7
views
0
recommends
+1 Recommend
1 collections
    0
    shares

      To submit your manuscript to JMIR, please click here

      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The Internet-Based Cognitive Assessment Tool: System Design and Feasibility Study

      research-article

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background

          Persistent cognitive impairment is prevalent in unipolar and bipolar disorders and is associated with decreased quality of life and psychosocial dysfunction. The screen for cognitive impairment in psychiatry (SCIP) test is a validated paper-and-pencil instrument for the assessment of cognition in affective disorders. However, there is no digital cognitive screening tool for the brief and accurate assessment of cognitive impairments in this patient group.

          Objective

          In this paper, we present the design process and feasibility study of the internet-based cognitive assessment tool (ICAT) that is designed based on the cognitive tasks of the SCIP. The aims of this feasibility study were to perform the following tasks among healthy individuals: (1) evaluate the usability of the ICAT, (2) investigate the feasibility of the ICAT as a patient-administered cognitive assessment tool, and (3) examine the performance of automatic speech recognition (ASR) for the assessment of verbal recall.

          Methods

          The ICAT was developed in a user-centered design process. The cognitive measures of the ICAT were immediate and delayed recall, working memory, and psychomotor speed. Usability and feasibility studies were conducted separately with 2 groups of healthy individuals (N=21 and N=19, respectively). ICAT tests were available in the English and Danish languages. The participants were asked to fill in the post study system usability questionnaire (PSSUQ) upon completing the ICAT test. Verbal recall in the ICAT was assessed using ASR, and the performance evaluation criterion was word error rate (WER). A Pearson 2-tailed correlation analysis significant at the .05 level was applied to investigate the association between the SCIP and ICAT scores.

          Results

          The overall psychometric factors of PSSUQ for both studies gave scores above 4 (out of 5). The analysis of the feasibility study revealed a moderate to strong correlation between the total scores of the SCIP and ICAT (r=0.63; P=.009). There were also moderate to strong correlations between the SCIP and ICAT subtests for immediate verbal recall (r=0.67; P=.002) and psychomotor speed (r=0.71; P=.001). The associations between the respective subtests for working memory, executive function, and delayed recall, however, were not statistically significant. The corresponding WER for English and Danish responses were 17.8% and 6.3%, respectively.

          Conclusions

          The ICAT is the first digital screening instrument modified from the SCIP using Web-based technology and ASR. There was good accuracy of the ASR for verbal memory assessment. The moderate correlation between the ICAT and SCIP scores suggests that the ICAT is a valid tool for assessing cognition, although this should be confirmed in a larger study with greater statistical power. Taken together, the ICAT seems to be a valid Web-based cognitive assessment tool that, after some minor modifications and further validation, may be used to screen for cognitive impairment in clinical settings.

          Related collections

          Most cited references21

          • Record: found
          • Abstract: not found
          • Article: not found

          IBM computer usability satisfaction questionnaires: Psychometric evaluation and instructions for use

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Reliability and validity of a computerized neurocognitive test battery, CNS Vital Signs.

            CNS Vital Signs (CNSVS) is a computerized neurocognitive test battery that was developed as a routine clinical screening instrument. It is comprised of seven tests: verbal and visual memory, finger tapping, symbol digit coding, the Stroop Test, a test of shifting attention and the continuous performance test. Because CNSVS is a battery of well-known neuropsychological tests, one should expect its psychometric properties to resemble those of the conventional tests upon which it is based. 1069 subjects age 7-90 participated in the normative database for CNSVS. Test-retest reliability (TRT) was evaluated in 99 Ss who took the battery on two separate occasions, separated, on the average, by 62 days; the results were comparable to those achieved by equivalent conventional and computerized tests. Concurrent validity studies in 180 subjects, normals and neuropsychiatric patients, indicate correlations that are comparable to the concurrent validity of similar tests. Discriminant validity is supported by studies of patients with mild cognitive impairment and dementia, post-concussion syndrome and severe traumatic brain injury, ADHD (treated and untreated) and depression (treated and untreated). The tests in CNSVS are also sensitive to malingerers and patients with conversion disorders. The psychometric characteristics of the tests in the CNSVS battery are very similar to the characteristics of the conventional neuropsychological tests upon which they are based. CNSVS is suitable for use as a screening instrument, or as a serial assessment measure. But it is not a substitute for formal neuropsychological testing, it is not diagnostic, and it will have only a limited role in the medical setting, absent the active participation of consulting neuropsychologists.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Bipolar disorders

