
Cambridge University releases an app that improves concentration akin to Ritalin - clouddrover
https://www.abc.net.au/news/2019-01-22/cambridge-uni-develops-app-with-ritalin-like-effects/10737268
======
lol768
It's unfortunate that the app was licensed out to a commercial vendor ("Peak
Brain Training") when the study received funding by the National Institute for
Health Research (via the Department of Health and Social Care) which is
taxpayer funded.

Why wasn't the code open sourced and made available under a free license?

~~~
ArtWomb
>>> The game involves asking players to watch a series of digits from two to
nine flashing up one by one, at a rate of 100 digits per minute. Over the
course of five minutes, players must press a button when they start to see a
sequence emerge.

C'mon, this could be cloned in a weekend ;)

Publish neuroscience findings in a public access journal by all means. Even
including pseudocode of the sequence generation algorithm.

But I am all for distributing their particular implementation via private
sector partnerships. That could yield further funding and experimentation. And
possibly alleviate taxpayer research dependency for their lab in future.

The work itself taps into some novel neuroscience. Do we we possess a Bayesian
brain that estimates probabilities in real time? Altering a belief net based
on new evidence. Or are patterns hard wired and must be learned. I think this
sort of training game based on integer series could work just as well with
text, images, music, video, animation, etc.

~~~
Ragib_Zaman
> Do we possess a Bayesian brain that estimates probabilities in real time?

You should read Daniel Kahneman's "Thinking Fast and Slow" \- the answer is a
resounding "No".

~~~
no_identd
You might wish to read Gerd Gigerenzer as well as Keith E. Stanovich, Richard
F. West & Maggie E. Toplak before citing Kahneman so quickly, and doubly so in
support of such a tremendously strong claim as the one you just made.

For Gigerenzer, you might wish to start out here:

[https://en.wikipedia.org/wiki/Gerd_Gigerenzer#Heuristics](https://en.wikipedia.org/wiki/Gerd_Gigerenzer#Heuristics)

[https://www.tandfonline.com/doi/abs/10.1080/1479277914300003...](https://www.tandfonline.com/doi/abs/10.1080/14792779143000033)
(Available here: [http://library.mpib-
berlin.mpg.de/ft/gg/gg_how_1991.pdf](http://library.mpib-
berlin.mpg.de/ft/gg/gg_how_1991.pdf))

And for Stanovich et al., you might want to start out here:

[http://cognet.mit.edu/book/rationality-
quotient](http://cognet.mit.edu/book/rationality-quotient)

[https://en.wikipedia.org/wiki/Dysrationalia](https://en.wikipedia.org/wiki/Dysrationalia)

Stanovich et al. showed that Kahneman & Tversky's classical "System 1/System
2" dual process model as one too simplistic, outlining at least 3 systems
involved:

* The Autonomous Mind

* The Reflective Mind

* The Algorithmic Mind

For points addressed by both Gigerenzer as well as Stanovich et al, see here:

[https://en.wikipedia.org/wiki/Great_Rationality_Debate](https://en.wikipedia.org/wiki/Great_Rationality_Debate)

None of this of course directly addresses your "Bayesian brain" point,
however, for that, you might want to take a look at "some" articles by
psychiatrist Scott Alexander, many of which speculative but citing a lot of
sources you might wish to look into:

[https://www.lesswrong.com/posts/ZiQqsgGX6a42Sfpii/the-
apolog...](https://www.lesswrong.com/posts/ZiQqsgGX6a42Sfpii/the-apologist-
and-the-revolutionary)

[https://www.lesswrong.com/posts/euJm4RwkAptZnP89i/bayes-
for-...](https://www.lesswrong.com/posts/euJm4RwkAptZnP89i/bayes-for-
schizophrenics-reasoning-in-delusional-disorders)

[https://slatestarcodex.com/2015/08/28/mysticism-and-
pattern-...](https://slatestarcodex.com/2015/08/28/mysticism-and-pattern-
matching/)

[http://slatestarcodex.com/2016/09/12/its-bayes-all-the-
way-u...](http://slatestarcodex.com/2016/09/12/its-bayes-all-the-way-up/)

[http://slatestarcodex.com/2017/06/28/why-are-transgender-
peo...](http://slatestarcodex.com/2017/06/28/why-are-transgender-people-
immune-to-optical-illusions/)

[http://slatestarcodex.com/2018/12/11/diametrical-model-of-
au...](http://slatestarcodex.com/2018/12/11/diametrical-model-of-autism-and-
schizophrenia/)

[https://slatestarcodex.com/2019/01/10/paradigms-all-the-
way-...](https://slatestarcodex.com/2019/01/10/paradigms-all-the-way-down/)

(And here, as a bonus, an article on dreaming, by Eliezer Yudkowsky:
[https://www.lesswrong.com/posts/8z2Fm2yaHpQz8rr5B/dreams-
wit...](https://www.lesswrong.com/posts/8z2Fm2yaHpQz8rr5B/dreams-with-damaged-
priors))

------
ssfrr
The game looks like a gamified version of the test they're using to measure
concentration. It seems likely that the subjects are getting better at that
specific task through practice, but I'd be skeptical that the results would
generalize to other tasks requiring concentration.

