Ready player one: the marriage of video games and medical technology

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Lazy eye, also known as amblyopia, is a condition that affects around 3% of the world’s population. This happens when the brain begins to prioritize the use of one eye over the other and thus begins to ignore its signals. Amblyotech, a US-based start-up developing a new treatment for the disease, has just been acquired by Swiss pharmaceutical giant Novartis. Going further than corrective eyewear, Amblyotech aims to treat lazy eye through a video game.

With 3D glasses and a tablet, Amblyotech’s Dig Rush app provides different images to each eye through different game elements, such as cartoon mole characters mining and collecting different objects. The game forces both eyes to work together to improve the patient’s binocular vision.

Early clinical studies demonstrated vision improvements for children and adults with lazy eye, with faster onset compared to standard treatments like wearing an eye patch. Now that it has acquired Amblyotech, Novartis will continue to work in partnership with Ubisoft to develop the software and create a series of engaging games for the Dig Rush app, with a proof-of-concept trial planned later this year.

This project is just one of many in the field of digital health that focuses on the gamification of medicine. Once the preserve of small start-ups, the biggest players in the industry are beginning to pay attention to the potential of video games in digital health.

A video game that improves cognitive functions

Amblyopia is far from the only condition for which therapies are gamified. Akili Interactive develops a line of prescription video games designed to combine specialized algorithms with gaming technology to improve cognitive function in patients with neurological disorders.

Akili’s flagship product is the EndeavorRx treatment, a tablet-based game designed to improve brain function in the prefrontal cortex by allowing the user to perform multiple increasingly complex tasks. It is designed to improve attention function in children ages 8-12 who have Attention Deficit Hyperactivity Disorder (ADHD).

EndeavorRX was cleared by the U.S. Food and Drug Administration (FDA) in June 2020 as a prescription treatment for children with ADHD, based on data from five clinical studies involving more than 600 children with ADHD. disease. This included a randomized controlled study published in The Lancet Digital Health, which showed that EndeavorRx improved objective measures of attention in these patients.

After four weeks of EndeavorRX treatment, one-third of participants no longer had measurable attention deficit on at least one objective measure of attention. About half of the parents of the participants also saw a clinically significant change in their child’s daily ADHD symptoms after one month of treatment, which increased to 68% after two months.

Akili Interactive CEO Dr. Eddie Martucci says, “The technology behind EndeavorRx presents specific sensory stimuli and simultaneous motor challenges designed to target and activate neural systems that play a key role in attention function, while using adaptive algorithms to personalize the treatment experience for each individual. patient. This enables second-by-second monitoring of patient progress after treatment sessions, and continuously challenges each patient to an optimized level, encouraging them to improve their performance.

“So, although it looks like a video game, it is designed with patented technology to directly access the neurological systems responsible for certain cognitive functions to improve cognitive function.”

In addition to ADHD, Akili is evaluating other iterations of the product for different cognitive issues: AKL-T02 is being studied as a potential treatment for attention-related symptoms in children with autism; AKL-T03 is being studied as a treatment for executive function problems in major depressive disorder and cognitive impairment in patients with multiple sclerosis (MS); and AKL-T04 is being evaluated for treating executive function alongside emotional processing and mood problems in depressed patients.

Make training more engaging

Along with hands-on therapies, clinical training also got the video game treatment. Level Ex creates video games for doctors that are designed to bridge the gap between training and entertainment. Cardio Ex, Gastro Ex, Pulm Ex and Airway Ex all simulate a range of medical cases in their respective fields, designed to help clinicians practice their craft. Recently, the company released free updates to Pulm Ex and Airway Ex that simulate Covid-19 patient scenarios, and is also working on a Covid-19 update for Cardio Ex.

The company’s team consists of software engineers and medical experts, who consult practicing physicians to develop the games, as well as draw inspiration from clinical guidelines to create different scenarios. Game levels provide immediate feedback on whether decisions made by the clinician playing the game are consistent with recommended clinical care. They also have impressive graphics for games designed to run on a smartphone, signaling a marked improvement over the more dated cartoonish aesthetic of other surgical simulators.

Level Ex Vice President and Chief Medical Officer, Eric Gantwerker, says, “Our company is truly thriving on the idea that gaming psychology and gaming technology can advance the way information is presented to clinicians and health care providers.

Turning something, which would typically be boring or otherwise unpleasant, into a video game essentially makes the process more engaging. Whether it’s a clinician in training or a child with ADHD developing attention skills, the more appealing the information to consume, the more likely it is to stick in the mind.

“There are all these deep psychology terms like compulsion loops and flow states about how games have a really good way of engaging users in the experience. If a game is too boring or too difficult or not fun, you won’t play it,” says Gantwerker. “The whole industry is built on this idea of ​​getting you involved, engaging you, giving you the experience and having you very focused and motivated to keep going. That’s where we bring the experience of care of health with the psychology of play, to conduct these experiences where you can interact and be more active through processes on information, so that you have a deeper understanding.It arouses interest and curiosity.

Regulatory approval is a bit different for companies like Level-Ex, which provides medical education, versus Akili, which provides treatment. While Level Ex has a rigorous internal process used to develop its products, going through third-party review to ensure accuracy and quality, the games are ultimately information resources for professionals rather than patient applications.

The future of medical video games

Historically, the popular narrative surrounding video games has been that excessive screen time can negatively impact cognitive function. However, academic research has found significant cognitive benefits from playing video games, and as the mainstream perspective on gaming has softened, the medical industry as a whole has become more interested in video games centered on Medicine.

Akili’s most recent funding round in 2018 hit $68 million, and Martucci says the company’s goal now is to become a leading digital medicine provider. At last year’s CES Digital Health Summit, he told a panel of experts that the company would buck the medtech trend of relying on one-to-one business relationships and sales channels. more established industrial partner to deploy its product, but would instead aim to build its own distribution. Platform.

Meanwhile, Level Ex games are played by 600,000 healthcare professionals across the industry, and the company has a respectable working relationship with Johnson & Johnson. The Covid-19 updates for Pulm Ex and Airway Ex were developed with an educational grant from the Johnson & Johnson Institute.

Time spent playing Level Ex games can also contribute to the US National Institutes of Health’s Continuing Medical Education (CME) credit program. CME credits are earned by completing educational activities that help maintain or develop a practitioner’s skills. In some US states, a specified number of CME credits are required each year for clinicians to maintain their medical license, and most hospitals require a specified number of credits for their physicians to continue practicing, regardless of state. Far from being a trivial distraction, playing video games can now help keep a doctor in his job.

Gantwerker says, “We are really doing everything we can to supply healthcare professionals around the world. We do our best and work hard to create this content.

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