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Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy
Open accessAbstract
BACKGROUND: Cognitive tasks are typically viewed as effortful, frustrating, and repetitive, which often leads to participant disengagement. This, in turn, may negatively impact data quality and/or reduce intervention effects. However, gamification may provide a possible solution. If game design features can be incorporated into cognitive tasks without undermining their scientific value, then data quality, intervention effects, and participant engagement may be improved. OBJECTIVES: This systematic review aims to explore and evaluate the ways in which gamification has already been used for cognitive training and assessment purposes. We hope to answer 3 questions: (1) Why have researchers opted to use gamification? (2) What domains has gamification been applied in? (3) How successful has gamification been in cognitive research thus far? METHODS: We systematically searched several Web-based databases, searching 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 papers published in English between January 2007 and October 2015. RESULTS: Our review identified 33 relevant studies, covering 31 gamified cognitive tasks used across a range of disorders and cognitive domains. We identified 7 reasons for researchers opting to gamify their cognitive training and testing. We found that working memory and general executive functions were common targets for both gamified assessment and training. Gamified tests were typically validated successfully, although mixed-domain measurement was a problem. Gamified training appears to be highly engaging and does boost participant motivation, but mixed effects of gamification on task performance were reported. CONCLUSIONS: Heterogeneous study designs and typically small sample sizes highlight the need for further research in both gamified training and testing. Nevertheless, careful application of 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 tasks in the future.
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TL;DR
This systematic review identified 33 studies covering 31 gamified cognitive tasks and found 7 reasons researchers gamify cognitive assessment or training. Gamified tasks generally improved motivation and engagement, but evidence for improved data quality was lacking, and effects on task performance were mixed.
Key findings
- The review included 33 relevant studies and 31 gamified cognitive tasks; working memory and general executive functions were common targets for both gamified assessment and training.
- Gamified assessments were typically validated successfully, with sample intertask correlations of 0.45–0.60 in some simpler validation studies, but mixed-domain measurement was a problem.
- Gamified training appeared highly engaging and boosted participant motivation, but mixed effects on task performance were reported; 21 of 33 studies compared a gamelike task directly against a nongamified counterpart.
- The authors found no evidence that gamified tests improve data quality and some indications they may worsen it, while positive training findings were tentative due to methodological problems.
Methods
- Systematic search of PsycInfo, Medline, ETHOS, EMBASE, PubMed, IBSS, Francis, Web of Science, and Scopus using `(gamif* OR game OR games) AND (cognit* OR engag* OR behavi* OR health* OR attention OR motiv*)`, limited to English papers from January 2007 to October 2015.
- Inclusion required primary empirical research on a novel gamelike task designed to assess or train cognition and either validated or piloted; non–peer-reviewed papers, education/health-promotion/rehabilitation gamification, and non-gamelike VR/3D environments were excluded.
- Papers were screened by one reviewer (JL) in three stages, with a second reviewer (EE) rescreening 20% from the title stage onward; inter-rater agreement was moderate (k=.526, 95% CI 0.416–0.633, P<.001).
Limitations
- The paper states that the review required a narrow scope focused on cognitive training and testing, which led to some papers being excluded on the subjective basis of not being “cognitive research,” and that many included studies were preliminary, making findings tentative.
- The paper states that sample sizes were small in nearly all reviewed studies and only 5 of 33 papers described a power calculation.
- Evident from the text: many training games used only a gamified task, so the effect of gamification could not be dissociated from the intervention effect, and validation standards were heterogeneous.
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“Gamified tests were typically validated successfully”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Results
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In the paper
“We found that working memory and general executive functions were common targets for both gamified assessment and training.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Results
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In the paper
“although mixed-domain measurement was a problem”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Results
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In the paper
“mixed effects of gamification on task performance were reported”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Results
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In the paper
“We identified 7 reasons for researchers opting to gamify their cognitive training and testing.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Results
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In the paper
“Three of the 6 games were very simplistic, with only a few specific game mechanics and carefully designed nongame controls, to make the effects of the game mechanics on the data as apparent as possible.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
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In the paper
“we found 11 studies (8 games) that used gamification to reduce participant dropout rates over a protracted testing or training programme.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
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In the paper
“Six studies cited evidence that playing video games can be cognitively beneficial and/or stimulating as a key factor in their decision to gamify.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
Strength:plain· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIn the paper
“Five other games were aimed at young children, and reframed the cognitive assessment as a game, to test the children under optimal mental conditions [41].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
- Not checked yetcites [41] source
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In the paper
“Eleven tasks were gamified specifically to enhance appeal with a given age group”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
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- It may state two separate claims as one. 44
- Probably not a substantial claim. 19
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In the paper
“Gamified training appears to be highly engaging and does boost participant motivation”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Results
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our review identified 33 relevant studies, covering 31 gamified cognitive tasks used across a range of disorders and cognitive domains.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Results
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In the paper
“we found 16 studies that explicitly used gamified tasks to measure or train cognition in a more motivating manner, and the majority (10 of 16) of these studies were assessment studies.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
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In the paper
“Heterogeneous study designs and typically small sample sizes”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Abstract > Conclusions
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In the paper
“Many of these games were used in an unobserved, nonlaboratory setting; therefore, the tasks made use of motivational features that made the training and testing intrinsically more appealing and less of a burden to perform on a regular basis.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
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In the paper
“One game, Watermons [38], was designed, using Self Determination Theory [50,51], to maximize participant intrinsic motivation and make any motivational effects of game mechanics as apparent as possible.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
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In the paper
“Again, working memory was a popular target, closely followed by EF and inhibitory control training.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
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In the paper
“Many games tested several cognitive domains and/or general EF, highlighting the difficulty of examining gamification effects on specific cognitive domains (and therefore comparing performance to standard cognitive tasks).”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
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In the paper
“It is also worth noting that the numbers of studies investigating cognitive testing (17) and training (15) were very similar”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
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In the paper
“General executive function (EF), attention, and inhibition were also commonly tested domains.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
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“The Great Brain Experiment aimed to keep task sessions below 5 minutes in duration and found that the shortest task, the Stop Signal Task, was the most popular mini game.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
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In the paper
“We found comparable numbers of games used for cognitive testing (17) and training (13), with one game that can be used for both testing and training”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
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In the paper
“these games tended to build simple game-archetypes, such as space invaders or whack-a-mole, around an existing cognitive task; with the goal of encouraging self-motivation, improving participant enjoyment, and even reducing test anxiety [17].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
- Not checked yetcites [17] McPherson, J, 2007, Behav Res Methods source
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In the paper
“For example, use of exploratory factor analysis showed that Whack-a-Mole’s primary output measure was correlated with 2 of the 3 EFs of interest: inhibition (r (22)=.60, P<.001) and updating (r (22) = .35, P<.05) [33].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
What the sources say
- Not checked yetcites [33] source
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In the paper
“Validation studies varied in their design, and some studies reported complex correlations between gamified and nongamified tasks with multiple outputs.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
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In the paper
“There is a smaller overlap in domains covered by cognitive training tasks; test batteries tend to test a wide range of domains, whereas training focuses on 1 or 2 domains exclusively.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
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In the paper
“The initial study was successful, with Space Code’s output measure correlating well with a conventional measure of processing speed (r (58)=.55, P<.001).”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
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In the paper
“The Continuous Performance Task-II detected more commission errors from the ADHD adults as expected (mean [M]=56, standard deviation [SD]=13 vs M=46, SD=10), but Retirement Party did not (M=14.4, SD=5.8 vs M=13.2, SD=4.3)”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
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In the paper
“We saw several games aimed at training and testing people with ADHD, and overall, these games appear highly engaging to users, in some cases, even increasing the time spent training.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Principal Results
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In the paper
“Indeed, gamification was reported as both motivational and positive by study authors and participants alike.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Conclusions
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In the paper
“Our review found no evidence to support that gamified tests can be used to improve data quality, either by reducing between-subject noise or by improving participant performance”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Conclusions
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In the paper
“3D graphics were quite prevalent, as was the use of avatars, points, levels, and dynamically growing game worlds”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Differences Between Training and Assessment Tasks
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In the paper
“In contrast, assessment games were simpler, predominantly using 2D graphics, sound effects, score, and theme to create the appearance of a game.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Differences Between Training and Assessment Tasks
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In the paper
“Training games typically contained many features and were similar in appearance to commercial video games.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Differences Between Training and Assessment Tasks
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- Rests on an assumption: Cognitive training normally requires several sessions to be effective.
