Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales.
Computerised cognitive assessment in patients with traumatic brain injury: an observational study of feasibility and sensitivity relative to established clinical scales.
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DOI：
10.1016/j.eclinm.2023.101980
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发表时间：
2023-05
影响因子：
15.1
通讯作者：
Hampshire, Adam
中科院分区：
文献类型：
--
作者：
Del Giovane, Martina;Trender, William R.;Balaet, Maria;Mallas, Emma-Jane;Jolly, Amy E.;Bourke, Niall J.;Zimmermann, Karl;Graham, Neil S. N.;Lai, Helen;Losty, Ethan J. F.;Oiarbide, Garazi Arana;Hellyer, PeterJ.;Faiman, Irene;Daniels, Sarah J. C.;Batey, Philippa;Harrison, Matthew;Giunchiglia, Valentina;Kolanko, Magdalena A.;David, Michael C. B.;Li, Lucia M.;Demarchi, Celia;Friedland, Daniel;Sharp, David J.;Hampshire, Adam
在线技术可能会彻底改变患者的认知评估和监测方式。然而，目前尚不清楚远程评估是否可以在敏感性和特异性方面与现有的纸笔神经心理学测试相匹配。这项观察性研究旨在优化用于创伤性脑损伤（TBI）诊所的在线认知评估。三级转诊诊所在临床上实施了这一工具，通常在慢性期看到患者受伤后至少6个月。在2019年3月至8月期间，我们在St.玛丽医院TBI诊所和帝国理工学院NHS信托基金和伦敦（英国）的圣乔治医院的主要创伤病房进行了跨组，跨设备和因素分析，以确定一系列任务，评估TBI影响的认知方面。在2019年9月至2020年2月期间，我们在帝国理工学院伦敦研究中心对在线电池进行了标准面对面神经心理学测试。典型相关分析（CCA）确定了在线电池和标准神经心理测试之间的共享方差。最后，在2020年10月至2021年12月期间，这些测试被整合到一个框架中，该框架自动生成结果报告，将患者的表现与大型规范数据集进行比较。我们在英国伦敦的St.玛丽医院TBI诊所进行了试验，将其作为一种实用工具在监督和非监督条件下使用。在线评估区分处理速度，视觉注意力，工作记忆，和执行功能缺陷TBI。CCA确定了两个显著模式，表明与标准神经心理测试共享方差（r = 0.86，p < 0.001和r = 0.81，p = 0.02）。TBI后认知缺陷的敏感性在TBI临床环境中在监督和非监督条件下是明显的（F（15，555）= 3.99; p < 0.001）。TBI患者的在线认知评估是可行的，敏感的，有效的。当与规范的社会人口模型和自动生成的报告相结合时，它有可能改变医疗保健环境中的认知评估。这项工作由授予DJS和AH（II-LB-0715-20006）的（i4 i）赠款资助。
Online technology could potentially revolutionise how patients are cognitively assessed and monitored. However, it remains unclear whether assessments conducted remotely can match established pen-and-paper neuropsychological tests in terms of sensitivity and specificity. This observational study aimed to optimise an online cognitive assessment for use in traumatic brain injury (TBI) clinics. The tertiary referral clinic in which this tool has been clinically implemented typically sees patients a minimum of 6 months post-injury in the chronic phase. Between March and August 2019, we conducted a cross-group, cross-device and factor analyses at the St. Mary’s Hospital TBI clinic and major trauma wards at Imperial College NHS trust and St. George’s Hospital in London (UK), to identify a battery of tasks that assess aspects of cognition affected by TBI. Between September 2019 and February 2020, we evaluated the online battery against standard face-to-face neuropsychological tests at the Imperial College London research centre. Canonical Correlation Analysis (CCA) determined the shared variance between the online battery and standard neuropsychological tests. Finally, between October 2020 and December 2021, the tests were integrated into a framework that automatically generates a results report where patients’ performance is compared to a large normative dataset. We piloted this as a practical tool to be used under supervised and unsupervised conditions at the St. Mary’s Hospital TBI clinic in London (UK). The online assessment discriminated processing-speed, visual-attention, working-memory, and executive-function deficits in TBI. CCA identified two significant modes indicating shared variance with standard neuropsychological tests (r = 0.86, p < 0.001 and r = 0.81, p = 0.02). Sensitivity to cognitive deficits after TBI was evident in the TBI clinic setting under supervised and unsupervised conditions (F (15,555) = 3.99; p < 0.001). Online cognitive assessment of TBI patients is feasible, sensitive, and efficient. When combined with normative sociodemographic models and autogenerated reports, it has the potential to transform cognitive assessment in the healthcare setting. This work was funded by a (i4i) grant awarded to DJS and AH (II-LB-0715-20006).
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影响因子：
11.2
作者：
Cole, James H.;Leech, Robert;Sharp, David J.
通讯作者：
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15.1
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