Note: Descriptions are shown in the official language in which they were submitted.
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METHOD FOR TREATING MEDICAL CONDITIONS
~ USING A MICROPitOCESSOR-BASED VIDEO GAME
Inventor: Stephen J. Brown
BACKGROUND -- FIELD OF THE INVENTION
The present invention relates to the field of medical
treatment, and in particular to the treatment of medical
conditions in human patients with the aid of a micro-
processor-based video game.
BACKGROUND -- DESCRIPTION OF PRIOR ART
Medical conditions associated with a patient's beh-
avior pattern or well-being are typically evaluated and
treated in therapy sessions conducted by a physician or a
health care specialist. Depending on the ailment, a pre-
liminary picture of the patient's condition may be avail-
able to the specialist in the form of answers to question-
naires or results of a battery of tests. This applies to
psychological conditions such as schizophrenia, depres-
sion, hyperactivity, phobias, panic attacks, anxiety,
overeating and other psychological disorders. In fact,
the number of diagnostic tests presently available for
classifying these conditions is vast. Such tests rely on
the patient to perform a self-examination and to respond
candidly to a series of personal questions. Since most
tests differ in their basic scientific assumptions the
results obtained are not standardized and can not often be
used to make meaningful case comparisons.
Consequently, the above-mentioned psychological cond-
itions are fully diagnosed and treated in therapy ses-
sions. In these settings the specialist can better eval-
uate the state of his/her patient and design appropriate,
individualized treatment. Unfortunately, because of the
amount of time required to do this, diagnosis and treat-
ment are very expensive.
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The actual therapeutic changes in the patient occur
outside of therapy as the patient applies cognitive and
behavioral strategies, learned in therapy, to problems
encountered in day-to-day situations. Progress is pre-
dicated to a large extent on patient cooperation, discip-
line, and self-management. Diaries are employed to ensure
patient compliance. Still, in many instances, lack of
compliance to long-term therapy regimes presents a major
obstacle to successful treatment. Children are a particu-
larly difficult group of patients in this respect. Frequ-
ently, children lack the understanding, maturity and pers-
everance required to successfully pursue a treatment plan.
In fact, it has recently been confirmed that in the
case of anxiety the best treatment involves teaching the
patients new ways of responding to old stimuli. Drugs may
be used to blunt the physical aspects, but there is no
data to confirm the positive effects of their long-term
use. Meanwhile, treatment of depressions requires attent-
ive counseling and listening to the patient. The same
applies to treatment of personality disorders, obsessive-
compulsive disorders, hysteria, and paranoia.
Unfortunately, cost of treatment and compliance with
suggestions made by the therapist are major problems, as
pointed out above. In difficult cases observation arid
comparison with criteria compiled in the Diagnostic and
Statistical Manual of Mental Disorders -- the standard
classification text of the American Psychiatric Associa-
tion-- are the only recognized treatment alternatives.
There is also a wide variety of medical conditions,
other than the above-mentioned psychological disorders,
requiring extensive self-help and self-treatment by the
patient. These conditions include addictions, compulsive
behaviors and substance abuse. Most common examples are
smoking, gambling and alcoholism. At the present time
treatment for these medical conditions involves counsel-
ing, distraction techniques and chemical replacement
therapy. Ultimately, however, all of these methods depend
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on the cooperation of the patient and a large dose of self motivation. This is
especially
important when the patient is in his or her own surroundings where the objects
of their
addiction or compulsion are easily accessible.
Unfortunately, compliance with medical advice is notoriously poor, and gentle
persistence may be necessary. Some physicians recommend that the entire family
or other
group of significant personal contacts in a patient's life should be involved
with the patient's
consent. This, of course, presents major problems and is a costly treatment
method.
Some attempts have been made at using computers to diagnose and educate
patients
about their medical condition. Typically, these attempts have produced
questionnaires which
can be filled out on a computer, or educational programs telling the patient
more about his or
her medical condition. Unfortunately, these projects stop short of being
sufficiently adapted
to patient needs to help with treatment or therapy. In fact, health care
professionals maintain
that computers can never replace the sense of caring and of relatedness, which
is the vehicle
in which most therapy takes place.
SUMMARY OF THE INVENTION
An illustrative embodiment of the present invention may provide a method for
treating a medical condition by using a microprocessor-based video game to
produce a better
preliminary picture of the ailment, make therapy considerably less costly, and
emphasize
superior patient self help responses.
