Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 28, Issue 2, Pages 300-308Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/13524585211018103
Keywords
Multiple sclerosis; cognition; digital biomarker; smartphone; ecological momentary assessment
Categories
Funding
- PPP Allowance by Health-Holland, Top Sector Life Sciences and Health [LSHM16060-SGF]
- Stichting MS Research [16-946 MS]
- Biogen
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The study found that self-administered smartphone-adapted SDMT scores were reliable and showed differences in performance among multiple sclerosis patients, while also demonstrating concurrent validity in assessing information processing speed.
Background: Early detection and monitoring of cognitive dysfunction in multiple sclerosis (MS) may be enabled with smartphone-adapted tests that allow frequent measurements in the everyday environment. Objectives: The aim of this study was to determine the reliability, construct and concurrent validity of a smartphone-adapted Symbol Digit Modalities Test (sSDMT). Methods: During a 28-day follow-up, 102 patients with MS and 24 healthy controls (HC) used the MS sherpa(R) app to perform the sSDMT every 3 days on their own smartphone. Patients performed the Brief International Cognitive Assessment for MS at baseline. Test-retest reliability (intraclass correlation coefficients, ICC), construct validity (group analyses between cognitively impaired (CI), cognitively preserved (CP) and HC for differences) and concurrent validity (correlation coefficients) were assessed. Results: Patients with MS and HC completed an average of 23.2 (SD = 10.0) and 18.3 (SD = 10.2) sSDMT, respectively. sSDMT demonstrated high test-retest reliability (ICCs > 0.8) with a smallest detectable change of 7 points. sSDMT scores were different between CI patients, CP patients and HC (all ps < 0.05). sSDMT correlated modestly with the clinical SDMT (highest r = 0.690), verbal (highest r = 0.516) and visuospatial memory (highest r = 0.599). Conclusion: Self-administered smartphone-adapted SDMT scores were reliable and different between patients who were CI, CP and HC and demonstrated concurrent validity in assessing information processing speed.
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