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In the paper
“Papers were only included in the review on the agreement of both JL and EE.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Methods > Screening
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In the paper
“We used Cohen K to assess inter-rater reliability of paper inclusion at the 20% data check stage (7590 papers checked). There was moderate agreement between the 2 reviewers (k=.526, 95% CI, 0.416 to 0.633, P<.001).”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Search Results
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In the paper
“Furthermore, using games as a vehicle to deliver cognitive training may also be advantageous simply because video games appear to have positive effects on a number of outcomes, including working memory, attentional capacity, problem solving, motivation, emotional control, and prosocial behaviors [6].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Introduction
What the sources say
- Not checked yetcites [6] source
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In the paper
“A second reviewer (EE) rescreened 20% of the papers from the title stage onward to ensure that no relevant papers were missed.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Methods > Screening
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In the paper
“In a similar vein, cognitive assessment has been accused of being ecologically invalid [60].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
- Not checked yetcites [60] source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, patients with ADHD react differently from controls to rewards and feedback: they prefer strong reinforcement and immediate feedback, as well as clear goals and objectives, all of which can easily be delivered in a gamelike environment [22,24,62].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“There is good evidence that video game players outperform nongamers on tests of working memory [52] visual attention [53,54] and processing speed [55,56].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This is likely due to its ease of testing and also because working memory deficit is a common symptom in many disorders.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Rests on an assumption: Working memory deficit is a common symptom in many disorders.
None of the sources cited for this claim have been checked yet.
In the paper
“As Dunbar et al explain [8], games are uniquely suited to some forms of cognitive training as they give the player freedom to make choices and experience feedback on the effects of those choices; in other words, they provide opportunities for experiential learning [61].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
- Not checked yetcites [8] source
- Not checked yetcites [61] Kolb, D, 1984, Experiential learning: experience as the source of learning and development
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the slightly smaller proportion of games used to deliver cognitive training is likely explained by the relative recency of the field.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > What Are the Application Areas of Gamification?
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Gamification aims to increase engagement with tasks that might otherwise be perceived as demotivating [48]”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
- Not checked yetcites [48] ErikssonBMusialikMWagnerJStudent essay20120862016-07-08Gamification - Engaging the Future https://gupea.ub.gu.se/handle/2077/30037
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“Commercial gamification is often used to create long-term interest around a user experience, product, or event [13].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Why Do Researchers Use Gamification?
What the sources say
- Not checked yetcites [13] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Broadly speaking, these were well-designed and well-powered studies, and together, they provide encouraging evidence that cognitive tests can be gamified and still be useful as a research tool.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Such a performance boost resulting from gamelike elements is a disadvantage when performing cognitive assessment but is likely to be desirable in a cognitive training scenario.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The fact that Space Code was thought to be a fairly pure measure in one study and then was shown to be mixed-domain in the next highlights the fact that designing gamified cognitive tasks is difficult, and multiple, well-powered validation studies may be required to ensure a task is measuring what is intended.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
Tests✓ Asserted: passes? Checkable: unclear✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
In the paper
“Given the relatively large combined sample size of these studies (N=200), they provide good evidence that game mechanics can be included in cognitive tests without invalidating the data and with the desired effect of increasing motivation.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
What the sources say
- Not checked yetcites [9] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The dopaminergic system is thought to be abnormal in ADHD [66,67].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Principal Results
What the sources say
- Not checked yetcites [66] source
- Not checked yetcites [67] 1996, Mol Psychiatry
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Gamified tasks may be valuable for assessing ADHD patients as computer games are particularly appealing to them: with rapid rewards, immediate feedback, and time-pressure being exactly the type of stimulus the ADHD brain craves [64,65].”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Principal Results
What the sources say
- Not checked yetcites [64] Kok, A, 2002, Autism source
- Not checked yetcites [65] WebMD20122016-04-19Video Games and ADHD: What's the Link? http://www.webmd.com/add-adhd/childhood-adhd/features/adhd-and-video-games-is-there-a-link?print=true
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The Great Brain Experiment [39] and GAME [46] both showed gamelike tasks to be appropriate for measuring and training working memory.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“McNab and Dolan showing that data collected from 2 very different gamified and nongamified tasks could fit similar models of working memory capacity.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
What the sources say
- Not checked yetcites [39] source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Children in the gamelike condition were also more engaged and enjoyed the training more, as measured by “absence time.””
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
What the sources say
- Not checked yetcites [24] source
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“They found that these gamelike features increased the effect of training, reducing reaction times and switch costs, compared against a non–gamelike version of the training.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Results > Does Gamification Work?
What the sources say
- Not checked yetcites [38] source
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An additional consideration is that many of the studies reviewed were of a preliminary nature, and as such, the findings reported here should be considered tentative.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Limitations
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“thus making the participant experience less effortful and potentially reducing drop-outs in longitudinal studies.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Tasks of this nature represent gamification at its simplest, but they were well received by users, implying that minimal gamification is better than no gamification.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Differences Between Training and Assessment Tasks
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The simplicity of gamification employed is likely due to the constant tension between creating an engaging task and the risk of undermining the task’s scientific validity: including unknown game mechanics might have deleterious effects on the data collected.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Differences Between Training and Assessment Tasks
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and served to sustain engagement over a long period.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Differences Between Training and Assessment Tasks
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“papers were only included in the review on consensus from both reviewers (JL and EE), and a 20% selection check was performed by EE on papers from the title-screening stage onward.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Limitations
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“However, Katz et al [34] and Miranda and Palmer [36] highlight that this can be difficult balancing act, with several game mechanics having unforeseen deleterious effects on performance.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Principal Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The results of references [9,17,18,38], show that gamified tasks can be used to improve motivation, while still maintaining a scientifically valid task.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Principal Results
What the sources say
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Many training games used a gamified task only, meaning the effect of gamification cannot be dissociated from the effect of the intervention.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Validating Gamified Tasks
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“this may improve player performance and motivation.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Principal Results
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Gamelike tasks may also reduce feelings of test anxiety and allow alternative interfaces to cognitive tests that would otherwise be difficult to deliver in certain populations.”
