A protocol for the development and validation of a virtual reality-based clinical test of social cognition

Abstract Background Impairments in social cognition are common after traumatic brain injury (TBI) and may have severe negative consequences for patients and their families. Most tests of social cognition have limited ecological validity due to simplistic and contrived social stimuli with limited rel...

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Main Authors: M Matre, T Johansen, A Olsen, S Tornås, AC Martinsen, A Lund, F Becker, C Brunborg, J Spikman, J Ponsford, D Neumann, S McDonald, M Løvstad
Format: Article
Language:English
Published: BMC 2023-09-01
Series:BMC Digital Health
Subjects:
Online Access:https://doi.org/10.1186/s44247-023-00036-x
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author M Matre
T Johansen
A Olsen
S Tornås
AC Martinsen
A Lund
F Becker
C Brunborg
J Spikman
J Ponsford
D Neumann
S McDonald
M Løvstad
author_facet M Matre
T Johansen
A Olsen
S Tornås
AC Martinsen
A Lund
F Becker
C Brunborg
J Spikman
J Ponsford
D Neumann
S McDonald
M Løvstad
author_sort M Matre
collection DOAJ
description Abstract Background Impairments in social cognition are common after traumatic brain injury (TBI) and may have severe negative consequences for patients and their families. Most tests of social cognition have limited ecological validity due to simplistic and contrived social stimuli with limited relevance to everyday social functioning. There is a need for measures of social cognition that reflect the dynamic, multimodal and contextualized nature of social situations and that predict real-world functioning. Three hundred sixty–degree (360°) Virtual Reality (VR) video can increase ecological validity through enhanced social presence, or a sense of “being there”. This paper describes the development and protocol design for validation of a Norwegian VR-version of The Awareness of Social Inference Test (TASIT), which is a widely used video-based test of social cognition. Methods Development of VR TASIT included filming 61 short videos depicting social interactions in both VR and desktop format, using a 360° camera. Software for standardized test administration and collection of performance data was developed in Unity, for administration on both VR and desktop interface. The validation study will test the reliability and validity of VR TASIT in participants with TBI (n = 100) and healthy controls (n = 100). Half of the participants will perform the desktop version, and the other half the VR version. Analyses will include known groups validity, convergent and divergent validity, as well as test–retest reliability of VR TASIT. A comparison of the ability of TASIT VR and desktop versions to predict real-world functioning (ecological validity) will be explored using the Social Skills Questionnaire for TBI and La Trobe Communication Questionnaire. Finally, the levels of perceived social presence of the stimulus materials and prevalence of cybersickness after exposure to the virtual environment will be documented. Discussion It is expected that VR TASIT will have comparable or better psychometric properties than the desktop version, and that the hypothesized increased level of social presence experienced in a virtual environment will result in improved ecological validity. More broadly, benefits and limitations of using VR video as stimulus material in assessment of social cognition and considerations for future development and clinical validation are discussed. Trial registration The study protocol was pre-registered in ClinicalTrials (April 4th 2022, NCT05309005). The study was retrospectively registered in Open Science Framework (December 15th 2022, osf.io/2vem8).
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spelling doaj.art-104927b57c1f453da9d51e7eef1fdc292023-11-20T10:59:54ZengBMCBMC Digital Health2731-684X2023-09-011111410.1186/s44247-023-00036-xA protocol for the development and validation of a virtual reality-based clinical test of social cognitionM Matre0T Johansen1A Olsen2S Tornås3AC Martinsen4A Lund5F Becker6C Brunborg7J Spikman8J Ponsford9D Neumann10S McDonald11M Løvstad12Department of Research, Sunnaas Rehabilitation HospitalDepartment of Research, Sunnaas Rehabilitation HospitalDepartment of Psychology, Norwegian University of Science and TechnologyDepartment of Research, Sunnaas Rehabilitation HospitalDepartment of Research, Sunnaas Rehabilitation HospitalDepartment of Occupational Therapy, Faculty of Health Sciences, Institute of Rehabilitation Science and Health Technology, Oslo Metropolitan UniversityDepartment of Research, Sunnaas Rehabilitation HospitalOslo Centre for Biostatistics and Epidemiology, Oslo University HospitalDepartment of Neurology, Subdepartment of Neuropsychology, University of Groningen, University Medical CenterSchool of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash UniversityDepartment of Physical Medicine and Rehabilitation, Indiana University School of MedicineSchool of Psychology, University of New South WalesDepartment of Research, Sunnaas Rehabilitation HospitalAbstract Background Impairments in social cognition are common after traumatic brain injury (TBI) and may have severe negative consequences for patients and their families. Most tests of social cognition have limited ecological validity due to simplistic and contrived social stimuli with limited relevance to everyday social functioning. There is a need for measures of social cognition that reflect the dynamic, multimodal and contextualized nature of social situations and that predict real-world functioning. Three hundred sixty–degree (360°) Virtual Reality (VR) video can increase ecological validity through enhanced social presence, or a sense of “being there”. This paper describes the development and protocol design for validation of a Norwegian VR-version of The Awareness of Social Inference Test (TASIT), which is a widely used video-based test of social cognition. Methods Development of VR TASIT included filming 61 short videos depicting social interactions in both VR and desktop format, using a 360° camera. Software for standardized test administration and collection of performance data was developed in Unity, for administration on both VR and desktop interface. The validation study will test the reliability and validity of VR TASIT in participants with TBI (n = 100) and healthy controls (n = 100). Half of the participants will perform the desktop version, and the other half the VR version. Analyses will include known groups validity, convergent and divergent validity, as well as test–retest reliability of VR TASIT. A comparison of the ability of TASIT VR and desktop versions to predict real-world functioning (ecological validity) will be explored using the Social Skills Questionnaire for TBI and La Trobe Communication Questionnaire. Finally, the levels of perceived social presence of the stimulus materials and prevalence of cybersickness after exposure to the virtual environment will be documented. Discussion It is expected that VR TASIT will have comparable or better psychometric properties than the desktop version, and that the hypothesized increased level of social presence experienced in a virtual environment will result in improved ecological validity. More broadly, benefits and limitations of using VR video as stimulus material in assessment of social cognition and considerations for future development and clinical validation are discussed. Trial registration The study protocol was pre-registered in ClinicalTrials (April 4th 2022, NCT05309005). The study was retrospectively registered in Open Science Framework (December 15th 2022, osf.io/2vem8).https://doi.org/10.1186/s44247-023-00036-xVirtual reality360-degree videoSocial cognitionAssessmentTraumatic brain injuryRehabilitation
spellingShingle M Matre
T Johansen
A Olsen
S Tornås
AC Martinsen
A Lund
F Becker
C Brunborg
J Spikman
J Ponsford
D Neumann
S McDonald
M Løvstad
A protocol for the development and validation of a virtual reality-based clinical test of social cognition
BMC Digital Health
Virtual reality
360-degree video
Social cognition
Assessment
Traumatic brain injury
Rehabilitation
title A protocol for the development and validation of a virtual reality-based clinical test of social cognition
title_full A protocol for the development and validation of a virtual reality-based clinical test of social cognition
title_fullStr A protocol for the development and validation of a virtual reality-based clinical test of social cognition
title_full_unstemmed A protocol for the development and validation of a virtual reality-based clinical test of social cognition
title_short A protocol for the development and validation of a virtual reality-based clinical test of social cognition
title_sort protocol for the development and validation of a virtual reality based clinical test of social cognition
topic Virtual reality
360-degree video
Social cognition
Assessment
Traumatic brain injury
Rehabilitation
url https://doi.org/10.1186/s44247-023-00036-x
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