Video games and health improvement: a literature review of randomized controlled trials
This is a critical appraisal of a non-systematic review of randomized trials of video games for improving health.Key Concepts addressed:
This article appeared in the inaugural issue of Games for Health Journal. In this resource, we present a critical summary of the paper, which is freely available in full text online.
For this critical appraisal, we used the Critical Appraisal Skills Programme (CASP) checklist for Systematic Reviews, which is freely available as a PDF download from their website.
- This is a literature review, not a systematic review. There may be other relevant research that the reviewers did not find, and they may have included biased studies in their analysis.
- The review may be useful as a source of randomized controlled trials (RCTs) that haven been carried out on video games.
- However, there is insufficient evidence presented here to be able to say whether video games can have health benefits.
- More research is needed, with larger cohorts of participants and focused on specific patient-important outcomes.
Critical appraisal notes
Did the review address a clearly focused question?
- Yes, although it was rather broad. The target population was not clearly specified, specific types of intervention were not described and the outcomes of interest were not defined in advance.
The review sets out a background of biased and contradictory research about the impact of video games on health and behaviour. As well as scare stories about the impact of too much screen time, there is evidence to suggest that video games may have beneficial effects on cognitive, emotional and social development.
The reviewers focused on finding randomized controlled trials (RCTs) that looked at the used of video games as tools for improving health.
Did the authors look for the appropriate sort of papers?
- Yes (RCTs)
Do you think the important, relevant studies were included?
The reviewers used a very simple search strategy and may have missed relevant studies that used different terminology. It is likely that they didn’t find all of the relevant research that has been done in this area. Other limitations of the search for evidence include:
- Limited to studies published post-2000
- Limited to English language studies only
- Limited to medical databases, and did not include grey literature, education, social science or computer science databases.
Did the review’s authors do enough to assess the quality of the included studies?
No explicit critical appraisal was undertaken. The reviewers comment that many of the studies were very small, with few participants. Such studies are more likely to produce unreliable results.
If the results of the review have been combined, was it reasonable to do so?
The results were not combined.
What are the overall results of the review?
These are presented via a narrative review across five different categories of videogame. It’s not clear whether these categories were specified in advance.
- Videogames and patient pain and stress reduction
Some evidence was found that video games can help burns victims cope with treatment.
- Videogames and patient behavioral change
The reviewers report that effective games need to be very carefully designed to appeal to its users.
- Videogames and patient rehabilitation
Promising results were found in this category of intervention, although the studies were of very small size. Many of these games required the creation specialist input devices to fit the needs of an individual.
- Videogames as diagnostic tools
- Videogames and cognitive ability
Some evidence was found for video games in helping older adults to combat cognitive decline and for younger people with learning disabilities such as autism.
No meta-analysis was attempted.
How precise are the results?
- There is a lot of uncertainty around these findings.
Can the results be applied to the local population?
- We can’t tell enough about the details of this research to be able to answer this question.
One consistent theme is that the design of successful video games needs to be tailored to user needs.
Were all important outcomes considered?
The review did not report any specific outcomes.
Are the benefits worth the harms and costs?
- We can’t tell enough about either of these variables to be able to answer this question.
Rahmani E and Boren SA. Videogames and Health Improvement: A Literature Review of Randomized Controlled Trials. Games for Health Journal. October 2012, 1(5): 331-341. doi:10.1089/g4h.2012.0031.