, and regression analyses. The Cronbach alpha was calculated to assess the scale’s internal reliability. Covariates included motivation to reduce alcohol consumption. Results: Responses on the DBCI Engagement Scale could be characterized in terms of two largely independent subscales related to experience and behavior. The experiential and behavioral subscales showed high (α=.78) and moderate (α=.45) internal reliability, respectively. Total scale scores predicted future behavioral engagement (ie, subsequent login) with and without adjusting for users’ motivation to reduce alcohol consumption (adjusted odds ratio [ORadj]=1.14; 95% CI 1.03-1.27; P=.01), which was driven by the experiential (ORadj=1.19; 95% CI 1.05-1.34; P=.006) but not the behavioral subscale. Conclusions: The DBCI Engagement Scale assesses behavioral and experiential aspects of engagement. The behavioral subscale may not be a valid indicator of behavioral engagement. The experiential subscale can predict subsequent behavioral engagement with an app for reducing alcohol consumption. Further refinements and validation of the scale in larger samples and across different DBCIs are needed

Attrition from Web-Based Cognitive Testing:A Repeated Measures Comparison of Gamification Techniques

This is the author accepted manuscript. The final version is available from JIMR Publications via the DOI in this record.Background: The prospect of assessing cognition longitudinally and remotely is attractive to researchers, health practitioners and pharmaceutical companies alike. However, such repeatedtesting regimes place a considerable burden on participants, and with cognitive tasks typically being regarded as effortful and unengaging, these studies may experience high levels of participant attrition. One potential solution is to gamify these tasks to make them more engaging: increasing participant willingness to take part and reducing attrition. However, such an approach must balance task validity with the introduction of entertaining gamelike elements. Objectives: We set out to investigate the effects of gamelike features on participant attrition using a between-subjects, longitudinal online testing study. Methods: We used three variants of a common cognitive task, the stop signal task, with a single gamelike feature in each: one variant where points were rewarded for performing optimally, another where the task was given a graphical theme, and a third variant which was a standard stop signal task and served as a control condition. Participants completed four compulsory test sessions over four consecutive days before entering a six-day voluntary testing period where they faced a daily decision to either drop out or continue taking part. Participants were paid for each session they completed. Results: 482 participants signed up to take part in the study, with 265 completing the requisite four consecutive test sessions. We saw no evidence for an effect of gamification on attrition. A log-rank test showed no evidence of a difference in dropout rates between task variants (X 2 (2, N = 265) = 3.022, p = .22) and a one-way ANOVA of the mean number of sessions completed per participant in each variant also showed no evidence for a difference (F [2,262] = 1.534, p = .21, partial η2 = 0.012. Conclusions: Our findings raise doubts about the ability of gamification to reduce attrition from longitudinal cognitive testing studies.Funding from British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, and the National Institute for Health Research, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. This work was supported by the Medical Research Council (MC_UU_12013/6 and MC_UU_12013/7), and a PhD studentship to JL funded by the Economic and Social Research Council and Cambridge Cognition Limited

Emotional bias training as a treatment for anxiety and depression:evidence from experimental medicine studies in healthy and medicated samples

BACKGROUND: Anxiety and depression are leading causes of disability worldwide, yet individuals are often unable to access appropriate treatment. There is a need to develop effective interventions that can be delivered remotely. Previous research has suggested that emotional processing biases are a potential target for intervention, and these may be altered through brief training programs. METHODS: We report two experimental medicine studies of emotional bias training in two samples: individuals from the general population (n = 522) and individuals currently taking antidepressants to treat anxiety or depression (n = 212). Participants, recruited online, completed four sessions of EBT from their own home. Mental health and cognitive functioning outcomes were assessed at baseline, immediately post-training, and at 2-week follow-up. RESULTS: In both studies, our intervention successfully trained participants to perceive ambiguous social information more positively. This persisted at a 2-week follow-up. There was no clear evidence that this change in emotional processing transferred to improvements in symptoms in the primary analyses. However, in both studies, there was weak evidence for improved quality of life following EBT amongst individuals with more depressive symptoms at baseline. No clear evidence of transfer effects was observed for self-reported daily stress, anhedonia or depressive symptoms. Exploratory analyses suggested that younger participants reported greater treatment gains. CONCLUSIONS: These studies demonstrate the effectiveness of delivering a multi-session online training program to promote lasting cognitive changes. Given the inconsistent evidence for transfer effects, EBT requires further development before it can be considered as a treatment for anxiety and depression