              Bipolar disorders are chronic and recurrent disorders that affect >1% of the global population. Bipolar disorders are leading causes of disability in young people as they can lead to cognitive and functional impairment and increased mortality, particularly from suicide and cardiovascular disease. Psychiatric and nonpsychiatric medical comorbidities are common in patients and might also contribute to increased mortality. Bipolar disorders are some of the most heritable psychiatric disorders, although a model with gene-environment interactions is believed to best explain the aetiology. Early and accurate diagnosis is difficult in clinical practice as the onset of bipolar disorder is commonly characterized by nonspecific symptoms, mood lability or a depressive episode, which can be similar in presentation to unipolar depression. Moreover, patients and their families do not always understand the significance of their symptoms, especially with hypomanic or manic symptoms. As specific biomarkers for bipolar disorders are not yet available, careful clinical assessment remains the cornerstone of diagnosis. The detection of hypomanic symptoms and longtudinal clinical assessment are crucial to differentiate a bipolar disorder from other conditions. Optimal early treatment of patients with evidence-based medication (typically mood stabilizers and antipsychotics) and psychosocial strategies is necessary.
                Bookmark

                Author and article information

                Contributors
                Journal
                JMIR Form Res
                JMIR Form Res
                JFR
                JMIR Formative Research
                JMIR Publications (Toronto, Canada )
                2561-326X
                Jul-Sep 2019
                26 July 2019
                : 3
                : 3
                : e13898
                Affiliations
                [1 ] Digital Health Section Department of Health Technology Technical University of Denmark Kongens Lyngby Denmark
                [2 ] Copenhagen Center for Health Technology Technical University of Denmark Kongens Lyngby Denmark
                [3 ] Department of Psychology University of Copenhagen Copenhagen Denmark
                [4 ] Neurocognition and Emotion in Affective Disorders Group, Copenhagen Affective Disorder Research Centre Psychiatric Centre Copenhagen Copenhagen University Hospital Copenhagen Denmark
                [5 ] Copenhagen Affective Disorder Research Centre Psychiatric Centre Copenhagen Copenhagen University Hospital Copenhagen Denmark
                Author notes
                Corresponding Author: Pegah Hafiz pegh@ 123456dtu.dk
                Author information
                http://orcid.org/0000-0002-2998-9356
                http://orcid.org/0000-0003-2572-1384
                http://orcid.org/0000-0001-9377-9436
                http://orcid.org/0000-0003-0404-0555
                http://orcid.org/0000-0002-7624-9545
                http://orcid.org/0000-0003-2706-1367
                http://orcid.org/0000-0002-9536-4784
                http://orcid.org/0000-0003-1390-8758
                Article
                v3i3e13898
                10.2196/13898
                6688443
                31350840
                59da7a8a-9eb4-4780-8d11-a25440774a68
                ©Pegah Hafiz, Kamilla Woznica Miskowiak, Lars Vedel Kessing, Andreas Elleby Jespersen, Kia Obenhausen, Lorant Gulyas, Katarzyna Zukowska, Jakob Eyvind Bardram. Originally published in JMIR Formative Research (http://formative.jmir.org), 26.07.2019.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Formative Research, is properly cited. The complete bibliographic information, a link to the original publication on http://formative.jmir.org.as well as this copyright and license information must be included.

                History
                : 4 March 2019
                : 6 April 2019
                : 30 May 2019
                : 29 June 2019
                Categories
                Original Paper
                Original Paper

                screening,memory,executive function,bipolar disorder,depression,cognitive impairments,neuropsychological tests,computer software,speech recognition software

                Comments

                Comment on this article