§ Gamification of Cognitive Assessment and Cognitive Training: A Systematic Review of Applications and Efficacy > Discussion > Conclusions
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✗ Based: failsProbably not a substantial claim. The paper may give no reason why it holds. It may state two separate claims as one.
The paper relies on this without support.
Cognitive tasks are typically viewed as effortful, frustrating, and repetitive.
“Cognitive tasks are typically viewed as effortful, frustrating, and repetitive, which often leads to participant disengagement.”
The paper relies on this without support.
To the authors' knowledge, there have been no systematic reviews of gamification in cognitive research.
“To our knowledge, there have been no systematic reviews of gamification in cognitive research.”
The paper relies on this without support.
The highly repetitive nature of cognitive tasks means they are ripe for improvement.
“the highly repetitive nature of cognitive tasks means they are ripe for improvement.”
The paper relies on this without support.
Cognitive tests are typically a one-off measure, and replayability is not a requirement.
“Cognitive tests are typically a one off measure, and replayability is not a requirement.”
The paper relies on this without support.
Working memory deficit is a common symptom in many disorders.
“working memory deficit is a common symptom in many disorders.”
The paper relies on this without support.
Cognitive training normally requires several sessions to be effective.
“Cognitive training normally requires several sessions to be effective”
The paper relies on this without support.
Engagement will be the key to collecting high-quality data as cognitive research moves out of the laboratory and onto personal computers and mobile devices.
“As cognitive research begins to move out of the laboratory and onto personal computers and mobile devices, engagement will be the key to collecting high-quality data.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Those authors found improvements in time management and planning/organization, and a reduction in hyperactivity symptoms in a group of students with ADHD who received an SG intervention.”
From Serious Games and Their Effect Improving Attention in Students with Learning Disabilities (2019) · cites this paper as [16]
In the citing paper
“These results are in line with previous research stating that playing videogames can increase concentration and other cognitive variables, such as processing speed or visual discrimination [12,13,14,15,16].”
From Serious Games and Their Effect Improving Attention in Students with Learning Disabilities (2019) · cites this paper as [16]
Statistics that don’t add up
Each reported p-value recomputed from its test statistic and degrees of freedom.
p-value fits an unstated one-tailed test: r (22) = .35, p < .05
MinorThe paper reports p < .05 here; recomputing from the test statistic and its degrees of freedom gives p = .094 (two-tailed). The reported value is what a one-tailed test gives, but the paper does not say near this result that a one-tailed test was used.
Reported p < .05 · recomputed p = .094
“r (22) = .35, P<.05”
p-value fits an unstated one-tailed test: r (22)=.60, p < .001
MinorThe paper reports p < .001 here; recomputing from the test statistic and its degrees of freedom gives p = .002 (two-tailed). The reported value is what a one-tailed test gives, but the paper does not say near this result that a one-tailed test was used.
Reported p < .001 · recomputed p = .002
“r (22)=.60, P<.001”
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Doesn’t add upr(22) = 0.6reported p < .001 · recomputed p = .002
“r (22)=.60, p < .001”
- Doesn’t add upr(22) = 0.35reported p < .05 · recomputed p = .094
“r (22) = .35, p < .05”
- Consistentr(58) = 0.55reported p < .001 · recomputed p < .001
“r (58)=.55, p < .001”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Trapp study has conflicting publication years
MinorTable 1 dates the Trapp et al study to 2008, while its matching reference lists BMC Psychiatry 2013.
“| Trapp et al, 2008 [19] | Cognitive remediation improves cognition and good cognitive performance increases time to relapse—results of a 5-year catamnestic study in schizophrenia patients | Xcog | Training |”
“19. Trapp W Landgrebe Michael Hoesl Katharina Lautenbacher Stefan Gallhofer Bernd Günther Wilfried Hajak Goeran Cognitive remediation improves cognition and good cognitive performance increases time to relapse--results of a 5 year catamnestic study in schizophrenia patients BMC Psychiatry 2013 13 184”
Ninaus finding points to a different reference
MinorThe text attributes the working-memory performance finding to Ninaus et al but cites reference 48, which is an essay by Eriksson and colleagues. The Ninaus study is listed as reference 46.
“With Ninaus et al, presenting evidence that gamification can improve overall participant performance in a working memory training task [48]”
“48. Eriksson B Musialik M Wagner J Student essay 2012 08 6 2016-07-08 Gamification - Engaging the Future”
Citations
Cites
Ryan, R. M., & Deci, E. L. (2000) · American Psychologist · doi:10.1037//0003-066x.55.1.68 · Cited by 54,599 · cited 1×
“One game, Watermons [38], was designed, using Self Determination Theory [50,51], to maximize participant intrinsic motivation and make any motivational effects of game mechanics as apparent as possible.”
Method(1983) · Cited by 33,192
Moral Identity and Developmental Theory
Lapsley, D. K. (2015) · Human Development · doi:10.1159/000435926 · Cited by 3,843
The motivational pull of video games: a self-determination theory approach
Ryan, R. M., Rigby, C. S., & Przybylski, A. (2006) · Motivation and Emotion · doi:10.1007/s11031-006-9051-8 · Cited by 3,332 · cited 1×
“One game, Watermons [38], was designed, using Self Determination Theory [50,51], to maximize participant intrinsic motivation and make any motivational effects of game mechanics as apparent as possible.”
MethodReality is Broken Why Games Make Us Better and How They Can Change the World
(2012) · Choice Reviews Online · doi:10.5860/choice.49-6095 · Cited by 2,933 · cited 1×
“By their nature, games present users with difficult challenges to overcome and use narrative structure, complex graphics, strategic elements, and intuitive rules to engage the user [3].”
BackgroundEysenbach, G. (2005) · Journal of Medical Internet Research · doi:10.2196/jmir.7.1.e11 · Cited by 2,524 · cited 1×
“This is a particular problem for Web-based studies where participants can simply close the browser window and drop out of the study the moment they decide it is not worth their time [5].”
BackgroundIs working memory training effective? A meta-analytic review
Melby-Lervåg, M., & Hulme, C. (2013) · Developmental Psychology · doi:10.1037/a0028228 · Cited by 1,782 · cited 1×
“Cognitive training has often suffered from a lack of transferability [57-59].”
