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

2019 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi

Abstract Background Cognitive impairment is common in patients with MS. Accurate and repeatable measures of cognition have the potential to be used as a marker of disease activity. Methods We developed a 5-minute computerized test to measure cognitive dysfunction in patients with MS. The proposed test –named 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, and examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores. Results ICA demonstrated excellent test-retest reliability (r=0.94), with no learning bias (i.e. no significant practice effect); and had high level of convergent validity with BICAMS. ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated a 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. Conclusions ICA has the potential to be used as a digital biomarker for assessment and monitoring of cognitive performance in MS patients. In comparison to standard cognitive tools for MS (e.g. BICAMS), ICA is shorter in duration, does not show a learning bias, is independent of language, and takes advantage of artificial intelligence (AI) to identify cognitive status of patients more accurately. Being a digital test, it further has the potential for easier electronic health record or research database integration.

2019 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi

Abstract Background Cognitive impairment is common in patients with MS. Accurate and repeatable measures of cognition have the potential to be used as a marker of disease activity. Methods We developed a 5-minute computerized test to measure cognitive dysfunction in patients with MS. The proposed test –named 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, and examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores. Results ICA demonstrated excellent test-retest reliability (r=0.94), with no learning bias (i.e. no significant practice effect); and had high level of convergent validity with BICAMS. ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated a 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. Conclusions ICA has the potential to be used as a digital biomarker for assessment and monitoring of cognitive performance in MS patients. In comparison to standard cognitive tools for MS (e.g. BICAMS), ICA is shorter in duration, does not show a learning bias, is independent of language, and takes advantage of artificial intelligence (AI) to identify cognitive status of patients more accurately. Being a digital test, it further has the potential for easier electronic health record or research database integration.


2019 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi

AbstractBackgroundCognitive impairment is common in patients with MS. Accurate and repeatable measures of cognition have the potential to be used as a marker of disease activity. We developed a 5-minute computerized test to measure cognitive dysfunction in patients with MS. The proposed test –named Integrated Cognitive Assessment (ICA)– is self-administered and language-independent.ObjectiveTo determine ICA’s validity as a digital biomarker for assessing cognitive performance in MS.Methods91 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, and examined the association between the level of serum neurofilament light (NfL) in these patients and their ICA scores.ResultsICA demonstrated excellent test-retest reliability (r=0.94), with no learning bias (i.e. no significant practice effect); and had high level of convergent validity with BICAMS. ICA was sensitive in discriminating the MS patients from the HC group, and demonstrated a 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.ConclusionsICA can be used as a digital biomarker for assessment and monitoring of cognitive performance in MS patients. In comparison to standard cognitive tools for MS (e.g. BICAMS), ICA is shorter in duration, does not show a learning bias, is independent of language, and takes advantage of artificial intelligence (AI) to identify cognitive status of patients more accurately. Being a digital test, it further has the potential for easier electronic health record or research database integration.


Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi

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.


2020 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi

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.


2017 ◽  
Vol 23 (14) ◽  
pp. 1929-1937 ◽  
Author(s):  
Stephen M Rao ◽  
Genna Losinski ◽  
Lyla Mourany ◽  
David Schindler ◽  
Bernadett Mamone ◽  
...  

Background: Cognitive dysfunction is common in multiple sclerosis (MS) patients and has important consequences for daily activities, yet, unlike motor function, is not routinely assessed in the clinic setting. We developed the Processing Speed Test (PST), a self-administered iPad®-based tool to measure MS-related deficits in processing speed. Objective: To determine whether the PST is valid for screening cognitive dysfunction by comparing it to the paper-and-pencil Symbol Digit Modalities Test (SDMT). Methods: We assessed PST test–retest reliability, sensitivity of PST and SDMT in discriminating MS patients from healthy controls (HC), convergent validity between PST and SDMT, correlations between T2 lesion load and PST and SDMT, and PST performance with and without technician present during administration. Results: PST had excellent test–retest reliability, was highly correlated with SDMT, was slightly more sensitive than SDMT in discriminating MS from HC groups, and correlated better with cerebral T2 lesion load than did SDMT. Finally, PST performance was no different with or without a technician in the testing environment. Conclusion: PST has advantages over SDMT because of its efficient administration, scoring, and potential for medical record or research database integration. PST is a practical tool for routine screening of processing speed deficits in the MS clinic.


2020 ◽  
Author(s):  
Seyed-Mahdi Khaligh-Razavi ◽  
Maryam Sadeghi ◽  
Mahdiyeh Khanbagi ◽  
Chris Kalafatis ◽  
Seyed Massood Nabavi

Abstract Background Cognitive impairment is common in patients with 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 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.


Author(s):  
Evgeniy Evdoshenko ◽  
Kristina Laskova ◽  
Maria Shumilina ◽  
Ekaterina Nekrashevich ◽  
Maria Andreeva ◽  
...  

