Table 2

The functionalities of the MyPal Child app offered to the child patients

FunctionalityDescription
P1Game playingThis is a prominent functionality of the MyPal gamified app. The patient is offered to play three new run sessions in a day, during which he/she controls a diver swimming in an underwater world. The patient can also customise various elements of the game (eg, the appearance of the diver) at any time.
P2In-game symptom reportingThis is the main ePRO data collection functionality of the MyPal gamified tablet app. During each gaming session, the game pauses five times for the user to answer a single symptom-related question (see figure 3); each question is seamlessly integrated in the flow of the game (the patient still sees the diver in his/her underwater environment). The set of questions to be asked stem from the unique digital adaption based on the validated SSPedi/Mini SSPedi paper-version questionnaire. Each question to be asked during a game session is determined by an internally validated novel question prioritisation algorithm.
P3Spontaneous symptom reportingThis is the secondary functionality that allows patients to report physical symptoms whenever they wish. An electronic implementation of the SSPedi/Mini SSPedi questionnaire outside the game is employed for the spontaneous reporting.
P4Periodic QoL reportingThis is the secondary functionality that asks patients to report their QoL once per month. An electronic implementation of the validated PedsQL questionnaire is, therefore, employed.