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Accepted for/Published in: Journal of Medical Internet Research

Date Submitted: Feb 13, 2020
Open Peer Review Period: Feb 13, 2020 - Apr 9, 2020
Date Accepted: Aug 2, 2020
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test

Middleton RM, Pearson OR, Ingram G, Craig EM, Rodgers WJ, Wood H, Hill J, Tuite-Dalton K, Roberts C, Watson L, Ford DV, Nicholas R, UK MS Regsister Research Group

A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test

J Med Internet Res 2020;22(9):e18234

DOI: 10.2196/18234

PMID: 32965240

PMCID: 7542403

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Validating CoRe in Multiple Sclerosis: A rapid electronic cognitive assessment measure

  • Rod McDonnell Middleton; 
  • Owen R Pearson; 
  • Gillian Ingram; 
  • Elaine M Craig; 
  • William J Rodgers; 
  • Hannah Wood; 
  • Joseph Hill; 
  • Katherine Tuite-Dalton; 
  • Christopher Roberts; 
  • Lynne Watson; 
  • David V Ford; 
  • Richard Nicholas; 
  • UK MS Regsister Research Group

ABSTRACT

Background:

Incorporating cognitive testing into clinical practice is a challenge in MS, given the wide spectrum of both cognitive and physical impairments. 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 already has computer-based versions and forms part of the cognitive batteries used in MS. We developed a computer-based variant of this that has the potential to be deployed on multiple devices outside of the clinic environment.

Objective:

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.

Methods:

The CoRe test was validated as an alternative to the paper SDMT, with test-retest reliability, in a MS population from two NHS sites.

Results:

SDMT and CoRe test scores were correlated and consistent with one-month retest values. Results were normally distributed and demonstrated consistency (Pearson’s correlation coefficient r = 0.947, t = 15.60, df = 28, P < .001). Lower scores were seen in patients with higher age (P < .001) and some effect was seen with increasing disability (P < .002). There was no learning effect evident. A novel metric in CoRe was found; Question Answer Velocity could be calculated. This demonstrated a small increase in speed over the 90s duration of the test in MS and healthy controls.

Conclusions:

This study validates a computer-based SDMT that can be utilised in clinic with little or no technician support. It enables accurate recording of elements of cognition relevant in MS but offers additional metrics which may offer further value. Practical aspects of its implementation will enable its deployment on multiple devices.


 Citation

Please cite as:

Middleton RM, Pearson OR, Ingram G, Craig EM, Rodgers WJ, Wood H, Hill J, Tuite-Dalton K, Roberts C, Watson L, Ford DV, Nicholas R, UK MS Regsister Research Group

A Rapid Electronic Cognitive Assessment Measure for Multiple Sclerosis: Validation of Cognitive Reaction, an Electronic Version of the Symbol Digit Modalities Test

J Med Internet Res 2020;22(9):e18234

DOI: 10.2196/18234

PMID: 32965240

PMCID: 7542403

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