TECHNICAL FIELD

The present invention relates to virtual-reality (VR) applications in general, and in particular to VR game-based applications for pain management.

BACKGROUND ART

Patients can suffer from pain due to many causes, for example, as a result of oncology treatments such as chemotherapy. Such treatments may also cause the patient discomfort, unpleasantness and anxiety.

Pain and especially excessive pain can have many dysfunctional effects on a patient, and may decrease patient compliance to treatment. Pain can be treated both by giving the patient pain-relieving drugs, and by soothing the patient with calming actions such as music or a calming environment, in addition to psychological sessions provided by the caretaker itself.

SUMMARY OF INVENTION

The present invention relates to a computing system comprising at least one processor, and at least one memory communicatively coupled to the at least one processor comprising computer-readable instructions that when executed by the at least one processor cause the computing system to implement a method of treating patients receiving a chemotherapy treatment in order to alleviate pain, anxiety and improve the patient’s mood by playing one or more virtual reality (VR) games.

The method comprises the following steps:

(i) initially, receiving a patient’s profile and chemotherapy regimen;

(ii) selecting a first VR game sequence for the patient to play;

(iii) selecting a schedule of playing the VR game in relation to the chemotherapy treatment;

(iv) evaluating the patient’s pain levels via a validated observational tool;

(v) measuring the patient’s anxiety;

(vi) measuring the patient’s mood; (vii) measuring the patient’s physiological parameters;

(viii) analyzing the patient’s pain levels, anxiety, mood and physiological parameters and adjusting the VR game for the patient in order to improve the patient’s condition.

In some embodiments, the VR game comprises meditation and interactive story telling.

In some embodiments, the VR game includes scenes in nature, with relaxing surroundings such as forests, mountains and oceans.

In some embodiments, the VR game is comprises one or more game sessions for each chemotherapy treatment.

In some embodiments, the first game session is scheduled before the chemotherapy treatment starts.

In some embodiments, the pain observational tool is a Wong Baker Faces questionnaire.

In some embodiments, the patient’s anxiety is measured by subjective units of distress scale (SUDS) questionnaire.

In some embodiments, the patient’s mood is measured by quantitative questionnaires.

In some embodiments, the VR game comprises 3 games sessions.

In some embodiments, physiological parameters comprise blood pressure and pulse.

In some embodiments, adjusting the VR game for the patient comprise, changing the game schedule, and changing part or all of the game’s content.

In some embodiments, the patient is represented in the game by an avatar.

In some embodiments, the system uses a virtual assistant in the game to assist the patient during the game.

The present invention is suitable for treating patients suffering from pain (or stress). Pain can be originated from different sources, including but not limited to, chemotherapy, accidents, burns, psychosomatic reasons, illness, injuries, physical handicaps and more. In another aspect, the present invention also relates to a computer- implemented method comprising:

(i) initially, receiving a patient’s profile and chemotherapy regimen;

(ii) selecting a first VR game sequence for the patient to play;

(iii) selecting a schedule of playing the VR game in relation to the chemotherapy treatment;

(iv) evaluating the patient’s pain levels via a validated observational tool;

(v) measuring the patient’s anxiety;

(vi) measuring the patient’s mood;

(vii) measuring the patient’s physiological parameters; and

(viii) analyzing the patient’s pain levels, anxiety, mood and physiological parameters and adjusting the VR game for the patient in order to improve the patient’s condition.

BRIEF DESCRIPTION OF DRAWINGS

Fig. 1 shows an embodiment of a VR game system.

Fig. 2 shows an embodiment of an architecture of a VR game system.

Fig. 3 shows a diagram of an embodiment of the schedule of 3 patient sessions.

Fig. 4 shows a VAS Pain Measurement tool.

Fig. 5 shows an example of an anxiety questionnaire.

Figs. 6a, 6b show an example of a mood questionnaire.

Fig. 7 shows a diagram of an embodiment of processing new acquired data.