BackgroundVideo game training enhances cognitive control in older adults
Anguera, J. A., Boccanfuso, J., Rintoul, J. L., Al-Hashimi, O., Faraji, F., Janowich, J., Kong, E., Larraburo, Y., Rolle, C., Johnston, E., et al. (2013) · Nature · doi:10.1038/nature12486 · Cited by 1,666 · cited 2×
“…of treated cases with bulimia nervosa Fagundo et al, 2013 [29] Training Neuroracer Video game training enhances cognitive control in older adults Anguera et al, 2013 [30] Training Braingame Brian A pilot study of the efficacy of a computerized executive functioning remediation training with…”
BackgroundBoyle, E. A., Hainey, T., Connolly, T. M., Gray, G., Earp, J., Ott, M., Lim, T., Ninaus, M., Ribeiro, C., & Pereira, J. (2016) · Computers & Education · doi:10.1016/j.compedu.2015.11.003 · Cited by 1,133 · cited 1×
“Furthermore, using games as a vehicle to deliver cognitive training may also be advantageous simply because video games appear to have positive effects on a number of outcomes, including working memory, attentional capacity, problem solving, motivation, emotional control, and prosocial behaviors [6].”
MethodDopamine and the regulation of cognition and attention
Nieoullon, A. (2002) · Progress in Neurobiology · doi:10.1016/s0301-0082(02)00011-4 · Cited by 1,131 · cited 1×
“However, it is thought that playing video games can facilitate the release of extrastriatal dopamine, which plays a role in focusing attention and heightening arousal [68,69]; this may improve player performance and motivation.”
Background
Flagged first, then by citations
1 of the 71 references couldn’t be matched to a known paper.
Research works printed but not linked: 2
- Gamberini, L, 2010, Stud Health Technol Inform, 154, 29
- 1996, Mol Psychiatry, 1, 121
Cited by
Sorted by citations
Items 201–300 of 584
Norrie, C. S., Deckers, S. R. J. M., Radstaake, M., & van Balkom, H. (2024) · Multimodal Technologies and Interaction · doi:10.3390/mti8050038 · Cited by 9
“…process, for example by introducing the motivational affordances of gamification, should not be underestimated on a high-resolution, multimedia-equipped device or platform calibrated to accept user commands, and deliver captivating responses, across the spectrum of sensory modalities [11,22,88,89].”
BackgroundInvestigating m-health gamification rewards elements for adults 50+
Tizuka, M. M., Clua, E., & Salgado, L. C. D. C. (2020) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah49190.2020.9201658 · Cited by 10
“Lumsden and co-authors [38] reviewed 33 studies on gamified applications for cognitive training and assessment purposes.”
BackgroundChatterjee, D., Gavas, R. D., Chakravarty, K., Sinha, A., & Lahiri, U. (2019) · Journal of Eye Movement Research · doi:10.16910/jemr.12.1.5 · Cited by 10
“One of the earlier attempts in digitizing the Symbol-Digit modalities test (SDMT) was done by McLeod et al. (1982). In that test, the user had to reproduce the test query symbol on a numeric keypad and 25 sessions, of 90 seconds each were conducted.”
BackgroundMethodLongitudinal analysis of sustained performance on gamified cognitive assessment tasks
Hu, Y. Z., Urakami, J., Wei, H. T., Vomberg, L. H., & Chignell, M. (2022) · Applied Neuropsychology Adult · doi:10.1080/23279095.2022.2039931 · Cited by 12
“A systematic review of gamified cognitive assessments by Lumsden et al. (2016) revealed that gamification can reduce participants ’ dropout rates over time.”
Using Serious Games to (Re)Train Cognition in Adolescents
Boendermaker, W. J., Peeters, M., Prins, P. J. M., & Wiers, R. W. H. J. (2017) · Springer eBooks · doi:10.1007/978-3-319-51645-5_14 · Cited by 12
“While many of these questions are currently being studied (e.g., Lumsden et al. 2016), several critical notions also apply.”
Broader Understanding of Gamification by Addressing Ethics and Diversity
Goethe, O., & Palmquist, A. (2020) · Lecture notes in computer science · doi:10.1007/978-3-030-60128-7_50 · Cited by 10
Does gamified training improve training performance? A dual-pathway moderated mediation model
Liu, S., & Zhou, H. (2024) · Journal of Business Research · doi:10.1016/j.jbusres.2024.115086 · Cited by 11
Effective engagement in computerized cognitive training for older adults
Guimarães, A. L., Lin, F. V., Panizzutti, R., & Turnbull, A. G. (2025) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102650 · Cited by 8
Zhu, D., Jing, Y., Huang, R., Gao, Y. F., Liu, Y., Zou, Z., & Liu, W. (2022) · Sustainability · doi:10.3390/su142114152 · Cited by 10
Thirkettle, M., Lewis, J., Langdridge, D., & Pike, G. E. (2018) · JMIR Serious Games · doi:10.2196/10519 · Cited by 7
“The large cohort collected by the OU Brainwave app, and, moreover, the repeated measurement of this cohort in quick, engaging gamified versions of classic and novel psychological tests, is another demonstration of the promise of mobile app-based testing [39].”
BackgroundDesigning a Crowdsourcing System for the Elderly: A Gamified Approach to Speech Collection
Seong, E., & Kim, S. (2020) · CHI Conference Extended Abstracts on Human Factors in Computing Systems (CHI EA) · doi:10.1145/3334480.3382999 · Cited by 9
“Furthermore, gamification for older participants is usually limited to the domains of physical and cognitive training and improvement [15, 21].”
BackgroundA Framework for Using Cognitive Assessment Games for People Living with Dementia
Zhang, B. B. B., & Chignell, M. (2020) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah49190.2020.9201813 · Cited by 12
“The existing serious games developed thus far often emphasize creative design, where irrelevant aesthetic or motivational features [39] may distract players from the cognitive task being performed.”
BackgroundChaldogeridis, A., & Tsiatsos, Τ. (2022) · Applied Sciences · doi:10.3390/app12199785 · Cited by 11
The Design Of A Game-based Software For Children With Autism Spectrum Disorder
Luongo, M., Simeoli, R., Marocco, ., et al. (2022) · IEEE International Conference on Metrology for eXtended Reality, Artificial Intelligence and Neural Engineering (MetroXRAINE) · doi:10.1109/metroxraine54828.2022.9967545 · Cited by 9
“Indeed, in recent years, serious games have been used to improve children's engagement, motivation and learning and reduce the negative aspects of classical cognitive assessment [19].”
BackgroundLee, R. S. C., Albertella, L., Christensen, E., Suo, C., Segrave, R. A., Brydevall, M., Kirkham, R., Liu, C., Fontenelle, L. F., Chamberlain, S. R., et al. (2023) · Journal of Medical Internet Research · doi:10.2196/44414 · Cited by 8
“…relies on people giving strong and enduring effort to the task at hand [16], “gamification” (ie, the redesign of tasks to include game elements) [17] was used with the goal of addressing the potential motivational challenges that stem from unsupervised testing environments and are inherent to…”
Paraskevopoulos, E., Chalas, N., Karagiorgis, A., Karagianni, M., Styliadis, C., Papadelis, G., & Bamidis, P. (2020) · Cerebral Cortex · doi:10.1093/cercor/bhaa213 · Cited by 9
Bastardo, R., Pavão, J., Martins, A. I., Silva, A. G., & Rocha, N. P. (2022) · Procedia Computer Science · doi:10.1016/j.procs.2021.12.097 · Cited by 8
Ho, W.-K., Sum, R. K. W., & Tang, D. (2024) · Current Psychology · doi:10.1007/s12144-024-05997-4 · Cited by 7
“Several reviews and meta-analyses have also investigated the effect of video games training as tools for enhancing individuals’ well-being, par - ticularly regarding cognitive and emotive enhancement in children and in older adults (Boyle et al., 2016 ; Lumsden et al., 2016 ).”
