Background: Incorporating cognitive testing into routine clinical practice is a challenge in multiple sclerosis (MS), given the wide spectrum of both cognitive and physical impairments people can have and the time that testing requires. 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 forms part of the cognitive batteries used in MS and has some computer-based versions. We developed a tablet-based SDMT variant that has the potential to be ultimately deployed to patients’ own devices. Objective: This paper aims to 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: We carried out analysis using Pearson and intraclass correlations, as well as a Bland-Altman comparison, to examine consistency between the SDMT and CoRe tests and for test-retest reliability. The SDMT and CoRe tests were evaluated for sensitivity to disability levels and age. A novel metric in CoRe was found: question answering velocity could be calculated. This was evaluated in relation to disability levels and age for people with MS and compared with a group of healthy control volunteers. Results: SDMT and CoRe test scores were highly correlated and consistent with 1-month retest values. Lower scores were seen in patients with higher age and some effect was seen with increasing disability. There was no learning effect evident. Question answering velocity demonstrated a small increase in speed over the 90-second duration of the test in people with MS and healthy controls. Conclusions: This study validates a computer-based alternative to the SDMT that can be used in clinics and beyond. It enables accurate recording of elements of cognition relevant in MS but offers additional metrics that may offer further value to clinicians and people with MS.

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中文翻译：

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多发性硬化症的快速电子认知评估方法：认知反应的验证，一种符号版本模态测试的电子版本。

背景：考虑到人们可能存在的多种认知和身体障碍以及测试所需的时间，将认知测试纳入常规临床实践是多发性硬化症（MS）的一项挑战。简短的纸质和口头评估占主导地位，但仍未常规使用。基于计算机的测试正变得越来越普遍。但是，纸质考试实施方式的变化会影响个人评估的准确程度。符号数字模态测试（SDMT）是一项经过验证的测试，它构成了MS中使用的认知电池的一部分，并且具有一些基于计算机的版本。我们开发了基于平板电脑的SDMT变体，它有可能最终部署到患者自己的设备上。目标：本文旨在开发，验证和部署基于计算机的SDMT变体，认知反应（CoRe）测试，可以可靠地复制纸质SDMT的特征。方法：我们使用Pearson和类内相关性以及Bland-Altman比较进行了分析，以检查SDMT和CoRe测试之间的一致性以及重新测试的可靠性。评估了SDMT和CoRe测试对残疾水平和年龄的敏感性。发现了CoRe中的一种新颖指标：可以计算答疑速度。对MS患者的残疾水平和年龄进行了评估，并与一组健康对照志愿者进行了比较。结果：SDMT和CoRe测试得分高度相关，与1个月的重新测试值一致。年龄较大的患者得分较低，并且随着残疾的增加，效果也有所改善。没有明显的学习效果。在患有MS和健康对照的人中，答题速度表明在测试的90秒钟内，速度有所提高。结论：这项研究验证了SDMT的基于计算机的替代方法，该替代方法可用于临床及其他领域。它可以准确记录与MS相关的认知要素，但提供其他指标，可能为MS的临床医生和患者提供更多价值。

这仅仅是抽象的。阅读JMIR网站上的全文。JMIR是互联网时代电子健康和医疗保健领域领先的开放获取期刊。