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. 2022 May 19;6(1):e75.
doi: 10.1017/cts.2022.405. eCollection 2022.

Using gamification to enhance clinical trial start-up activities

Karen Lane  1 , Ryan Majkowski  1 , Joshua Gruber  1 , Daniel Amirault  1 , Shannon Hillery  1 , Cortney Wieber  2 , Dixie D Thompson  3 , Jacqueline Huvane  4 , Jordan Bridges  3 , E Paul Ryu  1 , Lindsay M Eyzaguirre  1 , Marianne Gildea  1 , Richard E Thompson  1 , Daniel E Ford  1 , Daniel Hanley  1
Affiliations

Using gamification to enhance clinical trial start-up activities

Karen Lane et al. J Clin Transl Sci. .

Abstract

Background: The Trial Innovation Network (TIN) is a collaborative initiative within the National Center for Advancing Translational Science (NCATS) Clinical and Translational Science Awards (CTSA) Program. To improve and innovate the conduct of clinical trials, it is exploring the uses of gamification to better engage the trial workforce and improve the efficiencies of trial activities. The gamification structures described in this article are part of a TIN website gamification toolkit, available online to the clinical trial scientific community.

Methods: The game designers used existing electronic trial platforms to gamify the tasks required to meet trial start-up timelines to create friendly competitions. Key indicators and familiar metrics were mapped to scoreboards. Webinars were organized to share and applaud trial and game performance.

Results: Game scores were significantly associated with an increase in achieving start-up milestones in activation, institutional review board (IRB) submission, and IRB approval times, indicating the probability of completing site activation faster by using games. Overall game enjoyment and feelings that the game did not apply too much pressure appeared to be an important moderator of performance in one trial but had little effect on performance in a second.

Conclusion: This retrospective examination of available data from gaming experiences may be a first-of-kind use in clinical trials. There are signals that gaming may accelerate performance and increase enjoyment during the start-up phase of a trial. Isolating the effect of gamification on trial outcomes will depend on a larger sampling from future trials, using well-defined, hypothesis-driven statistical analysis plans.

Keywords: Gamification; Trial Innovation Network; clinical trials; metrics; trial start-up.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Clinical trial start-up tasks (left panel) were gamified into a Mt. Everest Climb (right panel) to enhance performance during a site activation phase. Monthly task completion was matched to reaching Mt. Everest base camps and the summit.
Fig. 2.
Fig. 2.
Hazard ratios (HR) for the association between z-value-adjusted Mt. Everest Scores and time to various gaming metrics across both TREAT-MS and VICTAS trials. A higher HR indicates a larger percent increase in the probability of achieving a shorter IRB submission time, IRB approval time, and time to activation.
Fig. 3.
Fig. 3.
Mean differences in Mt. Everest Score between those who enjoyed or did not enjoy the Mt. Everest game. Enjoyment appeared to be an important moderator of performance in TREAT-MS, but not in VICTAS. Neither result was significant.
Fig. 4.
Fig. 4.
Mean differences in various start-up timeline metrics between those who enjoyed or did not enjoy the Mt. Everest game by study. In TREAT-MS, those who enjoyed playing the game performed better, on average, in all metrics; shorter time to activation and training completion were significant. Differences in mean completion times in VICTAS were small.
Fig. 5.
Fig. 5.
Mean differences in Mt. Everest Score between those who did or did not feel too much pressure playing the Mt. Everest game. Lack of feeling pressure was significantly associated with better Mt. Everest performance in TREAT-MS but not in VICTAS.
Fig. 6.
Fig. 6.
Mean differences in various start-up timeline metrics between those who did or did not feel too much pressure playing the Mt. Everest game by study. In TREAT-MS, those not feeling pressured performed better across all metrics; no result was significant. Differences in mean completion times in VICTAS were small.
See this image and copyright information in PMC

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