Implementation of game methods in the preparation of management personnel
Vinichenko, M. V., Melnichuk, A. V., & Makushkin, S. A. (2018) · International Conference on Higher Education Advances (HEAd) · doi:10.4995/head18.2018.8000 · Cited by 8
“Age and gender specificities of gaming are studied (Marti-Parreno et al, 2016), security and confidentiality (Baxter et al, 2016), cognitive learning (Lumsden et al, 2016).”
BackgroundButler, S. K., Runge, M. A., & Milad, M. P. (2020) · Southern Medical Journal · doi:10.14423/smj.0000000000001165 · Cited by 7
“The data gathered on gaming as a primary tool for education have largely focused on learner satisfaction.(3,7,24) Although learner outcome data have begun to emerge, a recent Cochrane systematic review only identified two high-quality research studies to review.”
BackgroundMartins, P. S. R., Barbosa‐Pereira, D., Valgas-Costa, M., & Alves, M. M. (2020) · Applied Neuropsychology Child · doi:10.1080/21622965.2020.1846128 · Cited by 10
A Game-Based Approach to Examining Students’ Conceptual Knowledge of Fractions
Ninaus, M., Kiili, K. J. M., McMullen, J. A., & Moeller, K. (2016) · Lecture notes in computer science · doi:10.1007/978-3-319-50182-6_4 · Cited by 8
Vugts, M. A. P., Joosen, M. C. W., Mert, A., Zedlitz, A. M. E. E., & Vrijhoef, H. J. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-016394 · Cited by 6
“…of gaming and simulation, no evident application seems to exist for supporting biopsychosocial adjustment processes in patients with CP or FSS. 2 3 32–37 Outcome improvement after treatment in patients with CP or FSS may be mediated by changes in aspects of self (beliefs about illness and fear…”
Gamification in psychological assessment in South Africa: A narrative review
Akoodie, Y. (2020) · African Journal of Psychological Assessment · doi:10.4102/ajopa.v2i0.24 · Cited by 7
Aubert, A. H., McConville, J. R., Schmid, S., et al. (2022) · EURO Journal on Decision Processes · doi:10.1016/j.ejdp.2022.100021 · Cited by 7
Ó’Caoimh, R., Molloy, D. W., Fitzgerald, C., van Velsen, L., Cabrita, M., Nassabi, M. H., de Vette, F., Weering, M. D.-V., Jansen-Kosterink, S. M., Kenter, W., et al. (2018) · Communications in computer and information science · doi:10.1007/978-3-319-93644-4_4 · Cited by 9
Eiler, T. J., Grünewald, A., Wahl, M. G., & Brück, R. (2020) · Communications in computer and information science · doi:10.1007/978-3-030-41590-7_7 · Cited by 7
Schweizer, S., Leung, J. T., Trender, W. R., Kievit, R., Hampshire, A., & Blakemore, S. (2023) · Psychological Medicine · doi:10.1017/s0033291723002167 · Cited by 7
“Meta-analytic evidence demonstrates that it is an effective tool to reliably encourage attentional engagement and motivation to increase rates of training (Lumsden, Edwards, Lawrence, Coyle, & Munafò, 2016).”
MethodPragmatics Communication Deficiencies and the Role of Gamification
Toki, E. I., Fakitsa, P., Drosos, K., Pange, J., Siafaka, V., Karampas, A., & Petrikis, P. (2018) · The European Journal of Social & Behavioural Sciences · doi:10.15405/ejsbs.232 · Cited by 8
Guglietti, B., Hobbs, D., Wesson, B., Ellul, B., McNamara, A., Drum, S., & Collins-Praino, L. (2022) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2022.728212 · Cited by 8
Kubota, A., Pei, R., Sun, E., Sandoval, D. C., Kim, S., & Riek, L. D. (2023) · ACM/IEEE International Conference on Human-Robot Interaction (HRI) · doi:10.1145/3568162.3576993 · Cited by 8
“Many existing cognitive training systems for older adults incorporate gamification features to improve and sustain engagement, motivation, and intervention effects [20, 37, 47].”
BackgroundBhargava, Y., & Baths, V. (2024) · JMIR XR and spatial computing. · doi:10.2196/59197 · Cited by 8
“In fact, direct user opinions and feedback are crucial to ground the VR-based games for cognitive assessment and help separate practical utility from the VR hype [51-54].”
Soltanlou, M., Jung, S., Roesch, S., Ninaus, M., Brandelik, K., Heller, J., Grust, T., Nuerk, H., & Moeller, K. (2017) · Springer eBooks · doi:10.1007/978-3-319-64274-1_7 · Cited by 8
Reflection Through Gaming: Reinforcing Health Message Response Through Gamified Rehearsal
Tikka, P., Laitinen, M., Manninen, I., & B, H. O.-K. A. (2018) · Lecture notes in computer science · doi:10.1007/978-3-319-78978-1_17 · Cited by 7
“Further to that, cognitive tests have also been used before as the basis of a gamified system [18].”
MethodInteractive Block Games for Assessing Children's Cognitive Skills: Design and Preliminary Evaluation
Lee, K., Jeong, D., Schindler, R. C., Hlavaty, L. E., Gross, S. I., & Short, E. J. (2018) · Frontiers in Pediatrics · doi:10.3389/fped.2018.00111 · Cited by 6
“A recent review reported that gamified cognitive tests, using a computer or other technical tools, were highly engaging and reduced anxiety and thus improved motivation (29).”
BackgroundAeberhard, A., Gschwind, L., Kossowsky, J., Lukšys, G., Papassotiropoulos, A., de Quervain, D. J. ‐., & Vogler, C. (2018) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-018-0071-5 · Cited by 8
Margolis, A. A., Kuravsky, L. S., Шепелева, Е. А., et al. (2018) · Journal of Modern Foreign Psychology · doi:10.17759/jmfp.2018070304 · Cited by 7
Bignardi, G., Dalmaijer, E. S., Anwyl-Irvine, A. L., & Astle, D. E. (2020) · doi:10.31219/osf.io/aw6c5 · Cited by 7
Freichel, R., Christensen, E., Mrkonja, L., de Jong, P. J., Cousijn, J., Franken, I. H. A., Yücel, M., Lee, R., Veer, I. M., Albertella, L., et al. (2024) · Addictive Behaviors Reports · doi:10.1016/j.abrep.2024.100534 · Cited by 5
Faisal, H., Lim, W., Dattagupta, A., Lin, P., Gupta, R. V., Lai, E. C., Xu, J., Wong, S. T. C., & Masud, F. N. (2024) · Games for Health Journal · doi:10.1089/g4h.2024.0039 · Cited by 6
Serious game for cognitive assessment. Validation of a psychometric embedded test
Zuluaga, C. A. M., Quimbaya, J., & Herrera-Marmolejo, A. (2024) · International Journal of Serious Games · doi:10.17083/ijsg.v11i3.667 · Cited by 9
Pang, Y. J., Singh, A., Chakraborty, S., Charness, N. H., Boot, W. R., & He, Z. (2024) · PLoS ONE · doi:10.1371/journal.pone.0311279 · Cited by 6
Fatima, E., Hill, I., Dover, N., et al. (2025) · Behavioral Sciences · doi:10.3390/bs15020186 · Cited by 6
“…and utilizing virtual reality (VR) for game-based CS can improve cognitive function (Tobar et al., 2017), (Gibbor et al., 2021) and increase participant engagement (Barnes et al., 2009; Brugada-Ramentol et al., 2022; Green & Bavelier, 2003; Lee et al., 2020; Lumsden et al., 2016; Man et al., 2013).”
