A novel computerized functional assessment for human immunodeficiency virus-associated neurocognitive disorder.

Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) is present in 30-60 % of HIV-positive (HIV+) individuals and can be assessed by neuropsychological testing and level of functional impairment. HAND diagnosis therefore requires accurate assessment of functional impairment. The Computer Assessment of Mild Cognitive Impairment (CAMCI) is a computer-based screening tool that includes performance-based measures of functional impairment. We sought to evaluate the CAMCI as a functional assessment tool in HAND. One hundred fourteen HIV+ patients and 38 HIV-negative (HIV-) patients underwent neuropsychological and CAMCI testing. Cognitive status for HIV+ subjects was classified using the Frascati criteria. HIV+ subjects grouped together and classified by cognitive impairment performed worse than HIV- subjects on several of the CAMCI tasks, including following directions to the supermarket (p = 0.05, p = 0.03), recalling which items to purchase (p = 0.01, p = 0.02), and remembering to stop at a supermarket (p < 0.01, p = 0.01) and the post office (p < 0.01, p = 0.03). After controlling for hepatitis C status and depression symptomatology, the tasks "following directions to the supermarket" and the "recalling which items to purchase" were no longer significant. The "remembering to run two separate errands" tasks retained their significance (p < 0.01 for both tasks). A subset of the CAMCI tasks therefore successfully differentiated HIV+ patients from HIV- individuals. Differences in hepatitis C status and depression symptomatology could account for some of the function assessment differences in the CAMCI. These results suggest the CAMCI could be a useful objective performance-based functional assessment in patients with HIV.

Computer assessment of mild cognitive impairment.

Many older individuals experience cognitive decline with aging. The causes of cognitive dysfunction range from the devastating effects of Alzheimer's disease (AD) to treatable causes of dysfunction and the normal mild forgetfulness described by many older individuals. Even mild cognitive dysfunction can impact medication adherence, impair decision making, and affect the ability to drive or work. However, primary care physicians do not routinely screen for cognitive difficulties and many older patients do not report cognitive problems. Identifying cognitive impairment at an office visit would permit earlier referral for diagnostic work-up and treatment. The Computer Assessment of Mild Cognitive Impairment (CAMCI) is a self-administered, user-friendly computer test that scores automatically and can be completed independently in a quiet space, such as a doctor's examination room. The goal of this study was to compare the sensitivity and specificity of the CAMCI and the Mini Mental State Examination (MMSE) to identify mild cognitive impairment (MCI) in 524 nondemented individuals > 60 years old who completed a comprehensive neuropsychological and clinical assessment together with the CAMCI and MMSE. We hypothesized that the CAMCI would exhibit good sensitivity and specificity and would be superior compared with the MMSE in these measures. The results indicated that the MMSE was relatively insensitive to MCI. In contrast, the CAMCI was highly sensitive (86%) and specific (94%) for the identification of MCI in a population of community-dwelling nondemented elderly individuals.

PsychMate: providing psychology majors the tools to do real experiments and learn empirical methods.

PsychMate is a set of software tools for undergraduate psychology students to run, develop, and analyze computerized experiments. It includes 30 psychological experiments in the areas of perception, cognition, social psychology, human factors, and cognitive neuroscience. Students run experiments themselves and see basic results immediately. The automatic spreadsheet analysis forms allow them to aggregate data and create analyses, presentations, and Web pages with a single click. Students can use the Psychology Experiment Authoring Kit experiment editor to create their own experiments in minutes and run experiments with other students using Web-based experiment-management tools. The BrainTutor and BrainViewer applications teach brain anatomy and permit students to analyze fMRI brain imaging data from subjects who have performed the same memory experiments in which they participated. PsychMate has been used in 83 classes in which 1,533 students submitted 5,464 completed experiments with few (less than 1%) requests for help and a very positive rating of the research experience.

Psychology Experiment Authoring Kit (PEAK): formal usability testing of an easy-to-use method for creating computerized experiments.

In academic courses in which one task for the students is to understand empirical methodology and the nature of scientific inquiry, the ability of students to create and implement their own experiments allows them to take intellectual ownership of, and greatly facilitates, the learning process. The Psychology Experiment Authoring Kit (PEAK) is a novel spreadsheet-based interface allowing students and researchers with rudimentary spreadsheet skills to create cognitive and cognitive neuroscience experiments in minutes. Students fill in a spreadsheet listing of independent variables and stimuli, insert columns that represent experimental objects such as slides (presenting text, pictures, and sounds) and feedback displays to create complete experiments, all within a single spreadsheet. The application then executes experiments with centisecond precision. Formal usability testing was done in two stages: (1) detailed coding of 10 individual subjects in one-on-one experimenter/subject videotaped sessions and (2) classroom testing of 64 undergraduates. In both individual and classroom testing, the students learned to effectively use PEAK within 2 h, and were able to create a lexical decision experiment in under 10 min. Findings from the individual testing in Stage 1 resulted in significant changes to documentation and training materials and identification of bugs to be corrected. Stage 2 testing identified additional bugs to be corrected and new features to be considered to facilitate student understanding of the experiment model. Such testing will improve the approach with each semester. The students were typically able to create their own projects in 2 h.