Sanchez-Escudero Juan Pablo, Aguillon David, Valencia Stella, Garcia-Barrera Mauricio A, Aguirre-Acevedo Daniel Camilo, Trujillo Natalia
Group of Epidemiology, Universidad de Antioquia, Medellín, Colombia.
Grupo de Neurociencias de Antioquia, University of Antioquia, Medellín, Colombia.
JMIR Serious Games. 2025 Apr 2;13:e66167. doi: 10.2196/66167.
Alzheimer disease (AD) is the leading cause of dementia worldwide. With aging populations and limited access to effective treatments, there is an urgent need for innovative markers to support timely preventive interventions. Emerging evidence highlights spatial cognition (SC) as a valuable source of cognitive markers for AD. This study presents NavegApp, a serious game (SG) designed to assess 3 key components of SC, which show potential as cognitive markers for the early detection of AD.
This study aimed to determine the content validity and usability perception of NavegApp across multiple groups of interest.
A multistep process integrating methodologies from software engineering, psychometrics, and health measurement was implemented to validate the software. Our approach was structured into 3 stages, guided by the software life cycle for health and the Consensus-Based Standards for the Selection of Health Status Measurement Instruments (COSMIN) recommendations for evaluating the psychometric quality of health instruments. To assess content validity, a panel of 8 experts evaluated the relevance and representativeness of tasks included in the app. In addition, 212 participants, categorized into 5 groups based on their clinical status and risk level for AD, were recruited to evaluate the app's digital ergonomics and usability at various stages of development. Complementary analyses were performed to identify group differences and to explore the association between task difficulty and user agreeableness.
NavegApp was validated as a highly usable tool by both experts and users. The expert panel confirmed that the tasks included in the game were representative (Aiken V=0.96-1.00) and relevant (Aiken V=0.96-1.00) for measuring SC components. Both experts and nonexperts rated NavegApp's digital ergonomics positively, with minimal differences between groups (r 0.08-0.29). Differences in usability perceptions were observed among participants with sporadic mild cognitive impairment compared to cognitively healthy individuals (r 0.26-0.29). A moderate association was also identified between task difficulty and user agreeableness (Cramér V=0.37, 95% CI 0.28-0.54).
NavegApp is a valid and user-friendly SG designed for SC assessment, developed by integrating software engineering and psychometric evaluation methodologies. While the results are promising, further studies are warranted to evaluate its diagnostic accuracy and construct validity. This work outlines a comprehensive framework for SG development in cognitive assessment, emphasizing the importance of incorporating psychometric validity measures from the outset of the design process.
阿尔茨海默病（AD）是全球痴呆症的主要病因。随着人口老龄化以及有效治疗手段有限，迫切需要创新标志物来支持及时的预防性干预。新出现的证据凸显了空间认知（SC）作为AD认知标志物的宝贵来源。本研究介绍了NavegApp，这是一款严肃游戏（SG），旨在评估SC的3个关键组成部分，这些组成部分显示出作为AD早期检测认知标志物的潜力。
本研究旨在确定NavegApp在多组感兴趣人群中的内容效度和可用性感知。
实施了一个多步骤过程，整合了软件工程、心理测量学和健康测量的方法来验证该软件。我们的方法分为3个阶段，以健康软件生命周期和基于共识的健康状况测量工具选择标准（COSMIN）对评估健康工具心理测量质量的建议为指导。为评估内容效度，由8名专家组成的小组评估了应用程序中包含的任务的相关性和代表性。此外，招募了212名参与者，根据他们的临床状态和AD风险水平分为5组，以在开发的各个阶段评估应用程序的数字人体工程学和可用性。进行了补充分析以确定组间差异，并探索任务难度与用户满意度之间的关联。
NavegApp被专家和用户验证为高度可用的工具。专家小组确认游戏中包含的任务对于测量SC组成部分具有代表性（艾肯V = 0.96 - 1.00）且相关（艾肯V = 0.96 - 1.00）。专家和非专家对NavegApp的数字人体工程学评价均为正面，组间差异最小（r = 0.08 - 0.29）。与认知健康个体相比，散发性轻度认知障碍参与者在可用性感知方面存在差异（r = 0.26 - 0.29）。还确定了任务难度与用户满意度之间存在中度关联（克莱默V = 0.37，95% CI 0.28 - 0.54）。
NavegApp是一款为SC评估设计的有效且用户友好的严肃游戏，通过整合软件工程和心理测量评估方法开发而成。虽然结果很有前景，但仍需进一步研究以评估其诊断准确性和结构效度。这项工作概述了认知评估中严肃游戏开发的综合框架，强调了从设计过程一开始就纳入心理测量效度测量的重要性。