O’Laughlin, K. D., Cheng, B. H., Volponi, J. J., Lorentz, J. D. A., Obregon, S. A., Younger, J. W., Gazzaley, A. H., Uncapher, M. R., & Anguera, J. A. (2025) · Journal of Medical Internet Research · doi:10.2196/60041 · Cited by 8
“These facets were targeted to improve user motivation and engagement (the studies by Lumsden et al [19] and Vermeir et al [20] present reviews on the same).”
InfluentialArnáez, S., Roncero, M., Santiago, J. L., del Valle, G. D. V., Cabedo, E., Bottesi, G., & García‐Soriano, G. (2025) · British Journal of Clinical Psychology · doi:10.1111/bjc.12537 · Cited by 5
“Consequently, the use of gamification in the treatment of mental disorders has significantly increased in recent years due to its ability to enhance treatment adherence, boost motivation and facilitate the learning of therapeutic strategies (Fleming et al., 2017; Lumsden et al., 2016).”
Advancing Cognitive Health in Aging Populations by Leveraging Digital Assessment
Coppola, Q., Yangüez, M., Tullo, D., Jaeggi, S. M., & Seitz, A. R. (2024) · Journal of Health Service Psychology · doi:10.1007/s42843-024-00102-6 · Cited by 5
“Thus, adapting and tailoring the visual elements of a task (e.g., font size) or even the structure of a task (e.g., gamified vs. non-gamified) to each individual’s needs has the potential to positively impact engagement and ultimately assessment fidelity (Lumsden et al., 2016).”
Nguyen, L., Murphy, K. A., & Andrews, G. (2024) · Entertainment Computing · doi:10.1016/j.entcom.2024.100892 · Cited by 7
Game On: A Pilot Study of a Gamified Digital Learning Platform and Protocol
Coelho, F., Gonçalves, D. J. V., & Abreu, A. M. (2024) · International Conference on Digital Technology in Education (ICDTE) · doi:10.1145/3696230.3696235 · Cited by 6
New frontiers in cognitive ability testing: working memory
Martin, N. R., Capman, J. F., Boyce, A. S., Morgan, K., Gonzalez, M. F., & Adler, S. (2020) · Journal of Managerial Psychology · doi:10.1108/jmp-09-2018-0422 · Cited by 6
Jayasinghe, H., Short, C. E., Braunack‐Mayer, A., Merkin, A., & Hume, C. (2020) · Journal of Medical Internet Research · doi:10.2196/17915 · Cited by 5
“There has been development in the field to make these tasks more engaging by adding elements of gamification that use visuals, sound effects, point systems, and rewards to make the tasks more engaging [19,24-27,50].”
BackgroundVeraksa, N. E., Сергеевна, А. М., Сергеевна, Т. К., & Klimenko, V. A. (2023) · Вестник Российского университета дружбы народов. Серия: Психология и педагогика · doi:10.22363/2313-1683-2023-20-1-105-125 · Cited by 8
Gamification and motivation: Impact on delay discounting performance
Harvey, S., Jensen, G., & Anderson, K. G. (2024) · PLoS ONE · doi:10.1371/journal.pone.0299511 · Cited by 7
Kratochvíl, T., Lebedíková, M. Š., Vaculík, M., Procházka, J., & Lieberoth, A. (2025) · Learning and Individual Differences · doi:10.1016/j.lindif.2025.102708 · Cited by 5
Exploring the potential of a game-based preschool assessment of mathematical competencies
Chatzaki, M.-A., Skillen, J., Ricken, G., & Seitz-Stein, K. (2024) · Frontiers in Education · doi:10.3389/feduc.2024.1337716 · Cited by 12
Adolphe, M., Pech, M., Sawayama, M., Maurel, D., Delmas, A., Oudeyer, P., & Sauzeon, H. (2025) · PLoS ONE · doi:10.1371/journal.pone.0316860 · Cited by 10
Somma, F., Rega, A., & Gigliotta, O. (2019) · Cited by 6
Who am I? - Development and Analysis of an Interactive 3D Game for Psychometric Testing
Afroza, A., Murray, K. R., Wünsche, B. C., et al. (2021) · Australasian Computer Science Week Multiconference (ACSW) · doi:10.1145/3437378.3442688 · Cited by 5
Karagiorgis, A., Chalas, N., Karagianni, M. A., Papadelis, G., Vivas, A. B., Bamidis, P. D., & Paraskevopoulos, E. (2021) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2021.742607 · Cited by 5
Gamification in Adult Learning
Gül, A., & Uz-Bilgin, C. (2021) · IGI Global eBooks · doi:10.4018/978-1-7998-8598-6.ch045 · Cited by 8
Video Game to Attenuate Pandemic-Related Stress From an Equity Lens: Development and Usability Study
Minian, N., Saiva, A., Gayapersad, A., Dragonetti, R., Proulx, C., Debergue, P., Lecce, J., Hussain, S., Desjardins, E., & Selby, P. L. (2022) · JMIR Formative Research · doi:10.2196/36820 · Cited by 5
A psychometric view of technology-based assessments
Liou, G., Bonner, C. V., & Tay, L. (2022) · International Journal of Testing · doi:10.1080/15305058.2022.2070757 · Cited by 7
“Assessing test-retest reliability does not appear to be standard in gamified assessments; in fact, a recent study reviewing 33 gamified cognitive assessments found that most studies did not look at reliability (Lumsden et al., 2016).”
BackgroundFrolli, A., Cerciello, F., Esposito, C., Russo, M., & Bisogni, F. (2023) · Pediatric Reports · doi:10.3390/pediatric15030046 · Cited by 11
“While the exact extent of their impact remains uncertain, it is worth exploring the development of gamified cognitive tasks in the future [40].”
BackgroundDécaillet, M., Denervaud, S., Huguenin-Virchaux, C., Besuchet, L., Graz, M. B., Fischer-Fumeaux, C., & Schneider, J. (2023) · Applied Neuropsychology Child · doi:10.1080/21622965.2023.2287059 · Cited by 4
“In addition, it is important to increase the attrac-tivity of the tasks to improve children’s involvement in the assessment (Lumsden et al., 2016).”
