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Accepted for/Published in: JMIR Mental Health

Date Submitted: Oct 4, 2021
Open Peer Review Period: Sep 27, 2021 - Nov 22, 2021
Date Accepted: Jul 20, 2022
(closed for review but you can still tweet)

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

An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study

Mcintyre R, Lipsitz O, Rodrigues NB, Subramaniapillai M, Nasri F, Lee Y, Fehnert B, King J, Chrones L, Kratiuk K, Uddin S, Rosenblat JD, Mansur RB, McCue M

An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study

JMIR Ment Health 2022;9(10):e33871

DOI: 10.2196/33871

PMID: 36301615

PMCID: 9650567

Evaluation of an App-Based DSST for Assessment of Cognitive Deficits in Adults With MDD

  • Roger Mcintyre; 
  • Orly Lipsitz; 
  • Nelson B. Rodrigues; 
  • Mehala Subramaniapillai; 
  • Flora Nasri; 
  • Yena Lee; 
  • Ben Fehnert; 
  • James King; 
  • Lambros Chrones; 
  • Kevin Kratiuk; 
  • Sharif Uddin; 
  • Joshua D. Rosenblat; 
  • Rodrigo B. Mansur; 
  • Maggie McCue

ABSTRACT

Background:

Cognitive dysfunction is an impairing core symptom of depression. Among adults with major depressive disorder (MDD) treated with antidepressants, residual cognitive symptoms interfere with patient-reported outcomes (PROs). The foregoing characterization of cognitive symptoms provides the rationale for screening and assessing the severity of cognitive symptoms at point of care. However, clinical neurocognitive assessments are time-consuming, difficult, and require specialist expertise to interpret. A smartphone-delivered neurocognitive test may offer an effective and accessible tool that can be readily implemented into a measurement-based care framework.

Objective:

We aimed to validate the use of a smartphone-delivered application (app)-based version of the established Digit Symbol Substitution Test (DSST) (Cognition Kit DSST) neurocognitive assessment versus a traditional paper-and-pencil version.

Methods:

Convergent validity and test-retest reliability of the 2 versions were evaluated. Patient satisfaction with the app was also assessed.

Results:

Assessments made using the app-based Cognition Kit DSST were highly correlated with the standard paper-and-pencil version of the test both at the baseline visit (r[58] = 0.69; P<.001) and at the end-of-study visit (r[58] = 0.82; P<.001) and were positively evaluated by 30 patients as being user-friendly, easy to navigate, and preferable over the paper-and-pencil version of the DSST. However, although the app-based Cognition Kit DSST was validated in patients with MDD, it still needs to be evaluated in healthy controls.

Conclusions:

App-based DSST may facilitate a more personalized, convenient, and cost-effective method of cognitive assessment, helping to guide measurement-based care and psychotherapeutic and pharmacologic treatment options for patients with MDD. Clinical Trial: ClinicalTrials.gov: NCT03999567


 Citation

Please cite as:

Mcintyre R, Lipsitz O, Rodrigues NB, Subramaniapillai M, Nasri F, Lee Y, Fehnert B, King J, Chrones L, Kratiuk K, Uddin S, Rosenblat JD, Mansur RB, McCue M

An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study

JMIR Ment Health 2022;9(10):e33871

DOI: 10.2196/33871

PMID: 36301615

PMCID: 9650567

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