A further illustrative embodiment may enable treatment in a patient's own,
private
environment, provide a treatment method to which the patient can resort as the
need arises,
and ensure higher treatment compliance for all patients, and in particular
children.
A further illustrative embodiment may provide a better method for
standardization of
treatment results for psychological disorders.
Surprisingly, it has been found that in the case of psychological disorders,
addictions,
substance abuse, and compulsions one can successfully use treatment methods
based on
computer-generated video games. An example of such a method for treating a
medical
condition in a human patient may include the steps o~ choosing a psychological
strategy for
treating the medical condition, encoding electronic instructions for an
interactive video game
in such a way that the interactive video game implements the psychological
strategy, loading
the electronic instructions into a microprocessor-based unit equipped with a
display for
displaying the interactive video game and with a patient input device for
receiving responses
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to the interactive video game from the human patient, and instructing the
human patient how
and when to use the microprocessor-based unit to play the interactive video
game.
The psychological strategy implemented by the interactive video game can
involve a
graphical game character faced with fictitious challenges representative of
the patient's
medical condition. The responses of the human patient to these challenges of
the graphical
game character can define the game success of the graphical game character.
Moreover, the
interactive video game can contain instructions for a scoring procedure for
quantitatively
analyzing the medical condition of the human patient. This enables a health
specialist to draw
comparisons between results obtained for different patients. Besides
psychological strategies
the video game can also contain counseling instructions or self care
instructions.
In fact, the video game can be used in conjunction with a standard monitoring
device.
To do this a monitoring device for measuring a physical parameter, e.g. blood
glucose level
for a patient with diabetes, is connected to the microprocessor-based unit.
Then a second set
of electronic instructions is encoded for operating said monitoring device,
where the second
set of electronic instructions is compatible with the first set of electronic
instructions. Finally,
the two sets of instructions are merged.
An illustrative embodiment of the invention may include a microprocessor
controlled
data processing system of the type capable of receiving commands generated by
a system
user suffering a medical condition, and in response thereto, generating a
complex multi-
dimensional information display as an out put, wherein the output is
characterized by the use
of indicia on the display configured and presented in a manner directed to the
treatment of
one or more pre-determined medical conditions.
The combination may include means for controlling the data processing system
using
a stored protocol of display controlling functions wherein the functions
include programming
commands for controlling one or more graphical elements presented on the
display and the
protocol is directed to one or more pre-defined medical conditions. The
combination may
also include means for storing the programmed protocol in communication with
the data
processing system; means for inputting the user generated commands into the
data processing
system wherein the user generated commands are interactively entered by the
system user in
response to the output presented on the display; and means for interpreting
the inputted user
generated commands, applying the stored protocols to the inputted user
generated commands
and based thereon, controlling the output to the display wherein the output is
specifically
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configured to provide a presentation to the user that enhances the treatment
of the medical
condition of the system user.
An illustrative system may also include a complex scenario that develops a
theme, the
basis of which enhances treatment of the target medical condition, wherein the
theme may
include one or more characters that interact in a manner directly controlled
by the user
generated commands. The system may also include a character corresponding, in
role
playing, to the user.
An illustrative combination may also include a microprocessor controlled data
processing system capable of generating a complex multi-dimensional
information display as
a series of outputs and receiving inputs generated by a patient, wherein the
series of outputs
are characterized by the use of indicia configured and presented in a manner
directed to the
treatment of one or more pre-determined medical conditions. The combination
may include
means for storing a programmed protocol of display controlling functions
directed to one or
more pre-defined medical conditions, wherein the functions comprise
programming
commands for controlling one or more graphical elements presented on the
display and
interactive commands for allowing the patient to make the input within a
defined parameter
of possible inputs, the means for storing in communication with the data
processing system.
An illustrative system may further include means for entering the patient
generated
inputs into the data processing system wherein the patient generated inputs
are interactively
entered by the patient in response to a first series of outputs presented on
the display; and
means for applying the stored programmed protocol to the patient generated
inputs and based
thereon, controlling a second series of outputs to the display wherein the
second series of
output are specifically configured to provide a presentation to the patient
that enhances the
treatment of the medical condition of the patient.
An illustrative combination may further include means for linking the system
to a
network, the linking means including a means for interfacing the
microprocessor to the
network; and at least one peripheral server linked to the network, the server
capable of
receiving the inputs and the outputs, and capable of exchanging data within
the network. The
combination can further include means for directly measuring physiological
status of the
patient, the measuring means including a second microprocessor controlled data
processing
system in communication with the combination, wherein the second
microprocessor
controlled data processing system is capable of exchanging data with the
combination.