The advantages of gamification for collecting linguistic data: A case study using Word Ladders
Genovese, F., Bolognesi, M., Iorio, A. D., & Vitali, F. (2024) · Online Journal of Communication and Media Technologies · doi:10.30935/ojcmt/14443 · Cited by 6
“Lumsden et al. (2016) for instance review six studies that provide empirical evidence in support to the claim that performance problems in ADHD patients may be alleviated by gamified settings, because this population is particularly sensitive to quick rewards and immediate feedback, which are…”
BackgroundResultInfluentialCo-Designing a Recommender System for the Elderly
Herpich, M., Rist, T., & André, E. (2017) · International Conference on PErvasive Technologies Related to Assistive Environments (PETRA) · doi:10.1145/3056540.3064948 · Cited by 5
“[5] reviewed 33 studies on gamified applications for cognitive training and assessment purposes.”
BackgroundSerious games for health, well-being, and medical applications
Kato, P. M. (2017) · Digital Medicine · doi:10.4103/digm.digm_53_16 · Cited by 4
“© 2017 DIGITAL MEDICINE | PUBLISHED BY WOLTERS KLUWER - MEDKNOW 43 scientific and clinical value of these efforts.[10] For example, using a game approach to assess the physical activity levels may not be a valid indicator of “normal” physical activity levels of an individual if the game components impact motivation an…”
BackgroundTaking Language out of the Equation: The Assessment of Basic Math Competence Without Language
Greisen, M., Hornung, C., Baudson, T. G., Muller, C., Martin, R., & Schiltz, C. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.01076 · Cited by 5
“This might be due to the video-game-like appearance of the assessment tool, which differs considerably from the paper-and-pencil material that they encounter in everyday math classes, which probably helped to promote task compliance and motivation (Lumsden et al., 2016).”
BackgroundGOAL (Games for Olders Active Life): A Web-Application for Cognitive Impairment Tele-Rehabilitation
GOAL Project Group, Martini, L., Vannetti, F., Fabbri, L., Gerli, F., Mosca, I., Pazzi, S., Baglio, F., & Bocchi, L. (2018) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-981-10-9023-3_32 · Cited by 6
Gamifying a BCSS: rehearsal and reflection in reinforcing a health message response
Tikka, P., Laitinen, M., Manninen, I., & B, H. O.-K. A. (2019) · Behaviour and Information Technology · doi:10.1080/0144929x.2019.1656778 · Cited by 5
Achiron, A., Alonix, R., Croisile, B., Gurevich, M., Doniger, G., & Tarpin-Bernard, F. (2019) · SeGAH ... IEEE ... International Conference on Serious Games and Applications for Health/IEEE International Conference on Serious Games and Applications for Health · doi:10.1109/segah.2019.8882446 · Cited by 4
Treating Children With Speech Sound Disorders: Development of a Tangible Artefact Prototype
Santos, J. P., Vairinhos, M., & Jesus, L. M. T. (2019) · JMIR Serious Games · doi:10.2196/13861 · Cited by 5
“By further hiding away the test or activity behind a game-like approach, the stakeholders might feel more relaxed and willing to participate [32].”
Aubert, A. H., & Friedrich, M. (2021) · PLoS ONE · doi:10.1371/journal.pone.0244077 · Cited by 7
“For instance, gamified cognitive tasks are more engaging and require less effort, resulting in lower drop-out rates from longitudinal studies than the traditional versions of the cognitive tasks [14].”
BackgroundResultInfluentialPrasch, J. E., Neelim, A., Carbon, C., Schoormans, J. P. L., & Blijlevens, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.705858 · Cited by 8
“Successfully engaging people in a task is vital for the effectiveness of that task (Lumsden et al., 2016).”
BackgroundInfluentialCowley, B. U., Charles, D. K., Pfuhl, G., & Rusanen, A. (2022) · Springer eBooks · doi:10.1007/978-3-031-09687-7_18 · Cited by 5
Comprehensive and Gamified Rehabilitation System for Upper-Limb Impairment Treatments
Yazdnian, V., Delavari, A., Moradi, H., Shams, S., Teymouri, M., & Rezaei, A. (2022) · RSI International Conference on Robotics and Mechatronics (ICRoM) · doi:10.1109/icrom57054.2022.10025334 · Cited by 7
“Lumsden et al. [15] reviewed studies on the efficacy of gamified cognitive tasks employed across a variety of disorders.”
BackgroundActitudes del profesorado hacia la gamificación
Gómez, M. V. C., & Gómez‐Baya, D. (2022) · Análisis y Modificación de Conducta · doi:10.33776/amc.v48i177.7185 · Cited by 5
“De igual modo, ha obtenido resultados positivos en su incorporación con alumnos con necesidades educativas especiales, pues han mejorado los problemas de rendimiento en alumnos con TDAH mediante el uso de tareas en relación con el juego (Lumsden et al., 2016).”
BackgroundZhang, Q., Grassi, A., & Vallati, M. (2025) · Sustainable Futures · doi:10.1016/j.sftr.2025.101589 · Cited by 6
Shaban, A., Chang, V. I. C., Amodu, O. D., Attia, M. R., & Abdelhamid, G. S. M. (2024) · Education Sciences · doi:10.3390/educsci14111260 · Cited by 9
“Thereby, this might negatively influence the quality of the collected data and/or reduce the effect of the intended intervention [26].”
Markovitch, B., Kamps, J. C. C., Markopoulos, P., & Birk, M. V. (2025) · Computers in Human Behavior · doi:10.1016/j.chb.2025.108720 · Cited by 5
Mantell, R., Hwang, Y. I., Dark, M., Radford, K. A., Kasumovic, M. M., Monds, L. A., Schofield, P. W., Butler, T. G., & Withall, A. (2025) · JMIR Aging · doi:10.2196/65252 · Cited by 4
“Tests of this nature have encountered validation issues [12] as well as similar problems to traditional testing, such as a lack of user motivation when performing somewhat uninteresting tasks on a computer [2].”
InfluentialComputational Empathy Counteracts the Negative Effects of Anger on Creative Problem Solving
Groh, M., Ferguson, C., Lewis, R., & Picard, R. W. (2022) · International Conference on Affective Computing and Intelligent Interaction and workshops · doi:10.1109/acii55700.2022.9953869 · Cited by 7
“These tests aid our understanding of the mechanisms of human decision-making and problem solving, and have found utility in various contexts including mental health monitoring where impairments in decision-making processes may be indicative of disorders like anxiety or anhedonia [25, 26].”
BackgroundDesign of a video game for assessment of executive functions in deaf and hearing children
Mejía, C., Herrera-Marmolejo, A., Pérez, M. R., Quimbaya, J., & Cardona, J. F. (2024) · Applied Neuropsychology Child · doi:10.1080/21622965.2024.2311096 · Cited by 4
“…gamification elements into non-gaming contexts has demonstrated its ability to motivate participants, reduce anxiety, and minimize dropout rates in long-term studies, highlighting the versatility of this approach in educational and clinical settings (Deterding et al., 2011; Lumsden et al., 2016).”
