Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study
Bibliographic record
Abstract
BACKGROUND: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. OBJECTIVE: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. METHODS: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. RESULTS: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. CONCLUSIONS: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.029 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.006 | 0.008 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".