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Such an illustrative combination can further include means for directly
measuring
physiological status of the patient, the measuring means including a second
microprocessor
controlled data processing system in communication with the combination,
wherein the
second microprocessor controlled data processing system is capable of
exchanging data
within the network. This combination can further include means for directly
measuring
physiological status of the patient such as a blood glucose meter, and the
network links the
patient to at least one terminal controlled by a health care professional.
Illustrative combinations may include programmed protocols of display
controlling
functions including programming commands for controlling graphical elements
presented on
the display, the graphical elements selected from the group consisting of
those providing
education, distraction, compliance structure, record maintenance and role
play.
In accordance with one illustrative embodiment of the invention, there is
provided a
combination in a microprocessor controlled data processing system of the type
capable of
receiving commands generated by a system user suffering a medical condition,
and in
response thereto, generating a complex multi-dimensional information display
as an output,
wherein the output is characterized by the use of indicia on the display
configured and
presented in a manner directed to the treatment of one or more predetermined
medical
conditions. The combination includes means for controlling the data processing
system using
a stored protocol of display controlling functions wherein the functions
include programming
commands for controlling one or more graphical elements presented on the
display and the
protocol is directed to one or more pre-defined medical conditions. The
combination also
includes means for storing the programmed protocol in communication with the
data
processing system, and means for inputting the user generated commands into
the data
processing system wherein the user generated commands are interactively
entered by the
system user in response to the output presented on the display. The
combination further
includes means for interpreting the inputted user generated commands, applying
the stored
protocols to the inputted user generated commands and based thereon,
controlling the output
to the display wherein the output is specifically configured to provide a
presentation to the
user that enhances the treatment of the medical condition of the system user.
In accordance with another illustrative embodiment of the invention, there is
provided
a combination in a microprocessor controlled data processing system capable of
generating a
complex mufti-dimensional information display as a series of outputs and
receiving inputs
generated by a patient, wherein the series of outputs are characterized by the
use of indicia
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configured and presented in a manner directed to the treatment of one or more
pre-determined
medical conditions. The combination includes means for storing a programmed
protocol of
display controlling functions directed to one or more pre-defined controlling
functions
directed to one or more pre-defined medical conditions, wherein the functions
include
programming commands for controlling one or more graphical elements presented
on the
display and interactive commands for allowing the patient to make the input
within a defined
parameter of possible inputs, the means for storing in communication with the
data
processing system. The combination further includes means for entering the
patient
generated inputs into the data processing system wherein the patient generated
inputs are
interactively entered by the patient in response to a first series of outputs
presented on the
display. The combination further includes means for applying the stored
programmed
protocol to the patient generated inputs and based thereon, controlling a
second series of
outputs to the display wherein the second series of output are specifically
configured to
provide a presentation to the patient that enhances the treatment of the
medical condition of
the patient.
Other aspects and features of the present invention will be apparent upon
review of
the following description of illustrative embodiments of the invention, in
conjunction with
the accompanying drawings thereof.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a block diagram of an autonomous computer system employed in the
method
according to an illustrative embodiment of the invention.
FIG. 2 is a block diagram of a computer network used in the method according
to an
illustrative embodiment of the invention.
FIG. 3 is a block diagram of a system employing a hand-held microprocessor
unit for
implementing the method of an illustrative embodiment of the invention.
FIG. 4 is a flow chart illustrating how to select an appropriate video game
treatment for
some common medical conditions.
FIG. 5 is an exemplary screen of a video game for treating growth disorders
according to
an illustrative embodiment of the invention.
FIG. 6 is another screen of the video game of FIG. 5.
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g
FIG. 7 is an exemplary screen of a video game for diabetes self treatment
according to an
illustrative embodiment of the invention.
FIG. 8 is another exemplary screen for the video game of FIG. 7.
FIG. 9 is still another exemplary screen for the video game of FIG. 7.
FIG. 10 is a screen indicating the blood glucose measurement results compiled
for the
video game of FIG. 7.
FIG. 11A is a general flowchart of an Addiction/ Distraction video game.
FIG. 11B is a detailed flowchart of the main game loop of the Addiction/
Distraction video
game shown in FIG. 11A.
FIG. 12 is a flowchart of the Growth Game.
FIG. 13 is a flowchart of an alternative game for measuring blood glucose
level.
