Computerized neuropsychological assessment devices in multiple sclerosis: A systematic review

Background: The proliferation of computerized neuropsychological assessment devices (CNADs) for screening and monitoring cognitive impairment is increasing exponentially. Previous reviews of computerized tests for multiple sclerosis (MS) were primarily qualitative and did not rigorously compare CNADs on psychometric properties. Objective: We aimed to systematically review the literature on the use of CNADs in MS and identify test batteries and single tests with good evidence for reliability and validity. Method: A search of four major online databases was conducted for publications related to computerized testing and MS. Test–retest reliability and validity coefficients and effect sizes were recorded for each CNAD test, along with administration characteristics. Results: We identified 11 batteries and 33 individual tests from 120 peer-reviewed articles meeting the inclusion criteria. CNADs with the strongest psychometric support include the CogState Brief Battery, Cognitive Drug Research Battery, NeuroTrax, CNS-Vital Signs, and computer-based administrations of the Symbol Digit Modalities Test. Conclusion: We identified several CNADs that are valid to screen for MS-related cognitive impairment, or to supplement full, conventional neuropsychological assessment. The necessity of testing with a technician, and in a controlled clinic/laboratory environment, remains uncertain.

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The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): Validation in Arabic and Lebanese Normative Values

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000102 ◽

2021 ◽

pp. 1-10

Author(s):

Hala Darwish ◽

Pia Zeinoun ◽

Natali Farran ◽

Husam Ghusn ◽

Bassem Yamout ◽

...

Keyword(s):

Multiple Sclerosis ◽

Psychometric Properties ◽

Cognitive Assessment ◽

Healthy Subjects ◽

Good Evidence ◽

Normative Values ◽

Arabic Version ◽

Retest Reliability ◽

Test Retest Reliability ◽

Healthy Participants

Abstract Objective: Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients’ cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. Method: The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2–3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test–retest reliability and criterion-related validity were examined, and regression-based norms were derived. Results: The test–retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. Conclusions: This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT’s reliability was shown in the healthy participants, less test–retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.

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Reliability and Validity of Composite Scores from the NIH Toolbox Cognition Battery in Adults

Journal of the International Neuropsychological Society ◽

10.1017/s1355617714000241 ◽

2014 ◽

Vol 20 (6) ◽

pp. 588-598 ◽

Cited By ~ 102

Author(s):

Robert K. Heaton ◽

Natacha Akshoomoff ◽

David Tulsky ◽

Dan Mungas ◽

Sandra Weintraub ◽

...

Keyword(s):

Cognitive Abilities ◽

Gold Standard ◽

Reliability And Validity ◽

Epidemiologic Studies ◽

Memory Processing ◽

Significant Relationships ◽

Gender Education ◽

Computer Based ◽

Composite Scores ◽

Test Retest Reliability

AbstractThis study describes psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) Composite Scores in an adult sample. The NIHTB-CB was designed for use in epidemiologic studies and clinical trials for ages 3 to 85. A total of 268 self-described healthy adults were recruited at four university-based sites, using stratified sampling guidelines to target demographic variability for age (20–85 years), gender, education, and ethnicity. The NIHTB-CB contains seven computer-based instruments assessing five cognitive sub-domains: Language, Executive Function, Episodic Memory, Processing Speed, and Working Memory. Participants completed the NIHTB-CB, corresponding gold standard validation measures selected to tap the same cognitive abilities, and sociodemographic questionnaires. Three Composite Scores were derived for both the NIHTB-CB and gold standard batteries: “Crystallized Cognition Composite,” “Fluid Cognition Composite,” and “Total Cognition Composite” scores. NIHTB Composite Scores showed acceptable internal consistency (Cronbach’s alphas=0.84 Crystallized, 0.83 Fluid, 0.77 Total), excellent test–retest reliability (r: 0.86–0.92), strong convergent (r: 0.78–0.90) and discriminant (r: 0.19–0.39) validities versus gold standard composites, and expected age effects (r=0.18 crystallized, r=−0.68 fluid, r=−0.26 total). Significant relationships with self-reported prior school difficulties and current health status, employment, and presence of a disability provided evidence of external validity. The NIH Toolbox Cognition Battery Composite Scores have excellent reliability and validity, suggesting they can be used effectively in epidemiologic and clinical studies. (JINS, 2014, 20, 1–11)