Bolt, G. L., Piercy, H., Bradshaw, J., & Manning, V. (2024) · Drug and Alcohol Review · doi:10.1111/dar.13827 · Cited by 6
A digital intervention to support childhood cognition after the COVID-19 pandemic: a pilot trial
Kirk, H., Spencer‐Smith, M. M., Jobson, L., Nicolaou, E., Cornish, K. M., Melzak, E., Hrysanidis, C., Moriarty, C., Davey, B., Whyman, T., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-63473-2 · Cited by 6
“Gamified cognitive training may promote greater effort and engagement during training, which may result in greater gains post training compared to non-gamified cognitive training interventions 41,42 .”
BackgroundSubstitution of a Traditional Face-to-Face Workshop With Virtual Escape Room in Higher Education
Krishnan, S., Ademi, Z., Malone, D. T., Abebe, T. B., & Lim, A. S. (2024) · Simulation in Healthcare The Journal of the Society for Simulation in Healthcare · doi:10.1097/sih.0000000000000811 · Cited by 4
Muszyński, M. A., Banasik‐Jemielniak, N., Żółtak, T., Rimfeld, K., Shakeshaft, N. G., Schofield, K. L., Malanchini, M., & Pokropek, A. (2025) · Quality & Quantity · doi:10.1007/s11135-025-02254-z · Cited by 6
“It is assumed that gamification increases participants’ engagement, but real effects depend on gamification design, test type (e.g. measured content) and purpose, and other factors that are yet to be researched (Khaleghi et al. 2021; Lumsden et al. 2016).”
Jackson, G. T., Lehman, B. A., & Grace, L. (2020) · International Conference on the Foundations of Digital Games (FDG) · doi:10.1145/3402942.3402998 · Cited by 4
Trapp, W. (2021) · International Psychogeriatrics · doi:10.1017/s1041610220003361 · Cited by 4
Trading Accuracy for Enjoyment? Data Quality and Player Experience in Data Collection Games
Gundry, D., & Deterding, S. (2022) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3491102.3502025 · Cited by 6
Guimar�ães, V., Sousa, I., de Bruin, E. D., et al. (2023) · Digital Health · doi:10.1177/20552076231167001 · Cited by 4
“For being played primarily as a form of entertainment, games allow assessments to be more frequent, affordable, and enjoyable.(11,12) Many commercial off-the-shelf games incorporate cognitive challenges such as memorizing sequences, making decisions, recognizing patterns, or analyzing complex information.”
BackgroundMarkovitch, B., Markopoulos, P., & Birk, M. V. (2024) · CHI Conference on Human Factors in Computing Systems · doi:10.1145/3613904.3642418 · Cited by 7
“Such cognitive games have been validated as cognitive measurements [36, 61, 104] and showed the ability to predict psychopathology [67].”
BackgroundInfluentialПрименение компьютерных игровых технологий для развития регуляторных функций дошкольников
Veraksa, A. N., & Bukhalenkova, D. А. (2017) · Российский психологический журнал · doi:10.21702/rpj.2017.3.6 · Cited by 4
Pearson, E., & Shaban, A. (2019) · International Web for All Conference (W4A) · doi:10.1145/3315002.3332440 · Cited by 4
The Use of Gamification in Evaluating Children’s Emotional Intelligence
Narimani, A., Khaleghi, A., Haedar, H., & Semnani, F. (2020) · Advances in intelligent systems and computing · doi:10.1007/978-3-030-49932-7_75 · Cited by 5
Cognitive pediatric tele-assessment: a scoping review
Viñas‐Guasch, N., Chia, P. S. Q., Yap, M. L.-M., Wu, C., & Chen, S. A. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1288021 · Cited by 4
Escudero, J. P. S., Aguillon, D. F., Valencia, S. M., García-Barrera, M. A., Aguirre–Acevedo, D. C., & Trujillo, N. (2024) · JMIR Serious Games · doi:10.2196/66167 · Cited by 4
“These games offer a viable solution for remote, repeated assessments on a population scale [4,5,33].”
InfluentialScreening for Cognitive Impairment and Dementia Among Older People in Custody: A Systematic Review
Iloabachie, M. C., Stoliker, B. E., Jewell, L. M., & Kent-Wilkinson, A. E. (2025) · Dementia · doi:10.1177/14713012251356587 · Cited by 3
“Users of serious games are given distinctive and engaging environments to accomplish tasks that go beyond simple amusement (Lumsden et al., 2016).”
Ahmed, M., Delisle, F., Hanafi, L., Hudon, A., Brunelin, J., Mondino, M., Potvin, S., & Cailhol, L. (2025) · Journal of Psychiatry and Neuroscience · doi:10.1503/jpn.250041 · Cited by 3
Digital Tools for Reading Success: Meta-analyses of Digital Interventions
Pasqualotto, A., Cunningham, E. G., Holman, C., Bediou, B., & Bavelier, D. (2025) · Journal of Cognitive Enhancement · doi:10.1007/s41465-025-00336-2 · Cited by 8
“…through finely tuned interactivity, ease of accessibility, low costs, attractive graphics, and acceptance by users as enjoyable and engaging activities (Barr & Kir-korian, 2023; Jamshidifarsani et al., 2019; Lumsden et al., 2016; Pasqualotto et al., 2023; Plass et al., 2019; Vermeir et al., 2020).”
Santángelo, A. P., & Solovey, G. (2021) · Journal of Cognition · doi:10.5334/joc.200 · Cited by 3
Metadata
- Authors
- Lumsden, J., Edwards, E. A., Lawrence, N. S., Coyle, D., & Munafò, M. R.
- Affiliations
- University of Bristol (GB)
- Queen Mary University of London (GB)
- University of Exeter (GB)
- University College Dublin (IE)
- Corresponding author
- Lumsden, Jim
- Venue
- JMIR Serious Games
- Publisher
- JMIR Publications Inc.
- Published
- 2016-07-15
- Volume
- 4
- Issue
- 2
- Pages
- e11
- ISSN
- 2291-9279 (ISSN-L)
- PMC
- PMC4967181
- OpenAlex
- W2465353856
- Semantic Scholar
- 4f2c6684a94d57d5dc731e41341a6b0109778428
- Cited by
- 555
- References
- 71
- Citations by year
- 2026: 57 · 2025: 77 · 2024: 74 · 2023: 52 · 2022: 61 · 2021: 56 · 2020: 70 · 2019: 43 · 2018: 37 · 2017: 22 · 2016: 6
- FWCI
- 6.76
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- JMIR Serious Games (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Open Research Exeter (University of Exeter) (acceptedVersion)
- Arrow@dit (Dublin Institute of Technology) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion, other-oa)
- Research Repository UCD (University College Dublin) (submittedVersion, cc-by-nc-nd)
- Funders
- Wellcome Trust (092731)
- United Kingdom Clinical Research Collaboration
- Cancer Research UK
- National Institute for Health and Care Research (NIHR-IPF-16-10-04)
- British Heart Foundation
- University of Bristol (092731, MC_UU_12013/6)
- Medical Research Council (MC_UU_12013, MR/K023195/1, 092731, MC_UU_12013/6)
- Economic and Social Research Council (ES/G007489/1, 1325188)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Educational Games and Gamification
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- gamification, cognitive assessment, cognitive training, participant engagement, working memory, executive function, game elements, task validation, motivation, neuropsychological assessment
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