DESCRIPTION OF PREFERRED EMBODIMENTS
FIG. 1 shows a block diagram representing a typical embodiment of a computer
or
microprocessor-based unit 10 capable of supporting video games for patient
treatment. At
the heart of unit 10 is a microprocessor 12_ In addition to operations
necessary to run unit 10,
microprocessor 12 can process video data. Of course, in complicated systems
the tasks of
microprocessor 12 can be performed by a number of microprocessors. In the most
preferred
embodiment microprocessor 12 is a SUPER NINTENDO (TM) microprocessor.
A display unit or screen 14 is connected to microprocessor 12. The resolution
and size
of display screen 14
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are sufficient to project visual images generated by video
games. In a preferred embodiment screen 14 is a high-
resolution video monitor or television screen. A speaker
15 for producing sounds associated with video games is
hooked up to microprocessor 12 as well.
A patient input device 16 is also connected to micro-
processor 12. Input device 16 can be a keyboard, joystick,
mouse, button, trigger, light-pen, or the like, or combin-
ations of these devices. A suitable choice of input dev-
ice 16 is made based on the video game displayed on dis-
play screen 1~ and the medical conditions of the human
patient. The selected input device 16 will thus permit
the patient to actively participate in the video game.
Additionally, microprocessor-based unit 10 has a
memory 18, which is in communication with microprocessor
12. memory 18 contains data required by microprocessor 12
to operate unit 10. While in the exemplary embodiment
illustrated in FIG. 1 memory 18 consists of a single unit,
configurations with many memory units of different types
are possible.
Unit 10 is also connected to a digital storage medium
20 and appropriate data reading devices (not shown).
Digital storage medium 20 can be a hard-disk, a floppy
disk, a compact disk (CD), a cartridge, a network storage
unit, or any other convenient medium capable of storing
electronic instructions for running a video game on unit
10. In the preferred embodiment storage medium 20 is a
high-storagecapacity CD disk. The ability to hold a large
amount of data is a prerequisite for storing large video
game programs.
FIG. 2 is a block diagram of a computer network for
practicing the video game treatment method. Individual
microprocessor-based units 10 on the computer network are
substantially the same as in FIG. 1, therefore the same
reference numbers are used for corresponding parts. In-
stead of digital storage medium 2 0, units 1 0 in FIG. 2
have a network interface 22 equipped with a network link
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24, Link 24 connects microprocessor 12 to network 26 via
interface 22, In a preferred embodiment network 26 is a
separate hospital network adapted to patient use.
On the hospital side network 26 is connected to a
hospital network server 28 " Server 28 is capable of
exchanging data, in particular video game data, with each
unit 10 connected to network 26" Server 28 is also con-
nected to computers used by monitoring personnel and phys-
icians at the hospital (not shown).
The block diagram of FIG. 3 shows a particularly con-
venient embodiment for implementing the diagnosis and
treatment method. A hand-held microprocessor unit 30 is
equipped with a video display 3 4 and a number of input
switches or keys 36a, 36b, 36c, 36d, and 36e, which are
mounted on a housing 32. A set of components including
a.microprocessor " memory circuits, and circuitry that
interfaces keys 36a " 36b " 36c" 36d, and 36e with the
microprocessor is installed inside housing 30 but not
shown in FIG. 3. Stored in the memory of programmable
hand-held microprocessor unit 30 is a set of electron-
ically encoded program instructions. These instructions
establish a data protocol that allows hand-held micro-
processor unit 30 to perform digital data signal proces-
sing and generate desired data or graphics for display on
display unit 34 when a program cartridge 38 is inserted
into a slot or other receptacle in housing 32. That is,
cartridge 38 of FIG. 3 includes read-only memory data
encoding the instructions for playing a particular video
game.
In the most preferred embodiment hand-held micro-
processor unit 30 is the compact game system manufactured
by Nintendo of America, Inc. under the trademark "GAME
BOY". This device is particularly simple. Furthermore,
unit 30 is hooked up to a remote communication unit 42 via
a connection cable 40. Preferably, for reasons of con-
venience, unit 42 can be a modem capable of communicating
over telephone lines, or a radio-frequency transceiver
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capable of wireless sending and receiving of information.
Of course, any other common telecommunications devices can
also be used,. It is assumed in the preferred embodiment
shown in FIG. 3 that unit 42 is a high-speed modem.
A communication line 44, in this event a telephone
line, connects unit 42 to a data clearing house 46 and
hospital computer 52. This set-up establishes an effic-
ient data pathway from hand-held microprocessor unit 30 to
clearing house 46 and hospital computer 52. Clearing
house 46 is capable of classifying data and sending
appropriate messages concerning the patient s medical
condition to a health care professional or physician In
the preferred embodiment clearing house 46 is connected by
transmission line to a facsimile machine 5o standing in
the office of a physician or health care professional.