Cognitive bias modification for facial interpretation:A randomized controlled trial of transfer to self-report and cognitive measures in a healthy sample

Cognitive bias modification is a potential low-intensity intervention for mood disorders, but previous studies have shown mixed success. This study explored whether facial interpretation bias modification (FIBM), a similar paradigm designed to shift emotional interpretation (and/or perception) of faces would transfer to: (i) self-reported symptoms and (ii) a battery of cognitive tasks. In a preregistered, double-blind randomized controlled trial, healthy participants received eight online sessions of FIBM (N = 52) or eight sham sessions (N = 52). While we replicate that FIBM successfully shifts ambiguous facial expression interpretation in the intervention group, this failed to transfer to the majority of self-report or cognitive measures. There was, however, weak, inconclusive evidence of transfer to a self-report measure of stress, a cognitive measure of anhedonia, and evidence that results were moderated by trait anxiety (whereby transference was greatest in those with higher baseline symptoms). We discuss the need for work in both larger and clinical samples, while urging caution that these FIBM training effects may not transfer to clinically relevant domains

Gamification of cognitive assessment and cognitive training: A systematic review of applications, approaches and efficacy

Background: Cognitive tasks are typically viewed as effortful, frustrating and repetitive, and these factors may lead participants to disengage with the task at hand. This, in turn, may negatively impact our data quality and reduce any intervention effects. Gamification may provide a solution. If we can successfully import game design elements into cognitive tasks without undermining their scientific value, then we may be able improve the quality of data, increase the effectiveness of our interventions, and maximise participant engagement. Aims: This systematic review aims to explore and evaluate the ways in which gamification has already been used for cognitive training and testing purposes. Essentially, we seek to answer five questions: 1. For what reasons have researchers opted to use gamification? 2. What scenarios has gamification been used in? 3. What game mechanics have been used and to what effect? 4. Which methods have been used to determine whether a gamified application is successful? 5. How successful has gamification been in cognitive testing and training thus far? Method: Using several online databases, we searched the titles, abstracts and keywords of database entries using the search strategy (gamif* OR game OR games) AND (cognit* OR engag* OR behavi* OR health* OR attention OR motiv*). Searches included articles published in English between January 2007 and October 2015. Non-peer reviewed studies such as abstracts or conference posters were excluded. Furthermore, due to the specific focus on cognitive assessment and training we excluded several other common uses of gamification including: gamification for education purposes, advertising purposes, disease management, health promotion, physical activity promotion, exposure therapy or rehabilitation. We also excluded studies that were merely used virtual reality or a 3D environment without involving any game mechanics: engagement had to be the primary reason for using a game-like design. Results: Our review identified 33 relevant studies, covering 31 gamified cognitive tasks used across a wide range of disorders and cognitive domains. Gamified cognitive training to relieve attention deficit hyperactivity disorder symptoms was particularly prominent. We describe the game mechanics used in gamified cognitive tasks, their effectiveness and frequency of use by designers. We also found that the majority of gamified cognitive tasks were rated as enjoyable or engaging by the study participants. Gamified assessments were typically validated successfully; however the efficacy of game-like cognitive training is more difficult to interpret due to several poor quality studies. High heterogeneity of study designs and small sample sizes highlight the need for further research in both training and testing. Conclusions: The evidence suggests that gamified cognitive training is motivating for users, though not necessarily an effective intervention. Nevertheless, gamification can provide a way to develop engaging and yet scientifically valid cognitive assessments and it is likely worthwhile to continue to develop gamified cognitive tests in the future

Gamification of cognitive assessment and cognitive training: A systematic review of applications, approaches and efficacy

Cognitive tasks are typically viewed as effortful, frustrating and repetitive, and these factors may lead participants to disengage with the task at hand. This, in turn, may negatively impact our data quality and reduce any intervention effects. Gamification may provide a solution. If we can successfully import game design elements into cognitive tasks without undermining their scientific value, then we may be able improve the quality of data, increase the effectiveness of our interventions, and maximise participant engagement. We conducted a systematic review of the existing literature of gamified cognitive testing and training tasks to identify where, how and why gamification has been used, and whether it has been successful. We searched several online databases, from January 2007 to January 2015, and screened 33,000 articles that matched our search terms. Our review identified 34 relevant studies, covering 31 gamified cognitive tasks used across a wide range of disorders and cognitive domains. Gamified cognitive training to relieve attention deficit hyperactivity disorder symptoms was particularly prominent. We also found that the majority of gamified cognitive tasks were validated successfully and were rated as enjoyable or engaging by the study participants. Despite this, the heterogeneity of study designs and typically small sample sizes highlights the need for further research. We describe the game mechanics used in gamified cognitive tasks, their effectiveness and how they relate to several models of player engagement. In conclusion the evidence suggests that gamification can provide a way to develop engaging and scientifically valid cognitive tasks, but that no single game can be engaging to every participant and therefore gamification is not a silver-bullet for all motivational problems in psychological research