MODES FOR CARRYING OUT THE INVENTION

In the following detailed description of various embodiments, reference is made to the accompanying drawings that form a part thereof, and in which are shown by way of illustration specific embodiments in which the invention may be practiced. It is understood that other embodiments may be utilized, and structural changes may be made without departing from the scope of the present invention.

The present invention relates to a computing system comprising at least one processor and at least one memory communicatively coupled to the at least one processor comprising computer-readable instructions that when executed by the at least one processor cause the computing system to implement a method of treating patients receiving a chemotherapy treatment in order to alleviate pain, anxiety and improve the patient’s mood.

Fig. 1 discloses an embodiment of a system according to the present invention. The interaction Virtual Reality (VR) game system includes a VR game together with VR equipment, preferably a VR headset. The game system is connected to an Electronic Medical Records (EMR) system, to receive information about the patient and medical treatment. The game system is connected to different sensors to receive input about the patient’s (user’s) physiological parameters like pulse and blood pressure, and game parameters like user movements, gestures, game selections and interactions. In some embodiments, users (patients) may interact with the game system via a remote access. In some cases, the system may be connected to an auxiliary monitor, for mirroring the gameplay.

Fig. 2 is an embodiment of an exemplary architecture of a system of the invention. The system consists of platform with interactive 3D VR games, Cloud/On- Premise based backend. Backend includes Al components, database for all of the telemetry & logs that are acquired while using the VR headset during the sessions, questioners and bio sensors, web-based applications for game content management, data visualization and reports.

Al components include an inference engine that runs on a standalone VR headset to analyze user (patient) behavior and dynamically adjust gameplay, difficulty, assets and various other aspects of the game to make it as adaptive as possible for the current user in order to better manage experienced pain.

The method is performed by having the patient play one or more virtual reality (VR) games, the method comprises the following steps.

Initially, the method starts by receiving a patient’s profile information and chemotherapy regimen. Profile information can include details such as the patient’s name, identity, age, sex, address, medical history, preferences, treatment history etc. The chemotherapy regimen includes relevant details about the treatment. Treatment recommendations can be based on a variety of information and factors, taking into account patient performance status, disease extent, rate of progression and potential sensitivity to treatment. The chemotherapy regimen includes details about the drugs to be used, their dosage, the frequency and duration of treatments, and other considerations.

Receiving patient treatment protocol relates to treatments such as chemotherapy, radiotherapy, targeted therapy (immunological \ biological treatments) or any other kind of therapy that may be accompanied with pain or stress.

The next step is selecting a first VR game sequence for the patient to play. The VR environment experience is comprehensive and takes place during immersion in fully interactive three-dimensional virtual reality environments utilizing computer generated graphics, images imported from photographs, and video for sensory stimulation. Immersion is achieved with adequate equipment including any combination of goggles, head-mounted-display, or other form of visual stimulation, such as surround projection screens or monitors or similar devices that permit the user to have a virtual experience. Immersion also includes the use of voice, music, and sound and other forms of physiological stimulation and feedback. Body sensors and devices such as a hand-held grip may also be used to enable the user to interact with objects and navigate within the virtual environment. The game selection is made according to the patient’s profile, treatment, treatment history, treatment results, game’s influence on the patient, and patient preferences.

The third step is selecting a schedule of playing the VR game in relation to the chemotherapy treatment. In one, non-limiting embodiment, as shown in Fig. 3, the VR game can include 3 sessions, for example, of 15 minutes each that include a combination of meditation or similar relaxing activity together with an interactive game or story. Optionally, there can be a break after each session, for example, a 5- 10 minutes recess, for questionnaires completion and physical parameters collection. At the beginning of each mini game session, the patient views a partially interactive narrated story introduction, followed by a relaxing meditation, for a total of 6 minutes. After the meditation, the selected game starts. When the mini game is completed, a calming storytelling and summery are projected, after which, the session ends.