A physical parameter measuring device 5~, e.g. a
glucose blood meter or a respiratory flow meter is also
connected to hand-held unit 30. Device 54 is designed for
patient self-monitoring while playing a video game. For
this purpose device 54 is capable of downloading measure-
ment data into hand-held unit 30. Appropriate choice of
device 54 is made by the physician depending on the other
hardware and intended video game for patient treatment.
OPERATION -- FIGS. 1 to 10
Before using microprocessor-based unit 10 shown in
FIG. 1, a patient will first visit a physician or health
care professional to evaluate his or her medical condi-
tion. The physician will diagnose the condition and
choose the proper treatment based on patient needs. The
flow chart in FIG. 4 shows the psychological strategies
which the physician can select for treating depression,
attention deficit, addiction, and diabetes. The psycho-
logical strategies listed include self-awareness training,
self-efficacy training, competition, communication, and
distraction. of course, other well-known strategies such
as positive reinforcement, negative reinforcement, role-
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playing, etc. can be employed as well. In addition to
these, the psychological treatment strategy can include
counseling methods and self-care instructions. Moreover,
the treatment strategies can be combined as shown. For
example, as shown in FIG. 4, overcoming depression is best
ensured by a therapy which joins self-awareness training
with learning self-efficacy to regain control over one's
life. In the particular case highlighted with two arrows
the medical condition to be treated is an addiction, e.g.
smoking or alcoholism, and the appropriate psychological
strategy for treating this condition is distraction.
Once the psychological treatment strategy has been
selected, the physician will choose an appropriate inter-
active video game program comprising this strategy. Exam-
ples of video games based on the most common psychological
strategies will be given in the specific examples to fol-
low. Meanwhile, the program itself consists of electro-
nically encoded instructions in data storage medium 20
(FIG. 1) The video game program is loaded f rom this
medium 20 into microprocessor 12 and memory is of unit 10.
In the preferred embodiment this is accomplished most con-
veniently by a CD disk drive (not shown) since digital
storage medium 20 is a CD disk. The patient receives unit
prepared in this way and is instructed by the physician
how and when to play the video game. of course, the phys-
ician may also load several video games at once and instr-
uct the patient when to play each one. Depending on the
type of video game and the patient's capabilities, the
physician will also determine what patient input device 16
should be employed in playing the game.
The patient takes home unit 10 prepared in this man-
ner, and follows the prescribed treatment by playing the
video game. once in operation, unit ZO displays the graph-
ical video game on display screen 14 and receives input
through patient input device 16. The beneficial effect of
playing the game is thus available to the patient at any
time in his own environment.
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The process described above can also be accomplished
with the computer network shown in FIG. 2. Here, appro-
priate treatment programs can be loaded directly into unit
l0 used by the patient while he is at home. To do this
the physician selects the appropriate video game, deter-
mines its destination address, i.e., unit 10, and places
the game on hospital network server 28. The designated
unit 10 then retrieves the video game via network 26 and
loads it into microprocessor 12 and memory 18. This is
done with the aid of network link 24 and interface 22.
A particularly convenient method for delivering a
video game to the patient is shown in FIG. 3. Hand-held
microprocessor unit 30 receives video games directly f rom
hospital computer 52. The video game is transmitted
through communication line 44 and received by remote com-
munication unit 42. Unit 42 downloads the game directly
into hand-held unit 30 via connection cable 40.
Hand-held unit 30 in FIG. 3 also communicates with
clearing house ~6 using communication line 44. Thus, the
patient's progress in playing the video game can be direc-
tly monitored, e.g., by checking the video game scores.
This information is screened, classified, and sorted by
clearing house 46. Then an abstract or report is trans-
mitted through transmission line 48 to facsimile machine
50 which can be conveniently located in the physician's
office.
Unit 30 shown in FIG. 3 can also be used by the pat-
ient to check his medical condition. To do this the pat-
ient follows instructions embedded in the video game which
tell him to connect to unit 30 his measuring device 54,
e.g. blood glucose meter in the case of a patient with
diabetes. Of course, unit 30 and device 54 may also be
hooked up permanently by the physician. Then the video
game instructions tell the patient that to continue play-
ing he needs to perform a regular self-measurement using
device 54.