~~~
sam_goody
Goodhart's law: "When a measure becomes a target, it ceases to be a good
measure."

If it is just training to become better at the test to measure ADHD (I don't
know enough about the game to be sure) than it would be a classic application
of that "law".

~~~
WhompingWindows
I don't know much about the product either, but there are not good
quantitative tests to measure ADHD. ADHD is a multifactorial diagnosis that
can present with myriad symptoms, and it's diagnosed by examining a list of
symptoms and their effect on the patient's life. For instance, do you lose
things you need, are you attentive to details, do you daydream or space out to
your own detriment, do you fidget or move when it's inappropriate, etc. It'd
be very lackluster for a single test, or a single person, to judge these
symptoms.

The gold standard ADHD diagnosis would involve examining the child (or adult)
in multiple settings with multiple people's evidence, and then comparing
symptoms against those for anxiety, depression, and other MH diagnoses. If
they have enough symptoms from the official list, and they've been carefully
examined, they may qualify. A simple game/test will never be able to replace
that process.

~~~
ThrustVectoring
One of the big issues with these distress-based diagnosis metrics is that it
fails to diagnose people whose social environments are particularly well
suited for their mental health issues. If an autistic child has parents who
manage their sensory sensitivities and work well with their communicative
difficulties, the system sees a child who isn't experiencing a lot of the
distress-based symptoms used to diagnose autism.

So like, your gold standard diagnosis ends up depending a lot on the
organizational and attention demands the patient is required to meet. A
business analyst who is required to sit at a desk for eight hours a day and
pay attention to boring numbers on a business spreadsheet is much more likely
to get diagnosed with ADHD, while a barber that hangs out and does short
haircuts while interacting with clients is much less likely to merit such
diagnosis.

------
talltimtom
This seems borderline scientific fraud. They are showing that participants get
better at a test when they practice the test. They use this to make outlandish
claims about the test-training app which is sold by a company previously fined
for making fraudulent claims around their braintraining apps.

~~~
Bartweiss
Pretty much every brain-training routine that's ever showed promise has turned
out to be a practice effect specific to the task. "Does it generalize?" is
_the_ question for regimens like this. After so many promising failures, I
think it's inappropriate to claim even preliminary success without looking at
that question. (Worse, in fact: they ran the Trail Making Test too, saw no
significant change, and declared success because scores hadn't gone _down_.)

Unless this stands up to a far stronger test, I'm not just dismissing the
result but considering it an embarrassment for Cambridge's Neuroscience
Institute, Frontiers in Behavioural Neuroscience, and ABC. Turning the results
so far into a news story promising to free people from stimulants is reckless
at best and dishonest at worst.

------
jressey
This whole thing has been scrutinized for years. A quick read shows that
people that play the game, get better at... playing the game. Whoda thunk?
Also, a private company gets to sop up profits from something created by
public money. Boo.

~~~
Bartweiss
It's not exactly encouraging that the first author consults for Peak. The
conflict of interest statement in the paper offers this deeply unpleasant
comment:

 _" BS consults for Cambridge Cognition and Peak. We have technology-
transferred the App to Cambridge Enterprise who intends to technology-transfer
the App to the games company Peak so that it can become widely available for
use on mobile devices. This has not occurred yet."_

In short: we put up a free demo, but now we're giving all our code to the for-
profit company our lead author happens to consult for. Also, they haven't
bothered to actually release it outside their branded iOs-only app.

~~~
systemBuilder
This is pretty typical in the psychiatry and psychology field. The only way to
make big money is to write a book or invent a test.

------
arkades
Interesting that their press release claims the “public facing” version of the
app is free ... but I can’t find anything except the peak brain trining app,
which keeps decoder behind its pay wall.

~~~
spzb
Thanks. You saved me wasting time downloading it.

~~~
jhhnn
And creating an account just to do anything. And being subject to whatever
horrors lie in their privacy policy.

------
MartinMond
Wonder how it compares to the dual n-back exercise.
[https://en.wikipedia.org/wiki/N-back](https://en.wikipedia.org/wiki/N-back)

------
blakesterz
"a month resulted in neurological improvements in healthy trial participants
that were comparable to those taking stimulants such as methylphenidate
(Ritalin) or nicotine."

I was pretty excited to read this headline, but the details don't make sense
to me. They only did this on people without ADD?

I don't understand why they didn't test this on people who have ADHD. "Healthy
trial participants" would never be taking stimulants such as methylphenidate
(Ritalin), so how do they compare how a healthy person changes from Ritalin.