The next step is evaluating the patient’s pain levels via a validated observational tool. The observational tool can be any combination of a validated questionnaire that the patient fills and using a measuring device.

Examples of pain evaluation tools include: the Visual Analog Scale (VAS), the Wong-Baker Faces Rating Scale and the McGill Pain Questionnaire (MPQ). The more common questionnaire pain measures include adjective scales, numeric scales (i.e. rating pain on a scale of 0-5, 0-10 or 0-100), and visual analog scales. Each of these scales measures the sensory component of a patient's pain, while MPQ measures the sensory, affective, and evaluative levels of pain.

The VAS is likely the most widely used pain measurement tool. As shown in Fig. 4, the VAS is usually a 10-cm line labelled at the ends with descriptors such as no pain and worst pain imaginable. Patients indicate pain magnitude by marking the line, and a measurement of the marking indicates the level of pain on a 0- to 100-mm scale. Variations include vertical or horizontal alignments, placing descriptors along the scale, scales of different lengths, use of mechanical devices, and presentation on a computer or mobile device.

As shown in Fig. 5, the Wong-Baker Faces Pain Rating Scale is a pain scale that was developed by Donna Wong and Connie Baker. The scale shows a series of faces ranging from a happy face at 0, or "no hurt", to a crying face at 10, which represents "hurts like the worst pain imaginable".

Motivational-affective and cognitive-evaluative components of pain are most frequently measured using the McGill Pain Questionnaire (MPQ). The MPQ consists of 20 sets of adjectives which describe all three components of pain: sensory, affective, and evaluative. Qualitative profiles and quantitative scores for each dimension as well as a total pain score can be derived from the selected adjectives.

Measuring the patient’s pain level is done according to a predetermined schedule. A non-limiting example of a schedule is shown at table- 1 below:

Table 1: Pain Measurement Schedule

The next step is measuring the patient’s anxiety levels. Anxiety is typically measure through a questionnaire such as the Subjective Units of Distress Scale (SUDS) questionnaire, the Anxiety Symptoms Questionnaire (ASQ), Generalized Anxiety Disorder 7-item (GAD-7) and the Hamilton Anxiety Scale (HAM- A).

Subjective Units of Distress Scale (SUDS) questionnaire, as shown in Fig. 5, is a self-administrated and consists of a single question.

The Anxiety Symptoms Questionnaire (ASQ) is a brief self-report questionnaire which measures frequency and intensity of symptoms and was developed to improve assessment of anxiety symptoms in a clinical setting.

The Generalized Anxiety Disorder 7-item (GAD-7) is an easy to perform initial screening tool for generalized anxiety disorder.

A common measure used to assess anxiety in treatment outcome studies is the Hamilton Anxiety Scale (HAM- A). The HAM- A is a 14-item clinician-rated scale measuring anxiety severity. Each item is defined by a series of symptoms and is rated on a 5-point scale ranging from 0 (no symptoms or absent) to 4 (very severe). Total HAM-A scores range from 0 to 56. HAM-A is administered by a clinician.

Measuring the patient’s anxiety level is done according to a predetermined schedule. A non-limiting example of a schedule is shown at table-2 below:

Table 2: Anxiety Measurement Schedule

The next step is measuring the patient’s mood. Mood is typically measured by questionnaire, such as the Brief Mood Introspection Scale (BMIS) questionnaire or a similar questionnaire.

The patient’s mood and feeling questionnaire assesses the impact of the IV treatment among patients during the game.

The questionnaire is typically self-administrated. Figs. 6A-6B shows an example of a mood questionnaire that consists of 11 questions.

The BMIS scale is an open-source mood scale consisting of 16 moodadjectives to which a person responds (e.g., Are you "happy"?). The scale can yield measures of overall pleasant-unpleasant mood, arousal-calm mood, and it also can be scored according to positive-tired and negative-calm mood.

Measuring the patient’s mood is done according to a predetermined schedule. A non-limiting example, having the patient complete the questionnaire twice during each session, at the end of the VR game and at the end of the IV chemotherapy treatment.