For a patient with diabetes this involves checking
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his blood glucose level by drawing a small blood sample
into device 54. The individual steps for doing this are
not a part of the invention. The measurement data is then
downloaded into hand-held unit 30 to be used as input for
the interactive video game session. Exemplary video game
using this technique to collect data is described in
Example 4, below. Meanwhile, the blood glucose-data is
also passed through cable 40 to remote communication unit
42. From there the data follows the same path as descr-
ibed above for the video game score, and can be examined
by the physician in the hospital.
The specific examples below describe exemplary micro-
pracessor-based, interactive video games used for treating
various medical conditions in human patients.
SMOKING -- EXAMPLE 1
The patient has a severe case of nicotine addiction.
The physician determines, according to the flowchart in
FIG. 4 that distraction is the best psychological strategy
to induce the patient to quit smoking. Therefore, the
physician prescribes playing the Quit Gamer a video game
containing a behavioral program based on distraction.
This game contains graphical game characters engaging in
various competitive activities upon proper input from the
user. The smoker plays the game whenever he or she feels
the urge to smoke. An exemplary game to provide such an
engaging distraction is shown in the flowchart illustrated
in FIGS. 11A and 11B. In this example, the game is des-
igned to distract the player with falling bricks which
have to be arranged in rows.
During the game the main characters communicate to
the patient instructions and simple strategies to quit
smoking immediately and advise the user to take this
approach, all within the context of an entertaining video
game.
Alternatively, the game provides a timer and timeline
for gradual reduction approaches to smoking cessation.
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Included among these programs are instructions for using
nicotine patches. Built in notification will serve to
remind smokers to shift to a lower dose patch. Once the
smoker has quit, the video game will provide a coping/
relapse prevention model by using distract ion methods
during periods of smoking urges.
A pilot study using the NINTENDO GAME BOY~ as a tool
to aid smoking cessation was highly successful. In the
pilot project, seven smokers were give a Game Boy portable
loaded with the Quit Game and instructed to use it any
time they felt the urge to smoke. Six of the seven
smokers successfully quit and were very enthusiastic about
this approach.
An analogous video game strategy is followed in deal-
ing with other substance abuse conditions, alcoholism, and
obsessive compulsive disorders.
GROWTH DISORDER -- EXAMPLE 2
The physician diagnoses the patient with a growth
disorder, such as Turner's Syndrome or a similar con-
dition, requiring growth hormone treatment and a psycho-
logical treatment strategy for helping the patient cope
with his or her condition. By following a selection
process similar to the one indicated in FIG. 4, the physi-
cian prescribes a video game combining self-awareness
training, self-efficacy, roleplaying, counseling and
competition.
In the video game the graphical game character,
Packy, is a young elephant who, like the patient, is on
growth hormone therapy. The video game consists of three
parts, each associated with a particular aspect of the
treatment. In the first part Packy encounters obstacles
which he must surmount, in the second he has to learn
about growth hormone injections, and in the third one he
has to keep a personal growth diary.
In the first part Packy learns about things that
grow, from the smallest things in the world to the largest
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ones, In each level of this part Packy can pick up icons
of OM (representing a growth hormone shot) for a boost of
energy. When he gets this boost, he will grow to a larger
size until the energy wears or he gets hit by one of his
opponents. Every time Packy meets someone who challenges
him he must push them away by pressing a button to lower
his head and walking into them, or squirt them by pressing
another button. The small antagonists push and squirt
away easily, but the large ones require some strategy such
as combining pushing and squirting. This stage is depic-
ted in FIG. 5. In each level Packy will occasionally find
obstacles that require a growth shot to get past. He will
also occasionally encounter a guardian to the pathway that
asks him questions from the information learned in the
other two parts, i.e., the growth hormone injection instr-
uctions and the personal growth diary.
In another level of part one Packy has a dream in
which he explores the world as a tiny creature. This
scenario is illustrated in FIG. 6. He finds that he is
very small himself, while all the surrounding items are
very large. As he works his way to the end of this level
he will encounter all types of animals and insects that
are very small. This level will give Packy a feeling for
what it is like to be really small. In the transition to
the next level, Packy will wake up and see that he is
still the same size, and grateful that he is not so
small.
In the final level, Packy finds himself very large.
He will be with the giant animals of the world. As he
works his way through this level he will encounter all
types of animals that are very large and the various types
of obstacles they face in daily life. when Packy is bigger
than the biggest elephant and cannot enter his home, he
begins to realize the problems of being big.
