Health based games have significant potential as therapeutic interventions due to the inherent mechanisms associated with social and individual game play and their capacity for sensor integration, data capture analysis and patient feedback. Moreover, they are low cost and they can be deployed at the point of care across an evolving digital ecosystem. However, a robust evidence base to support their wider adoption as a clinical intervention for chronic diseases is lacking and significant methodological barriers exist for health games developers creating efficacious 'digital medicines'. Game design is complex and it must utilise validated game mechanics balanced with a creative and engaging game design. The aim of this review is therefore to outline the fundamental steps of game development for health professionals and to critically appraise the methodology for assessing health games as medical interventions. This requires (1) The adoption of clearly defined global language for health games development based on a targeted function as therapeutic agents. (2) The development of multidisciplinary teams with a broad portfolio of development and clinical skill sets. (3) The creation of health game engines specifically built to facilitate clinical game development. (4) Robust trial design and assessment of translational impact: If games are to be prescribed, their efficacy and toxicity must be based on a rigorous assessment of their use within a real world clinical environment. Trials for precision health games have specific challenges around blinding, learning curves, bias and confounding that are particularly problematic. We propose the adoption of the IDEAL-GAMES framework for game development that systematically assess and validates games through open registries. In conclusion we propose a new framework for assessing the robustness and clinical efficacy of games for health as clinical interventions in the clinical environment.

中文翻译：

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健康的精准游戏：作为数字医学的电脑游戏

由于与社交和个人游戏相关的内在机制及其传感器集成、数据捕获分析和患者反馈的能力，基于健康的游戏作为治疗干预具有巨大的潜力。此外，它们成本低，可以部署在不断发展的数字生态系统中的护理点。然而，缺乏强有力的证据基础来支持它们作为慢性病的临床干预措施被更广泛地采用，并且健康游戏开发商在创造有效的“数字药物”方面存在重大的方法障碍。游戏设计是复杂的，它必须利用经过验证的游戏机制与创造性和引人入胜的游戏设计相平衡。因此，本综述的目的是概述健康专业人员游戏开发的基本步骤，并批判性地评估将健康游戏评估为医疗干预的方法。这需要 (1) 基于作为治疗剂的目标功能，采用明确定义的全球语言进行健康游戏开发。(2) 具有广泛的开发和临床技能组合的多学科团队的发展。(3) 专门为促进临床游戏开发而构建的健康游戏引擎的创建。(4) 稳健的试验设计和转化影响评估：如果要规定游戏，其功效和毒性必须基于对其在现实世界临床环境中使用的严格评估。精准健康游戏的试验在致盲方面有特定的挑战，尤其成问题的学习曲线、偏见和混杂。我们建议采用 IDEAL-GAMES 框架进行游戏开发，通过开放注册系统地评估和验证游戏。总之，我们提出了一个新的框架，用于评估健康游戏作为临床环境中的临床干预措施的稳健性和临床功效。