The next step is measuring the patient’s physiological parameters. Physiological parameters may include parameters such as pulse and blood pressure. These parameters are collected according to a predetermined schedule, for example, before the game starts, in between the game sessions (along with the IV treatment), after the game ends, and after the IV treatment ends.

The last step is analyzing the patient’s pain levels, anxiety, mood and physiological parameters and adjusting the VR game for the patient in order to improve the patient’s condition. As more data about patients is collected, big data techniques such as machine learning and deep learning, can be applied to deduct from the data the best game to match for a new patient, and during treatment, adapt the game parameters (length of sessions, breaks and length of break between sessions, and changing the game) during treatment.

In some embodiments of the present invention, the system monitors the patient’s physiological parameters, pain level, anxiety and mood during the game in real-time (or near real-time), and applies a positive feedback using a virtual realitybased Al engine personalized and customized to the patient and his current condition, adaptively alternating the brain’s perception of pain, to improve the patient’s condition.

In some embodiments, the Al engine includes an inference engine that receives input from the VR equipment the patient is interacting with, including but not limited to VR headset, hand control, body sensors, external movement sensors, physiological sensors, microphones. Using all this input, and information about the patient and medical treatment, the Al engine analyzes the patient’s behavior and dynamically adjusts gameplay, difficulty, assets and various other aspects of the game to make it as adaptive as possible for current patient. During the sessions all patient decisions, interactions together with physiological data from all sensors is logged and used for improvement of the models for future sessions and patients.

In some embodiments, each treatment session is a collection of mini, first- person, single player, puzzle adventure games, in virtual reality (VR) with a common narrative and linear storytelling. The story happens in nature, with surroundings like forests, mountains, and oceans, for the purposes of meditation and relaxation. The main concept is to use positive psychology as a tool to that enables patient to better tolerate mentally difficult processes of treatment, in particular with children. Players (patients) face a chain of challenges during the mini games. Mini games sessions are separated by intermission levels of for meditation, in order to let the players rest and think about what was accomplished during the latest session of a particular mini game. The entire storyline of the mini games and meditation levels can be thought of as a process of continuous self-improvement of the player (patient), mastering different skills and acquiring tools during the different levels of the mini games, deciding what to do with them and how to advance. Throughout the session, the player (patient) is guided by a narrator audio and partial visual presence, meeting several characters that help solving various puzzles and teach useful skills, skills that can potentially help the patient also in real life.

In order to make game experience more adaptive and balanced, the system can make use of various Machine Learning techniques (supervised, semi- supervised learning, etc.) including Deep Learning algorithms to study gamers (patients) and create unique, concise and interesting games adapted to their profile, preferences and needs. For this purpose, the system collects information about the patients, e.g. what gamers (patients) like, their backgrounds, lifestyle, family, friends before, during and their gameplay sessions while taking various measurements for creation of the games mechanics and their fine tuning, Al, assets, etc. In addition, after each session of gameplay, the system can collect additional data to validate the success level of current configuration and enable the system algorithms to learn more about the users to improve the algorithms.

System input parameters include, but are not limited to:

1. Game world usage analysis;

2. Heatmaps;

3. Physiological measurements (blood pressure, pulse etc.);

3. Questionnaires (according to regulation metrics, e.g. satisfaction, pain level relief, mood, anxiety etc.);

4. (Upper) Body tracking;

5. Hand tracking;

6. Gaze tracking;

7. Mouth tracking;

8. Audio analysis; and

9. Mood analysis.

Fig. 7 shows a typical cycle of acquiring and using information. In (1), data is acquired, for example, from one or more of the 9 sources mentioned above or any other source. In (2), the data is processed and “cleaned”, for example, data can be normalized, combined with other data, verified and authenticated, extreme or irrational results may be ignored etc. In (3), the appropriate model is trained with the acquired and processed data. In (4), the model is tested with the new data and in (5), the system is improved if the new data is shown to be useful.