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Reliability and validity of a Mediterranean diet and culinary index (MediCul) tool in an older population with mild cognitive impairment

British Journal Of Nutrition ◽

10.1017/s0007114518002428 ◽

2018 ◽

Vol 120 (10) ◽

pp. 1189-1200 ◽

Cited By ~ 4

Author(s):

Sue Radd-Vagenas ◽

Maria A. Fiatarone Singh ◽

Michael Inskip ◽

Yorgi Mavros ◽

Nicola Gates ◽

...

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Mediterranean Diet ◽

Reliability And Validity ◽

Community Dwelling ◽

Systematic Bias ◽

Older Individuals ◽

Retest Reliability ◽

The Mean ◽

Test Retest Reliability

AbstractDementia is a leading cause of morbidity and mortality without pharmacologic prevention or cure. Mounting evidence suggests that adherence to a Mediterranean dietary pattern may slow cognitive decline, and is important to characterise in at-risk cohorts. Thus, we determined the reliability and validity of the Mediterranean Diet and Culinary Index (MediCul), a new tool, among community-dwelling individuals with mild cognitive impairment (MCI). A total of sixty-eight participants (66 % female) aged 75·9 (sd 6·6) years, from the Study of Mental and Resistance Training study MCI cohort, completed the fifty-item MediCul at two time points, followed by a 3-d food record (FR). MediCul test–retest reliability was assessed using intra-class correlation coefficients (ICC), Bland–Altman plots and κ agreement within seventeen dietary element categories. Validity was assessed against the FR using the Bland–Altman method and nutrient trends across MediCul score tertiles. The mean MediCul score was 54·6/100·0, with few participants reaching thresholds for key Mediterranean foods. MediCul had very good test–retest reliability (ICC=0·93, 95 % CI 0·884, 0·954, P<0·0001) with fair-to-almost-perfect agreement for classifying elements within the same category. Validity was moderate with no systematic bias between methods of measurement, according to the regression coefficient (y=−2·30+0·17x) (95 % CI −0·027, 0·358; P=0·091). MediCul over-estimated the mean FR score by 6 %, with limits of agreement being under- and over-estimated by 11 and 23 %, respectively. Nutrient trends were significantly associated with increased MediCul scoring, consistent with a Mediterranean pattern. MediCul provides reliable and moderately valid information about Mediterranean diet adherence among older individuals with MCI, with potential application in future studies assessing relationships between diet and cognitive function.

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Validity and Reliability of Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in Indonesia and the Correlation with Quality of Life

Neurology Research International ◽

10.1155/2019/4290352 ◽

2019 ◽

Vol 2019 ◽

pp. 1-7

Author(s):

Riwanti Estiasari ◽

Yuhyi Fajrina ◽

Diatri Nari Lastri ◽

Syarli Melani ◽

Kartika Maharani ◽

...