Abstract Objective: Cognitive dysfunction is common in multiple sclerosis (MS). The Brief International Cognitive Assessment for MS (BICAMS) battery of tests has been suggested as a measure for the evaluation of the cognitive status of MS patients. This study aims to validate the BICAMS battery in the Russian population of MS patients. Methods: Age- and sex-matched MS patients (n = 98) and healthy individuals (n = 86) were included in the study. Symbol Digit Modalities Test (SDMT), California Verbal Learning Test, 2nd edition (CVLT-II) and the Brief Visuospatial Memory Test – Revised (BVMT-R) were administered to all participants. The battery was readministered 1 month later to 44 MS patients to investigate the test–retest reliability. Results: MS patients exhibited a significantly lower performance in testing with BICAMS than the control group in all three neuropsychological tests. Test–retest reliability was good for SDMT and CVLT-II (r = .82 and r = .85, respectively) and adequate for BVMT-R (r = .70). Based on the proposed criterion for impairment as z score below 1.5 SD the mean of the control group, we found that 34/98 (35%) of MS patients were found impaired at least in one cognitive domain. Patients with Expanded Disability Status Scale score ≥3.5 performed significantly worse than controls (SDMT, p < .0001; CVLT–II, p = .03; BVMT-R, p = .0004), while those with ≤3.0 scores did not. Conclusion: This study demonstrates that the BICAMS battery is a valid instrument to identify cognitive impairment in MS patients and it can be recommended for routine use in the Russian Federation.


2020 ◽  
Author(s):  
Nele Demeyere ◽  
Marleen Haupt ◽  
Sam Sappho Webb ◽  
Lea Strobel ◽  
Elise Milosevich ◽  
...  

ObjectiveHere, we present the Oxford Cognitive Screen-Plus, a computerised tablet-based screen designed to briefly assess domain-general cognition and provide more fine-grained measures of memory and executive function. The OCS-Plus was designed to sensitively screen for cognitive impairments and provide a differentiation between memory and executive deficits. MethodsThe OCS-Plus contains 10 subtasks and requires approximately 20 minutes to complete. In this study, 320 neurologically healthy ageing participants (age M=62.66, SD=13.75) from three sites completed the OCS-Plus. The convergent validity of this assessment was established in comparison to the ACE-R, CERAD and Rey-Osterrieth. Divergent validity was established through comparison with the BDI. Internal consistency of each subtask was evaluated, and test-retest reliability was determined. ResultsWe established the normative impairment cut-offs for each of the subtasks. Predicted convergent and divergent validity was found, high internal consistency for most measures was also found with the exception of restricted range tasks, as well as strong test-retest reliability, which provided evidence of test stability. Further research demonstrating the use and validity of the OCS-Plus in various clinical populations is required.ConclusionThe OCS-Plus is presented as a standardised cognitive assessment tool, normed and validated in a sample of neurologically healthy participants. The OCS-Plus will be available as an Android App and provides an automated report of domain-general cognitive impairments in executive attention and memory.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kuan-Wei Chen ◽  
Ya-Chen Lee ◽  
Tzu-Ying Yu ◽  
Li-Jung Cheng ◽  
Chien-Yu Chao ◽  
...  

Abstract Background Fluid intelligence deficits affect executive functioning and social behaviors in patients with schizophrenia. To help clinicians manage fluid intelligence deficits, a psychometrically sound measure is needed. The purposes of this study were to examine the test–retest reliability and convergent validity of the Test of Nonverbal Intelligence-Fourth Edition (TONI-4) assessing fluid intelligence in patients with schizophrenia. Methods A total of 103 patients with stable condition were assessed with the TONI-4 twice with a 4-week interval to examine the test–retest reliability. We further used the Montreal Cognitive Assessment (MoCA) and the Tablet-Based Symbol Digit Modalities Test (T-SDMT) to examine the convergent validity of the TONI-4. Results The intra-class correlation coefficient was 0.73 for the TONI-4. The percentages of standard error of measurement and minimal detectable change for the TONI-4 were 5.1 and 14.2%, respectively. The practice effect of the TONI-4 was small (Cohen’s d = − 0.03). Convergent validity showed small to moderate significant correlations between the TONI-4 and the MoCA as well as the T-SDMT (r = 0.35, p = .011 with the T-SDMT and r = 0.61, p < .001 with the MoCA). The results demonstrated that the TONI-4 had good test–retest reliability, limited random measurement error, and a trivial practice effect. The convergent validity of the TONI-4 was good. Conclusions These findings indicate that the TONI-4 has potential to be a reliable and valid assessment of fluid intelligence in patients with schizophrenia.


2021 ◽  
Author(s):  
Qi Zhang ◽  
Ke Zhang ◽  
Miao Li ◽  
Jiaxin Gu ◽  
Xintong Li ◽  
...  

Abstract Objectives To examine the validity and reliability of the Mandarin version of the Treatment Burden Questionnaire (TBQ) among stroke patients. Background Stroke patients need long-term management of symptoms and life situation, and treatment burden has recently emerged as a new concept that can influence the health outcomes during the rehabilitation process. Methods The convenience sampling method was used to recruit 187 cases of stroke patients in a tertiary grade hospital in Tianjin for a formal investigation. Item analysis, reliability and validity tests were carried out. The reliability test included internal consistency and test–retest reliability. And as well as content, structure and convergent validity were performed for the validity test. Results Of the 187 completed questionnaires, only 180 (96.3%) were suitable for analysis. According to the experts’ evaluation, the I-CVI of each item was from 0.833 to 1.000, and the S-CVI was 0.967. The exploratory factor analysis yielded three-factor components with a cumulative variation of 53.054%. Convergent validity was demonstrated using measures of Morisky’s Medication Adherence Scale 8 (r = –0.450, P &lt; 0.01). All correlations between items and global scores ranged from 0.403 to 0.638. Internal consistency reliability and test–retest reliability were found to be acceptable, as indicated by a Cronbach’s α of 0.824 and an intraclass correlation coefficient of 0.846, respectively. Conclusions The Mandarin TBQ had acceptable validity and reliability. The use of TBQ in the assessment of treatment burden of stroke survivor may benefit health resources allocation and provide tailor therapeutic interventions to construct minimally disruptive care.


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