In this Stage 1 Registered Report, Karhulahti and colleagues (2021) propose a qualitative, interview-based study of videogame play, with the central aim to understand key phenomological differences between gaming behaviour that is associated with vs. without health problems. This question is particularly important given the recent inclusion of "gaming disorder" in the WHO's International Statistical Classification of Diseases and Related Health Problems (ICD).
In recent years, the validity of "gaming disorder" as an identifiable mental illness has been controversial (e.g. Van Rooij et al, 2018), as has the debate concerning purported harms or benefits of gaming for mental health. This Stage 1 manuscript describes a rigorous qualitative investigation that should provide new insights on this question, and will also include a longitudinal component to examine changes in phenomonology over time, as well as an examination of the extent to which the phenomonology of gaming is reflected in the experiences of medical experts such as doctors, nurses, and therapists who have worked with gaming-related health problems.
More broadly, the manuscript breaks new ground for Registered Reports, being one of the first to focus on qualitative methods, while also making use of the Programmatic submission track in which the approved Stage 1 manuscript is intended to produce two Stage 2 manuscripts focusing on different elements of the project.
Three expert reviewers with a variety of field-specialist and qualitative methodological expertise assessed the Stage 1 manuscript over two rounds of in-depth review. Following revision, the reviewers and recommender agreed that the manuscript met the Stage 1 criteria and therefore awarded in-principle acceptance (IPA).
URL to the preregistered Stage 1 protocol: https://osf.io/a2rwg
Level of bias control achieved: Level 4. At least some of the data/evidence that will be used to answer the research question already exists AND is accessible in principle to the authors (e.g. residing in a public database or with a colleague), BUT the authors certify that they have not yet accessed any part of that data/evidence.
List of eligible PCI RR-friendly journals:
Version of the report: v2
The revised Stage 1 manuscript was returned to the three reviewers who evaluated the original submission. The good news is that the reviewers are broadly satisfied and we are now close to being able to award Stage 1 in-principle acceptance (IPA). Among the remaining issues to address are methodological clarifications and minor presentational issues, together with assurances regarding the anonymisation of participant data.
Other than these points, the one remaining significant issue is the suitability of the proposed design for the programmatic RR track in which there will be two separate Stage 2 outputs. After the first round of review, I was not fully convinced that the second proposed Stage 2 output was sufficiently robust and substantive to justify a separate RR (in accordance with Stage 1 criterion 1C).
This concern is revisited here by one of the three reviewers (Malte Elson), and I admit I do share the reviewer's concern. However, after re-reading the revised manuscript myself, including especially the authors' contingency plan for the designation of the second Stage 2 output as either a complete qualitative report or a case study, I have decided that the best course of the action in this case is to grant the authors' the benefit of the doubt, much as with many Stage 1 RRs that, in spite of careful planning, face a non-zero risk of recruitment failure. To comprehensively settle this issue, in this final revision, I would like to see (in both the manuscript and in the authors' response to reviewers) a clear description of the conditions under which the second RR would be impossible -- i.e. presumably if the sample size is below the minimum needed even for a case study. Although this may seem obvious, I believe it needs to be clearly articulated, primarily for the authors' own sake. As noted in the PCI RR policy, once a programmatic IPA is awarded, the prespecified boundaries defining different Stage 2 outputs are treated as design elements; therefore, like any other design element, Stage 1 IPA will be contingent on authors adhering to the prespecified and approved article boundaries at Stage 2. Where one of these elements becomes impossible to complete, authors must ensure that they are aware of the conditions under which a Withdrawn Registration would be required, and the resulting reporting requirements: "For programmatic RRs, entire components that are planned as separate Stage 2 outputs can be withdrawn without affecting the IPA of the remaining components. In such cases, each remaining Stage 2 output must include a URL to the Withdrawn Registration of the withdrawn component." Therefore, while I am satisfied for the authors to split the project as described, the authors should bear this in mind in reaching their own final decision about the risks and benefits of the programmatic track.
Overall, given the enthusiastic evaluations of the reviewers, provided the authors are able to respond comprehensively to these remaining points in a final revision, Stage 1 IPA should be forthcoming without requiring further in-depth review.
Three reviewers with a range of field-specialist and qualitative methodological expertise have now assessed the Stage 1 manuscript. As you will see, the comments are generally encouraging and constructive, while also critical, noting a range of areas that will need careful attention to achieve Stage 1 IPA. At a broad level, the reviews identify shortcomings that cut across several Stage 1 criteria, including justification of the hypotheses (with one reviewer especially identifying concerns with QH2), feasibility, and the degree of detail provided concerning the study procedures and analysis plans.
One reviewer also questions whether the follow-up study proposed for the second of the two proposed Stage 2 outputs is sufficiently substantive, robust, and resistant to recruitment failure to include now as part of a programmatic Stage 1 RR -- or whether it may be preferable to focus on the first part and then later submit a second Stage 1 RR that includes a more adequately defined, and risk-controlled longitudinal study. This evaluation falls appropriately under Stage 1 criterion 1C, which, for programmatic RRs, includes "whether the separate study components are sufficiently robust and substantive to justify separate Stage 2 outputs". At present, given the comments of this reviewer, I think that test is not yet met, but I am open to being convinced otherwise through a substantive and major revision that addresses this concern.
Overall, the manuscript falls within scope for a Major Revision. Please note that a revised submission is likely to be returned to the reviewers for further consideration.