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Assessment ◽

Verbal Learning ◽

Retest Reliability ◽

Cognitive Evaluation ◽

Test Retest Reliability

Introduction. Multiple Sclerosis (MS) can affect cognitive function that might interfere with quality of life. Processing speed and memory are the most common area of cognitive impairment. Cognitive evaluation in daily practice is often difficult to be performed since it needs neuropsychological expert and is time-consuming. Brief International Cognitive Assessment for MS (BICAMS) is valid and practical for cognitive evaluation. This study aims to validate BICAMS in Indonesian MS patients and healthy controls (HC) and to analyse the effect of cognitive impairment on quality of life. Methods. BICAMS, which composes Symbol Digits Modalities Test (SDMT), California Verbal Learning Test-Second Edition (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R), was translated and cross-culturally adapted to Indonesian from the original BICAMS and then administered to 40 Indonesian MS patients and 66 HC matched by sex, age, and education. Test-retest reliability was performed on 16-MS patients and 42 HC. Quality of life was measured using Multiple Sclerosis Quality of Life (MSQOL-54) instrument. Results. The SDMT, CVLT-II, and BVMT-R score in MS patients were significantly lower than those in HC (effect size, r: 0.61, 0.36, and 0.47, respectively). Test-retest reliability for all tests was satisfactory with correlation coefficient for SDMT, CVLT-II, and BVMT-R in MS subjects 0.86, 0.81, and 0.83, respectively. Using 5th percentile of HC score as cut-off, 15% MS subjects had impairment in one test, 27.5% in two tests, and 40% in three tests. BICAMS was moderately correlated with EDSS but was not correlated with disease duration and relapse rate. SDMT score correlated with physical function and physical and mental role limitation. Conclusion. BICAMS is valid and reliable for assessing cognitive function of Indonesia MS patients.

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Novel computer-based testing shows multi-domain cognitive dysfunction in patients with multiple sclerosis

Multiple Sclerosis Journal - Experimental Translational and Clinical ◽

10.1177/2055217318767458 ◽

2018 ◽

Vol 4 (2) ◽

pp. 205521731876745 ◽

Cited By ~ 2

Author(s):

Andrew D Smith ◽

Charles Duffy ◽

Andrew D Goodman

Keyword(s):

Multiple Sclerosis ◽

Cognitive Dysfunction ◽

Neuropsychological Testing ◽

Poor Quality ◽

Cognitive Testing ◽

Routine Clinical Setting ◽

Baseline Testing ◽

Computer Based ◽

Test Retest Reliability

Background Although cognitive dysfunction is a leading cause of disability and poor quality of life in patients with multiple sclerosis (MS), it is infrequently tested in routine clinical evaluation. Development of a cognitive testing paradigm that captured MS-related cognitive dysfunction and could be obtained in a routine clinical setting may increase surveillance and recognition of cognitive dysfunction. Objectives This was a pilot study to determine if Cognivue could find cognitive performance differences between patients with MS and healthy controls (HC). Methods: A total of 24 patients with MS and 12 HCs between 18 and 50 years old were enrolled. Baseline testing included an Expanded Disability Scale (EDSS), paced auditory serial additions test (PASAT), symbol digit modalities test (SDMT) and Cognivue. Subjects then had repeat testing every 1–2 months for a maximum of three tests. Results Significant differences were found between MS and HC on SDMT, PASAT, and Cognivue Total score. Most Cognivue subtests showed significant differences between MS and HC. Cognivue scores correlated with both SDMT and PASAT and had high test-retest reliability in HCs. Conclusion Cognivue was able to detect multi-domain cognitive dysfunction in MS. Further studies to determine validity of Cognivue in MS with comparison with neuropsychological testing and sensitivity to clinical change are still needed.

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The Reliability and Validity of the Safety Assessment of Function and the Environment for Rehabilitation (SAFER Tool)

British Journal of Occupational Therapy ◽

10.1177/030802269806100309 ◽

1998 ◽

Vol 61 (3) ◽

pp. 127-132 ◽

Cited By ~ 26

Author(s):

Lori Letts ◽

Sheri Scott ◽

Jill Burtney ◽

Linda Marshall ◽

Martha McKean

Keyword(s):