Throughout his quest to feel comfortable with his
growth, Packy is accompanied by his mosquito sidekick
Zippy. His companion plays the role of a mentor and
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counsellor throughout the various levels of Packy~s
adventures.
In part two the patient will learn about preparing
and administering doses of growth hormone,. First, the
user will see how to mix a dose, then prepare a pen for
injecting the hormone, and then actually see how an injec-
tion is performed, In the game aspect of this part the
user will be challenged to mix and administer a dose seven
times (Monday through Sunday) and provide accuracy
results.
The third part of the game is a growth diary where
the patient records and sees various graphics displaying
his or her personal progress. Playing this game is re-
assuring and helps children overcome growth disorders by
emphasizing self-awareness and self-efficacy training,
role-playing, competition, and counseling strategies
embedded in the video game. Analogous video game strategy
is also used to treat anxiety and hyperactivity disorders,
various types of phobias, as well as enuresis. The
flowchart for the Growth Game is provided in FIG. 12.
DIABETES--EXAMPLE 3
The patient is diagnosed with insulin-dependent
diabetes. As treatment the physician prescribes insulin
shots and a video game based on positive-reinforcement and
self-management. In the video game the graphical game
character is a pilot who has diabetes, just like the pat-
ient. The pilot needs to follow proper diet and exercise
regimen to avoid crashing a plane or balloon which he is
flying. The screens for the video game are shown in FIG.
7 and FIG. 8. Eating wrong foods causes blood glucose
level to increase and the pain or balloon starts gaining
altitude uncontrollably. Eventually, above a certain
threshold, the balloon or the plane spins out of control.
The flowchart for this games is depicted in FIG. 13.
During the game the patient is requested to enter his
own blood glucose level by using blood glucose meter 54.
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An exemplary set-up for doing this is shown in FIG. 9. The
reading is used in the game and can also be transmitted to
the hospital, as described in example 3. Also, the user
can view his blood glucose readings in the form trans-
mitted to the hospital and used in the game. An example
of such reading for a number of measurement records is
illustrated in FIG. 10.
If the user does not comply with the request for
measuring and entering his blood glucose level the plane
or balloon disappears behind clouds, representing un-
certainty in blood glucose level. This is visualized by
the clouds in FIGS. 7 and 8. The clouds obscure the
pilot s vision and lead to collisions with objects in the
plane s or balloon s path. Alternatively, if the blood
glucose level drops below a minimum threshold, the plane
or balloon crashes against the ground.
This positive reinforcement-based strategy, in which
the blood glucose level is correlated to a game parameter,
e.g. plane altitude, teaches the patient how to cope with
his condition on a day-to-day basis while making blood
glucose monitoring fun. It also produces higher treatment
compliance rates, especially in children who need to learn
early on about proper diabetes self-management.
NON-INSULIN DEPENDENT DIABETES MANAGEMENT--EXAMPLE 4
A video game treatment can be used for management of
noninsulin dependent cases of diabetes (NIDDM). In such
cases the video game is an interactive information re-
source, as well as a role-playing. game. The game helps
the patient, especially an adult patient, explore the
topic of Staged Diabetes Management. The information is
presented in hypertext format, allowing the patient to
select a stage, read a brief overview of it, and select
details to examine it in greater depth in desired. The
game encourages active involvement in learning and pro-
vides opportunities to rehearse various health behaviors
and see the consequences that result by observing what
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happens to a graphical game character who displays these
behaviors.
The content of the game is based on the Staged
Diabetes management program, developed by the Inter-
national Diabetes Center and Becton Dickinson & Company.
The progressive set of stages ranges from least to most
severe. For example, a patient in Stage I will learn to
manage NIDDM through diet alone.
In the video game the user can configure the graph-
ical game character in many ways. A checklist of choices
allows the patient to combine a variety of physical
features and clothes, as well as specifics about the
character's health status including weight, age, and
medications taken.
The game character, and thus the patient, will make
decisions in realistic settings such as restaurants and
parties where rich foods are available. Also, an exercise
plan will fit in with the character's busy schedule of
family, community, and work commitments. This format pro-
vides the patient with a playful atmosphere in which
choices which the patient faces in his or her own life can
be rehearsed.
If blood glucose levels do not remain in the normal
range in Stage I. then the patient is instructed by the
graphical game character to advance to the next treatment
steps, eventually arriving at the stage where the patient
will be instructed to inject insulin to control blood
glucose levels. The goal of the NIDDM game is to remain
at Stage I.
Similar video games can help to deal with hemophilia,
and other medical condition requiring the patient to be
aware of his or her surroundings.
