A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test.
A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test.
复制标题
DOI：
10.2196/18234
复制
发表时间：
2020-09-23
影响因子：
7.4
通讯作者：
UK MS Register Research Group
中科院分区：
文献类型：
--
作者：
Middleton RM;Pearson OR;Ingram G;Craig EM;Rodgers WJ;Downing-Wood H;Hill J;Tuite-Dalton K;Roberts C;Watson L;Ford DV;Nicholas R;UK MS Register Research Group
在多发性硬化症(MS)中，将认知测试纳入常规临床实践是一个挑战，因为人们可能有广泛的认知和身体障碍，而且测试需要时间。简短的论文和口头评估占主导地位，但仍不是常规使用。以计算机为基础的考试正变得越来越普遍；然而，纸质考试实施方式的变化可能会影响个人的确切评估。符号数字通道测试(SDMT)是一种经过验证的测试，它构成了MS使用的认知电池的一部分，并有一些基于计算机的版本。我们开发了一种基于平板电脑的SDMT变体，最终有可能部署到患者自己的设备上。本文旨在开发、验证和部署一个基于计算机的SDMT变体-认知反应(CORE)测验，该测验能够可靠地复制纸质SDMT的特征。我们使用皮尔逊相关性和组内相关性以及Bland-Altman比较进行了分析，以检查SDMT和核心测试之间的一致性，以及重测的可靠性。评估了SDMT和核心测试对残疾程度和年龄的敏感性。在核心中发现了一种新的度量：可以计算问题回答速度。对多发性硬化症患者的残疾程度和年龄进行了评估，并与一组健康对照志愿者进行了比较。SDMT和核心测试分数高度相关，并与1个月的重测值一致。年龄越大的患者得分越低，且随着残疾程度的增加而出现一定的效果。没有明显的学习效果。问题回答速度显示，在90秒的测试持续时间内，多发性硬化症患者和健康对照组的速度略有增加。这项研究验证了SDMT的一种基于计算机的替代方案，可以在临床和其他地方使用。它能够准确记录与多发性硬化症相关的认知元素，但提供了额外的指标，可能会为临床医生和多发性硬化症患者提供进一步的价值。
Incorporating cognitive testing into routine clinical practice is a challenge in multiple sclerosis (MS), given the wide spectrum of both cognitive and physical impairments people can have and the time that testing requires. Shortened paper and verbal assessments predominate but still are not used routinely. Computer-based tests are becoming more widespread; however, changes in how a paper test is implemented can impact what exactly is being assessed in an individual. The Symbol Digit Modalities Test (SDMT) is one validated test that forms part of the cognitive batteries used in MS and has some computer-based versions. We developed a tablet-based SDMT variant that has the potential to be ultimately deployed to patients’ own devices. This paper aims to develop, validate, and deploy a computer-based SDMT variant, the Cognition Reaction (CoRe) test, that can reliably replicate the characteristics of the paper-based SDMT. We carried out analysis using Pearson and intraclass correlations, as well as a Bland-Altman comparison, to examine consistency between the SDMT and CoRe tests and for test-retest reliability. The SDMT and CoRe tests were evaluated for sensitivity to disability levels and age. A novel metric in CoRe was found: question answering velocity could be calculated. This was evaluated in relation to disability levels and age for people with MS and compared with a group of healthy control volunteers. SDMT and CoRe test scores were highly correlated and consistent with 1-month retest values. Lower scores were seen in patients with higher age and some effect was seen with increasing disability. There was no learning effect evident. Question answering velocity demonstrated a small increase in speed over the 90-second duration of the test in people with MS and healthy controls. This study validates a computer-based alternative to the SDMT that can be used in clinics and beyond. It enables accurate recording of elements of cognition relevant in MS but offers additional metrics that may offer further value to clinicians and people with MS.
登录
查看更多内容
DOI：
10.1177/1352458518769837
发表时间：
2019-04
期刊：
Multiple sclerosis (Houndmills, Basingstoke, England)
影响因子：
--
作者：
Kobelt G;Langdon D;Jönsson L
通讯作者：
Jönsson L
影响因子：
2.6
作者：
Klein, Olga A.;das Nair, Roshan;Drummond, Avril
通讯作者：
Drummond, Avril
影响因子：
9.9
作者：
RAO, SM;LEO, GJ;UNVERZAGT, F
通讯作者：
UNVERZAGT, F
影响因子：
3
作者：
de Gobbi Porto, Fabio Henrique;Spindola, Livia;Dozzi Brucki, Sonia Maria
通讯作者：
Dozzi Brucki, Sonia Maria
影响因子：
6
作者：
Akbar, Nadine;Honarmand, Kimia;Feinstein, Anthony
通讯作者：
Feinstein, Anthony