Cognitive Impairment ◽

Activities Of Daily Living ◽

Daily Living ◽

Safety Assessment ◽

Reliability And Validity ◽

Predictive Ability ◽

Retest Reliability ◽

Functional Activities ◽

Limited Variation ◽

Test Retest Reliability

The Safety Assessment of Function and the Environment for Rehabilitation (SAFER Too)) was developed to assess people's abilities to manage functional activities safety within their homes. The results of a study to evaluate the instruments inter-rater and test-retest reliability and construct validity are reported. Reliability was evaluated using kappa for each dichotomous item. For inter-rater reliability, 59 of 66 items had acceptable reliability. For test-retest reliability, 63 of 70 items had acceptable kappa scores. For items where kappa could not be calculated because of limited variation between raters, percentage agreement was over 80%. For validity, higher SAFER Tool scores (that is, more safety problems) were hypothesised to be associated with less independence in activities of daily living (ADL) and instrumental activities of daily living (IADL) and more cognitive impairment. The correlation between SAFER Tool scores and cognitive impairment supported this hypothesis. The results of the correlations with ADL and IADL scores were less clear. This could be attributed to caregivers' assistance with activities which might have reduced risk, and generally limited variation in ADL scores. The reliability results from this study are positive. Further research to assure the SAFER Tools validity and predictive ability are needed.

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Cognitive Impairment in Patients with Multiple Sclerosis as Assessed by Objective Computerized Testing

Neurological Sciences and Neurosurgery ◽

10.47275/2692-093x-113 ◽

2020 ◽

Vol 2 (1) ◽

Author(s):

Roberto Bomprezzi ◽

Kerime Ararat ◽

Evdokia Eleftheriou ◽

Kara Smith ◽

Reina Benabou

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Computerized Testing

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Reliability, Validity, and Feasibility of a Computer-Based Geriatric Assessment for Older Adults With Cancer

Journal of Oncology Practice ◽

10.1200/jop.2016.013136 ◽

2016 ◽

Vol 12 (12) ◽

pp. e1025-e1034 ◽

Cited By ~ 44

Author(s):

Arti Hurria ◽

Chie Akiba ◽

Jerome Kim ◽

Dale Mitani ◽

Matthew Loscalzo ◽

...

Keyword(s):

Older Adults ◽

Geriatric Assessment ◽

Hematologic Malignancy ◽

Social Activity ◽

Reliability And Validity ◽

Data Capture ◽

Computer Based ◽

Paper And Pencil ◽

Test Retest Reliability ◽

Completion Times

Purpose: The goal of this study was to evaluate the feasibility, reliability, and validity of a computer-based geriatric assessment via two methods of electronic data capture ( SupportScreen and REDCap) compared with paper-and-pencil data capture among older adults with cancer. Methods: Eligible patients were ≥ 65 years old, had a cancer diagnosis, and were fluent in English. Patients were randomly assigned to one of four arms, in which they completed the geriatric assessment twice: (1) REDCap and paper and pencil in sessions 1 and 2; (2) REDCap in both sessions; (3) SupportScreen and paper and pencil in sessions 1 and 2; and (4) SupportScreen in both sessions. The feasibility, reliability, and validity of the computer-based geriatric assessment compared with paper and pencil were evaluated. Results: The median age of participants (N = 100) was 71 years (range, 65 to 91 years) and the diagnosis was solid tumor (82%) or hematologic malignancy (18%). For session 1, REDCap took significantly longer to complete than paper and pencil (median, 21 minutes [range, 11 to 44 minutes] v median, 15 minutes [range, 9 to 29 minutes], P < .01) or SupportScreen (median, 16 minutes [range, 6 to 38 minutes], P < .01). There were no significant differences in completion times between SupportScreen and paper and pencil ( P = .50). The computer-based geriatric assessment was feasible. Few participants (8%) needed help with completing the geriatric assessment (REDCap, n = 7 and SupportScreen, n = 1), 89% reported that the length was “just right,” and 67% preferred the computer-based geriatric assessment to paper and pencil. Test–retest reliability was high (Spearman correlation coefficient ≥ 0.79) for all scales except for social activity. Validity among similar scales was demonstrated. Conclusion: Delivering a computer-based geriatric assessment is feasible, reliable, and valid. SupportScreen methodology is preferred to REDCap.