~~~
dijit
> "Healthy trial participants" would never be taking stimulants such as
> methylphenidate (Ritalin), so how do they compare how a healthy person
> changes from Ritalin.

Maybe in your circles. But I know a lot of people who abuse focus enhancing
drugs (often touted as "nootropics") to keep up with their academic struggles.

~~~
jeherr
I think the point is that there is little research on how healthy patients
react to stimulants because they don't need them in the same way that those
with ADHD do. This study says nothing about how this may help people with ADHD
because you can't assume that they will have the same result.

------
eranation
I didn't read the entire study and didn't play too much with the app, but this
entire article reads like an advertisement to the peak app. The only relation
I found on peak's about page to Cambridge is Barbara Sahakian, FMedSci DSc,
Scientific Advisor. [http://www.peak.net/about/](http://www.peak.net/about/)

I'm not calling this a fraud but didn't numerous studies showed that any of
the so called brain trainig apps don't show translation of skill to the real
world? e.g. you do get better that the games the apps have, but not helping in
actual real life scenarios?

The test they used (Rapid Visual Information Processing test) is just another
"game" in a way. You can train someone to be better at the test, but it
doesn't make their ADHD go away magically. I wish it was that easy.

It looks like the app includes games that are way too similar to the actual
test that was used to determine progress in the test subjects.

From the article:

About the game:

"To meet the objective, users have to identify different combinations of
number strings in missions littered with distraction."

About the test (used to prove the game does improve cognitive abilities):

"Those tested were asked to detect digit sequences (such as 2-4 or 6-8), and
then hit a button once detected as quickly as they could — and multiple
sequences could appear at the same time"

Am I missing something or this sounds like almost the same thing?

One can train and learn all the answers to an IQ test, this doesn't make one a
genius.

This feels like a real great promoted article in the cover of scientific
writing, but maybe I'm just and old cynic.

Once a study shows actual translation, after years of observation, that ADHD
subjects get improvements in other aspects of life (school, social, grades,
self esteem etc) then I'll be the first to support it. Until then, it just
looks like greed and bottom line. I guess it's better than playing candy crush
at least.

~~~
Bartweiss
> _didn 't numerous studies showed that any of the so called brain trainig
> apps don't show translation of skill to the real world? e.g. you do get
> better that the games the apps have, but not helping in actual real life
> scenarios?_

Yes, this is almost always the problem. For quite a while, we thought dual
n-back tests had generalized results, and so brain-training apps were
basically attempting to stumble on a gamified version of that task.
Unfortunately, newer studies[1] suggest that dual n-back _also_ doesn't
produce fluid intelligence or working memory improvements, so there's no proof
of concept here at all.

As for this study, the game and metric were exceedingly similar, and practice
effects on the metric are an obvious risk. The researchers did apply a second
metric less similar to their task, a standard dot-connecting task called Trail
Making Task. Unfortunately, their stated intent was to show that improved
single-task attention didn't degrade focus-switching attention, so this was a
substantially different task for which they hypothesized no change.

Their abstract reports a statistically significant improvement on TMT, which
could be quite interesting. However, the full paper shows that Decoder had
p=0.03 improvement on TMT over the active control (people who played Bingo),
but the passive control (no play) was not significantly different than Decoder
_or_ the active control. This isn't regarded as a failure because they
expected no change, but it means the study failed to show clear improvement in
any metric which didn't precisely replicate the game's task.

You're absolutely right to be skeptical here. Practice effects are a constant
problem with this sort of research, and the study seems to be confusingly
short on attempts to test for that. The actual app focuses more on
gamification than using any type of proven test, and the lead author's
corporate connection to Peak is at best concerning. I don't think there's any
sort of fraud here, but it's a field riddled with well-meaning projects that
turn out to lack any general benefit, and this result has all the warning
signs for another promising failure.

[1]
[https://www.sciencedirect.com/science/article/pii/S016028961...](https://www.sciencedirect.com/science/article/pii/S0160289613001293)

------
rchaud
> available on iPhone and iPad

I understand if there's no web version, but no Android version in 2019 is
ridiculous. That and the plus university research angle seems to indicate that
this is a one-off app that is unlikely to be updated or maintained down the
line.

~~~
Bartweiss
I think it's the opposite problem, actually: Decoder is made by Peak, a
company that specializes in Lumosity-style brain training games. This is
basically a corporate/academic partnership, where Peak just wanted to develop
for the higher-margin platform.

As for the university research angle... it's _bad_ research, embarrassingly
so. There's a reason companies like Lumosity keep getting warned about making
unsupported claims, and this looks like an attempt to get academic backing for
a product with all the same problems as prior ones.

------
sandworm101
I always thought of Ritalin as a thing for kids. Then I went to law school on
the east coast of the US. What totally changed my perspective was the large
number of adult students (mid-20s/30s) still on Ritalin. I was no slouch, but
many of them were _getting better grades than me_. At what point did Ritalin
shift from being something to correct a legitimate deficiency into something
meant to increase performance? If you are getting strait As in a graduate
program, maybe you don't need it as much as you think.