Attrition from Web-Based Cognitive Testing: A Repeated Measures Comparison of Gamification Techniques

The prospect of assessing cognition longitudinally and remotely is attractive to researchers, health practitioners, and pharmaceutical companies alike. However, such repeated testing regimes place a considerable burden on participants, and with cognitive tasks typically being regarded as effortful and unengaging, these studies may experience high levels of participant attrition. One potential solution is to gamify these tasks to make them more engaging: increasing participant willingness to take part and reducing attrition. However, such an approach must balance task validity with the introduction of entertaining gamelike elements.Science Foundation IrelandBritish Heart FoundationCancer Research UKEconomic and Social Research CouncilMedical Research CouncilNational Institute for Health Researc

‘Gamification’ for Health Behaviour Change in Smartphone Apps

Background: Gamification techniques are showing promise in promoting healthy behaviours and delivering health promotion advice, however, their use in Mobile-Health is relatively new. Gamification involves using ‘gaming’ elements such as badges, leader boards, health-related challenges, rewards, ability to ‘level up’ and use of avatars to motivate and engage people to change health behavior. Gamification techniques may also overlap with validated health behaviour change techniques (BCTs), however, few apps appear to apply the techniques systematically or to define the BCTs they include. Aim: We aimed a) to assess the number apps that incorporate gamification to modify health behaviors, b) to examine the BCT repertoire and combinations used in these apps c) to consider associations with user satisfaction. Methods: English-language health apps that contain gamification techniques were identified through a systematic search of the official Apple and Google Play store and the NHS health apps library. Top rated free and paid Medical, Health & Wellness, Health & Fitness apps as defined by Apple and Google Play stores were searched. Apps were coded for BCTs according to the Michie et al. taxonomy. The taxonomy comprises 16 categories and 93 individual BCTs. BCT coding was conducted by two trained researchers (EE, JL) who scored independently and then cross-checked for discrepancies. BCT numbers, user ratings and app pricing were compared. We explored the association between number of BCTs per app, user and NHS libraries’ ratings and price. We also investigated, which of the 16 BCT categories and the individual 93 BCTs and their combinations were most commonly used. Results: 1,680 Medical, Health & Wellness or Health & Fitness Apps were reviewed and seventy containing gamification techniques were identified. The mean number of BCTs used was 12.5 (range 1-24). There was no correlation between number of BCTs, customer ratings, NHS library app rating or pricing. Commonly used BCT categories were: feedback & monitoring, reward & threat, goals & planning and comparison of behaviour. Commonly used individual BCTs were: self-monitoring of behaviour, non-specific reward, social support unspecified and non-specific incentive. Common combinations of BCTs were a) goal setting, self-monitoring and focus on past success b) goal setting, self-monitoring, non-specific reward and non-specific incentive. Only four apps were included in the NHS library. Conclusion: Our systematic review of smartphone health apps from two major providers suggests that gamification in Mobile-Health is relatively underused and there was wide variation in the use of BCTs. Whilst our data suggest that app designers are making some use of BCTs, as all apps contained at least one technique, many health apps underutilize them thus limiting the potential to modify health behaviour. In addition, there appears to be no correlation between what users rate as a good app (a possible proxy for the app having health benefits), and the app’s content and potential ability to modify health behaviour. We suggest that app designers should work collaboratively with public health practitioners, health psychologists and with users to ensure that apps incorporate appropriate BCTs together with gamification in order to modify health behavior more effectively, to enhance user retention and to increase user enjoyment/ratings. Further research and clinical evaluation is needed for health care apps to evaluate their effectiveness in modifying actual health behavior and clinical outcomes. There is also a need for regulation of Health Care apps to ensure patients are given access to apps, which are safe and have proven benefit to health. Greater use of gamification and behavior change techniques could provide a potentially cost effective platform for health behaviour change and health promotion and have enormous Public Health impact