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A self-administered, artificial intelligence (AI) platform for cognitive assessment in multiple sclerosis (MS)

10.21203/rs.2.10768/v5 ◽

2020 ◽

Cited By ~ 1

Author(s):

Seyed-Mahdi Khaligh-Razavi ◽

Maryam Sadeghi ◽

Mahdiyeh Khanbagi ◽

Chris Kalafatis ◽

Seyed Massood Nabavi

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Dysfunction ◽

Cognitive Assessment ◽

Cognitive Rehabilitation ◽

Convergent Validity ◽

Strong Association ◽

Therapeutic Interventions ◽

Retest Reliability ◽

Test Retest Reliability

Abstract Background Cognitive impairment is common in patients with multiple sclerosis (MS). Accurate and repeatable measures of cognition have the potential to be used as markers of disease activity. Methods We developed a 5-minute computerized test to measure cognitive dysfunction in patients with MS. The proposed test – named the Integrated Cognitive Assessment (ICA) – is self-administered and language-independent. 91 MS patients and 83 healthy controls (HC) took part in Substudy 1, in which each participant took the ICA test and the Brief International Cognitive Assessment for MS (BICAMS). We assessed ICA’s test-retest reliability, its correlation with BICAMS, its sensitivity to discriminate patients with MS from the HC group, and its accuracy in detecting cognitive dysfunction. In Substudy 2, we recruited 48 MS patients, 38 of which had received an 8-week physical and cognitive rehabilitation programme and 10 MS patients who did not. We examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores and Symbol Digit Modalities Test (SDMT) scores pre- and post-rehabilitation. Results The ICA demonstrated excellent test-retest reliability (r=0.94), with no learning bias, and showed a high level of convergent validity with BICAMS. The ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated high accuracy (AUC = 95%) in discriminating cognitively normal from cognitively impaired participants. Additionally, we found a strong association (r=-0.79) between ICA score and the level of NfL in MS patients before and after rehabilitation. Conclusions The ICA has the potential to be used as a digital marker of cognitive impairment and to monitor response to therapeutic interventions. In comparison to standard cognitive tools for MS, the ICA is shorter in duration, does not show a learning bias, and is independent of language.

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Cognitive impairment in pediatric-onset multiple sclerosis is detected by the Brief International Cognitive Assessment for Multiple Sclerosis and computerized cognitive testing

Multiple Sclerosis Journal ◽

10.1177/1352458517701588 ◽

2017 ◽

Vol 24 (4) ◽

pp. 512-519 ◽

Cited By ~ 13

Author(s):

Leigh E Charvet ◽

Michael Shaw ◽

Ariana Frontario ◽

Dawn Langdon ◽

Lauren B Krupp

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Cognitive Assessment ◽

Outpatient Setting ◽

Cognitive Testing ◽

Cognitive Screening ◽

Healthy Control ◽

Computer Based ◽

Brief Cognitive Assessment ◽

Pediatric Onset

Background: Cognitive impairment is a common and troubling feature of pediatric-onset multiple sclerosis (POMS). Brief cognitive assessment in the outpatient setting can identify and longitudinally monitor cognitive involvement so that early intervention is possible. Objectives: The goal of this study was to measure the sensitivity of two cognitive assessment approaches that are brief, repeatable, and suitable for clinical practice and for multicenter investigation. Methods: Participants with POMS ( n = 69) were consecutively evaluated as part of outpatient neurologic visits and compared to healthy control participants (HC, n = 66) using the Brief International Cognitive Assessment for MS (BICAMS) approach and timed information processing measures from Cogstate, a computer-based assessment. Results: There was strong agreement in the detection rate of impairment between both assessments, with 26% for the BICAMS and 27% for Cogstate. Two of the Cogstate tasks were the most sensitive individual measures. Conclusion: Both the BICAMS and Cogstate timed processing measures offer practical, sensitive, and standardized approaches for cognitive screening assessment in POMS.

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