~~~
reitanqild
> I was no slouch, but many of them were getting better grades than me.

ADHD doesn't mean stupid. Many people who suffer under ADHD are really bright,
they just have problems with focusing in school.

And AFAIK Ritalin doesn't increase intelligence, the best explanation I've
come across is it just lowers the threshold for "interesting" in the ADHD
brain until things like driving according to speed limits and listening to
teachers isn't mind numbingly boring anymore.

------
yters
Anecdotally, for awhile I was solving Soduku entirely in my head, and I had a
noticeable improvement in memory. Once I stopped the improvement went away.
So, there seems to be benefit to some sorts of brain training.

~~~
maceurt
How do you solve soduku entirely in your head?

~~~
yters
I memorize the layout, and solved the puzzle by imagining the grid. Don't use
paper at all. The easy puzzles tend to have a certain symmetry that make them
not too difficult to memorize.

------
BrockSamson
Very interesting to see how a particular style of game can have beneficial
effects on attention. I wonder if the opposite is also true, although I'm sure
there's some ethical issue with trying to find out.

------
arippberger
Does the app block access to Hacker News

~~~
stevewodil
and reddit and youtube?

In all seriousness I downloaded a browser extension to lock me into my course
work when I need it. It's pretty sad for me

------
ChuckMcM
So basically this is a counter study to the 'brain stimulating games' do
nothing papers.

Presumably the game is not that complex in its mechanic such that an open
source version that ran on more platforms could be devised.

That said, I'm waiting for the study where they take participants and
structure their access to email, social media, and television in such a way as
to limit it to a prescribed time and duration. One hypothesis is that trying
to multi-task negatively affects the ability to single task (concentrate)
effectively.

------
jimkri
This is pretty cool. When I was younger I was hooked up to a game that was
similar to EKGs with the connectors on my head and I would have to concentrate
to play the game. It's great seeing its available for anyone with a phone.

I think VR games would be great for improving concentration, but at short
intervals at first. Similar to meditation where you focus on breathing and
then move onto other areas of meditation.

------
anonytrary
I wonder if they did research into MOBA games like League of Legends before
making this app. League of Legends and other MOBA games are fun, competitive
and require a boatload of concentration and reflexes if you wanna get good. I
would point people to play those games if they wanna improve their
concentration, although I'm not sure how much research there is on it.

------
zeristor
Whomst?

The article points to Decoder being embedded in an app, Peak Brain training:

[https://itunes.apple.com/gb/app/peak-brain-
training/id806223...](https://itunes.apple.com/gb/app/peak-brain-
training/id806223188)

~~~
zeristor
From the article it’s twice as effective as playing bingo, I take this is the
FDA approved standard bingo, quite a strange comparison to make.

~~~
Matticus_Rex
Bingo has been studied for its effects in this regard:
[https://journals.sagepub.com/doi/abs/10.1177/153331750101600...](https://journals.sagepub.com/doi/abs/10.1177/153331750101600214)

------
1rs
That site is not a news site... That's just paid advertising?

~~~
barbs
ABC News? Probably one of the most reputable news sources in Australia. It's
also funded and owned by the government and has no ads so I doubt it's paid
advertising.

------
Ice_cream_suit
Sounds very much like the snake oil that accompanied Lumosity...

------
jpkeisala
And of course, I read it Cambridge Analytica... I cannot image what kind of
damage that company gave to Cambridge University.

~~~
pergadad
Cambridge is a city. There are many organisations calling themselves Cambridge
(or Oxford for that matter), either because they are genuinely based there or
because they hope to benefit from the association. Can't really trademark a
city name though.

------
dura-ace88
Let’s not forget that it was Cambridge who first identified the political
opportunities of knowing people’s psychological tendencies through survey
collection on Facebook - before Cambridge Analytica was born.

Can’t help but feel that this is slightly on the nose.

------
dura-ace88
Let’s not forget that it was Cambridge who first identified the political
opportunities of knowing people’s psychological tendencies through survey
collection on Facebook - before Cambridge Analytica was born.

Can’t help but feel that doing something similar with cognition is slightly on
the nose.

