Multimedia Mixed Reality Interactive Shared Decision-Making Game in Children with Moderate to Severe Atopic Dermatitis, a Pilot Study

Abstract

(1) Objective: Atopic dermatitis (AD) is a recurring skin disease that affects children’s daily activities and sleep quality. Due to the limitations of children’s understanding and ability to express themselves, shared decision making (SDM) is often made by guardians, which thus affects the acceptance and effectiveness of children’s treatments. Previous studies have demonstrated that involving both children and parents in decision making may help improve treatment outcomes; thus, we designed a multimedia mixed reality (MR) interactive game of SDM for children with moderate to severe AD. (2) Methods: Research participants included 6–18-year-old patients with moderate to severe AD. This research consisted of the following steps: designing SDM; character setting and visual design; performing games; system modification and optimization; screen editing and dubbing; and user testing and questionnaires by the System Usability Scale (SUS). (3) Results: We completed the SDM design for children with moderate to severe AD. Four different treatments were biologics, oral immune-modulating drugs, phototherapy, and wet wrap. An animated PowerPoint slide showed the AD apple rolling around before treatments and the AD apple sleeping soundly after treatments. Instructions with video teaching for the four different treatments were played, and then, the MR was turned on so that the patients could help the AD apple in the metaverse to undergo these four treatments. A total of 12 moderate to severe AD patients and six control patients used the game, all aged between six and eighteen years old, with an average SUS score of 81.0 and a standard error of 2.1 points. Adjective ratings yielded a rating between good and excellent. The game showed acceptable usability. We found no statistically significant differences in SUS scores between patients with and without moderate to severe AD or between boys and girls nor significant associations between SUS and age or severity. The analysis identified that the two items with the lowest SUS scores were “I think that I would need the support of a technical person to be able to use this product” and “I needed to learn a lot of things before I could get going with this product”. Both of these comments show the limitations of this game. (4) Conclusions: Overall, this study provides the first MR SDM game that has passed the SUS and can be used as an aid in clinical SDM.

Pediatric Urology Metaverse

“…Lastly, Chang et al [10] provided the first interactive multimedia mixed reality game with the purpose of implementing shared decision-making processes in children with atopic dermatitis. In chronic diseases, such as atopic dermatitis itself, the issues in children's communication and their difficulties in explaining their own clinical symptoms limit the treatment's effectiveness; therefore, therapeutic decisions are often decided with the children's parents' collaboration.…”

Perinatal Characteristics and the Sensitization to Cow Milk, Egg Whites and Wheat in Children up to 3 Years of Age

“…After validation, the Chang Gung Research Database included a population with high disease severity [52]. The adults did not visit medical centers for mild rhinitis or dermatitis [53]. We also found that the positive rate of food allergens in adults was much lower than that in children [54].…”

Navigating the metaverse: A technical review of emerging virtual worlds

“…Twenty-six cerebral palsy children were included in a randomized controlled experiment by the authors to show that metaverse-based physical treatment is superior to traditional physical therapy. Chang et al (2023) developed their initial multimedia interactive game to encourage collaborative decision-making among children with atopic dermatitis.…”

“…The pressing need for digital transformation within healthcare settings has significantly escalated during this period. Metaverse enabled healthcare developments, and research have been discussed by Aamer et al (2019), Ahmadpour et al (2020), Alaraj et al (2011), Ali and Puthusserypady (2015), Anthony Jnr (2021), Arpaia et al (2020), Arpaia et al (2021), Ayed et al (2019), Borges et al (2016), Brown et al (2020), Cardoş et al (2017), Chang et al (2023), Chen et al (2019), Cheng et al (2020), Chung et al (2018), Clus et al (2018), Crescentini et al (2016), Cuperus et al (2018), Dermody et al (2020), Dyer et al (2022), Faller et al (2010), Faric et al (2019), Fernández et al (2017), Gaggioli et al (2014), Gannotta et al (2018), García‐Batista et al (2020), Goldenhersch et al (2020), Howard (2017), Jung et al (2020), Kala (2022), Kerous and Liarokapis (2017), Kim et al (2017), Kim et al (2020), Kim et al (2021), Kim and Kim (2023), Kip et al (2019), Krijn et al (2004), Lenhardt and Ritter (2010), Lin et al (2020), López‐Ojeda and Hurley (2023), Martens et al (2012), Matsangidou et al (2022), Mattila et al (2020), McMahon and Schukat (2018), Mercado et al (2019), Mertens et al (2019), Miloff et al (2020), Moon et al (2023), Ng et al (2019), Orr et al (2023), O'Sullivan et al (2018), Park et al (2021), Pedram et al (2020), Pot‐Kolder et al (…”