ASTHMA--EXAMPLE 5
A youngster diagnosed with asthma is given an asthma
selfmanagement game for hand-held unit 30. The graphical
game character, a young dinosaur from the pre-historic
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town of San Saurian, must cope with and manage his asthma.
The game character confronts common asthma triggers, while
learning to recognize early warning signs of an oncoming
asthmatic episode. Asthma management techniques including
avoidance, relaxation, and medicinal inhalers are part of
the daily routine for the young dinosaur who must return
to his cave. The dinosaur runs, jumps, and shoots a
squirt gun at oncoming triggers while conquering each
level and mastering his condition. In addition to these
inputs, the dinosaur requests the player to input the
player's asthma condition by using physical parameter
measuring device 54, which in this case is a respiratory
flow meter. These data can then be transmitted to the
physician as described above.
Playing the video game involving these real asthma
triggers, relaxation techniques, etc., affects the mental
state of the player to improve his own asthma management
outside of video game sessions. This treatment based on
role-playing and positive reinforcement makes the patient
aware of the importance of prescribed drugs and teaches
appropriate measures for dealing with the patient's con-
dition in real life situations.
EATING DISORDER--EXAMPLE 6
The physician determines that the patient suffers
from an eating disorder causing the patient to gorge. The
physician loads into the patient's microprocessor-based
unit 10 or hand-held unit 30 a video game in which the
graphical game character has to stay thin to survive. The
game challenges confronting the game character include
avoiding fatty foods to stay trim and eating a sufficient
amount to combat dragons and surmount obstacles on his
way. Doing this involves making choices about what food
presented on the screen to eat, keep for later, or reject.
wrong food choices have diet consequences in the graphical
character's ability to survive. The game is scored
according to the length of time the patient is capable of
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keeping his game character alive and obstacles the chara-
cter overcomes.
The physician instructs the patient to play the game
every time the patient feels an eating urge outside reg-
ular meal times. During a regular follow-up visit the
doctor evaluates the patient's progress and checks the
scores obtained in playing the video game. Based on the
analysis of the sores the physician determines the sev-
erity of the problem and gets an insight into the pat-
ient's motivation to comply with the therapy.
Sufficiently high scores reflect progress and read-
iness to proceed with the next treatment stage. At this
point the physician may instruct the patient to play
another video game designed for milder eating disorders or
a game utilizing a different psychological approach, e.g.,
negative reinforcement or distraction.
DEPRESSION--EXAMPLE 7
A psychiatrist enrolls a patient in a series of home-
based interactive video game sessions, which the patient
accesses from his microprocessor-based unit 10 through
hospital network 26 . The video game is then transmitted
from the hospital network server 28 to the patient in unit
. The game involves interaction with a graphical game
character resembling the Yoda character from the popular
movie "Star wars". Yoda acts as a counselor and mentor to
the patient, preparing him for various trial episodes in
the video game. Based on patient's scores in playing the
video game sent, the physician reviews how the patient
responds to video game counseling and prepares another
game to be transmitted to the patient. This treatment
method is part of an on-going therapy for mild to medium-
severe depression. This approach is also used for schizo-
phrenia and other purely psychological disorders.
Presented herein is a particularly simple method for
treating medical conditions in human patients using a
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microprocessor-based video game. This method gives a
better picture of the ailment through its standardized
scoring procedure and makes the treatment much less costly
by considerably reducing the number of therapy sessions
with the physician or health care professional. In ad-
dition, video games emphasize superior treatment in the
patient's own environment. This leads to self-help
responses difficult to foster in therapy sessions. The
patient recognizes the importance of medications and
treatment regimens-in an entertaining manner. Moreover,
the patient participates actively in the treatment by
following instructions embedded in the video game or even
generating positive physiological responses due to stimuli
presented in the video game.
The method of the invention also provides a treatment
to which the patient can resort as the need arises. The
intrinsic fun in playing video games ensures higher treat-
ment compliance for all patients, and in particular child-
ren. The self-treatment instructions communicated by this
method can be used to additionally induce patients to ind-
ependently perform measurements of physical parameters as-
sociated with their medical condition.
Finally, the scoring of the video game provides an
excellent standardized measure for evaluating treatment
results and improving continued treatment. In carrying
out the method the microprocessor-based system can be
expanded to use any number of communications devices,
monitoring set-ups, and other state-of-the-art medical
equipment. Therefore, the scope of the invention should
be determined, not by examples given, but by the appended
claims and their legal equivalents.