In some embodiments, the system offers an avatar that can represent the user (patient) in the game. The avatar can take different shapes and forms, and can also have different capabilities in each game. The avatar can be customized per the patient’s needs and preferences.

In some embodiments, the system can have a virtual personal assistant in the game, that can assist the user (patient) with any question or request regarding the game.

Although the invention has been described in detail, nevertheless changes and modifications, which do not depart from the teachings of the present invention, will be evident to those skilled in the art. Such changes and modifications are deemed to come within the purview of the present invention and the appended claims.

It will be readily apparent that the various methods and algorithms described herein may be implemented by, e.g., appropriately programmed general purpose computers and computing devices. Typically, a processor (e.g., one or more microprocessors) will receive instructions from a memory or like device, and execute those instructions, thereby performing one or more processes defined by those instructions. Further, programs that implement such methods and algorithms may be stored and transmitted using a variety of media in a number of manners. In some embodiments, hard-wired circuitry or custom hardware may be used in place of, or in combination with, software instructions for implementation of the processes of various embodiments. Thus, embodiments are not limited to any specific combination of hardware and software.

A "processor" means any one or more microprocessors, central processing units (CPUs), computing devices, microcontrollers, digital signal processors, or like devices.

The term "computer-readable medium" refers to any medium that participates in providing data (e.g., instructions) which may be read by a computer, a processor or a like device. Such a medium may take many forms, including but not limited to, non-volatile media, volatile media, and transmission media. Non-volatile media include, for example, optical or magnetic disks and other persistent memory. Volatile media include dynamic random- access memory (DRAM), which typically constitutes the main memory. Transmission media include coaxial cables, copper wire and fiber optics, including the wires that comprise a system bus coupled to the processor. Transmission media may include or convey acoustic waves, light waves and electromagnetic emissions, such as those generated during radio frequency (RF) and infrared (IR) data communications. Common forms of computer-readable media include, for example, a floppy disk, a flexible disk, hard disk, magnetic tape, any other magnetic medium, a CD-ROM, DVD, any other optical medium, punch cards, paper tape, any other physical medium with patterns of holes, a RAM, a PROM, an EPROM, a FLASH-EEPROM, any other memory chip or cartridge, a carrier wave as described hereinafter, or any other medium from which a computer can read.

Various forms of computer readable media may be involved in carrying sequences of instructions to a processor. For example, sequences of instruction (i) may be delivered from RAM to a processor, (ii) may be carried over a wireless transmission medium, and/or (iii) may be formatted according to numerous formats, standards or protocols, such as Bluetooth, TDMA, CDMA, 3G.

Where databases are described, it will be understood by one of ordinary skill in the art that (i) alternative database structures to those described may be readily employed, and (ii) other memory structures besides databases may be readily employed. Any illustrations or descriptions of any sample databases presented herein are illustrative arrangements for stored representations of information. Any number of other arrangements may be employed besides those suggested by, e.g., tables illustrated in drawings or elsewhere. Similarly, any illustrated entries of the databases represent exemplary information only; one of ordinary skill in the art will understand that the number and content of the entries can be different from those described herein. Further, despite any depiction of the databases as tables, other formats (including relational databases, object-based models and/or distributed databases) could be used to store and manipulate the data types described herein. Likewise, object methods or behaviors of a database can be used to implement various processes, such as the described herein. In addition, the databases may, in a known manner, be stored locally or remotely from a device which accesses data in such a database.

The present invention can be configured to work in a network environment including a computer that is in communication, via a communications network, with one or more devices. The computer may communicate with the devices directly or indirectly, via a wired or wireless medium such as the Internet, LAN, WAN or Ethernet, Token Ring, or via any appropriate communications means or combination of communications means. Each of the devices may comprise computers, such as those based on the Intel.RTM. Pentium.RTM. or Centrino.TM. processor, that are adapted to communicate with the computer. Any number and type of machines may be in communication with the computer.