Digital cognitive testing using a tablet-based app in patients with brain tumors: a single-center feasibility study comparing the app to the gold standard.

OBJECTIVE: Healthcare digitization has led to increasing tablet-based apps to improve diagnostics, self-discipline, and well-being in patients. Moreover, patient-reported outcome measures are crucial for optimized treatment, with superior applicability if independent from patient visits. Whereas most uses cover health maintenance, only a few studies have focused on cognitive testing in neurosurgical patients despite its nature as one of the most integrative outcome measures in neurooncology. METHODS: The authors performed a prospective single-center feasibility study including neurosurgical patients affected by intraaxial tumors and healthy subjects, testing cognitive function by using a digitized app-based approach and conventional paper-and-pencil (PP) tests. Healthy subjects underwent follow-up testing for retest reliability. RESULTS: The authors included 24 patients with brain tumor and 10 healthy subjects, all of whom completed both tests. Equivalent mean performance results were found in the tablet-based digital app and PP counterparts; whereas the digital approach had shorter test duration in patients (29.9 minutes for PP vs 21.9 minutes for app, p = 0.019) and in the healthy cohort (23.2 minutes for PP vs 16.4 minutes for app, p = 0.003), patients with brain tumor scored lower when both test strategies were applied. Results were consistent in healthy subjects after a median of 3 months. CONCLUSIONS: Cognitive function assessment is feasible using a digitized tablet-based app, with equivalent results to those of PP tests in healthy subjects and patients with brain tumor. Thus, this approach allows much closer follow-up independent of patient visits and might provide a viable option to improve patient follow-ups.

Multiple Sclerosis Performance Test: validation of self-administered neuroperformance modules.

BACKGROUND AND PURPOSE: The purpose was to determine the test-retest reliability, practice effects, convergent validity and sensitivity to multiple sclerosis (MS) disability of neuroperformance subtests from the patient self-administered Multiple Sclerosis Performance Test (MSPT) designed to assess low contrast vision (Contrast Sensitivity Test, CST), upper extremity motor function (Manual Dexterity Test, MDT) and lower extremity motor function (Walking Speed Test, WST) and to introduce the concept of regression-based norms to aid clinical interpretation of performance scores using the MSPT cognition test (Processing Speed Test, PST) as an example. METHODS: Substudy 1 assessed test-retest reliability, practice effects and convergent validity of the CST, MDT and WST in 30 MS patients and 30 healthy controls. Substudy 2 examined sensitivity to MS disability in over 600 MS patients as part of their routine clinic assessment. Substudy 3 compared performance on the PST in research volunteers and clinical samples. RESULTS: The CST, MDT and WST were shown to be reliable, valid and sensitive to MS outcomes. Performance was comparable to technician-administered testing. PST performance was poorer in the clinical sample compared with the research volunteer sample. CONCLUSIONS: The self-administered MSPT neuroperformance modules produce reliable, objective metrics that can be used in clinical practice and support outcomes research. Published studies which require patient voluntary consent may underestimate the rate of cognitive dysfunction observed in a clinical setting.

Domestic hens succeed at serial reversal learning and perceptual concept generalisation using a new automated touchscreen device.

Improving the welfare of farm animals depends on our knowledge on how they perceive and interpret their environment; the latter depends on their cognitive abilities. Hence, limited knowledge of the range of cognitive abilities of farm animals is a major concern. An effective approach to explore the cognitive range of a species is to apply automated testing devices, which are still underdeveloped in farm animals. In screen-like studies, the uses of automated devices are few in domestic hens. We developed an original fully automated touchscreen device using digital computer-drawn colour pictures and independent sensible cells adapted for cognitive testing in domestic hens, enabling a wide range of test types from low to high complexity. This study aimed to test the efficiency of our device using two cognitive tests. We focused on tasks related to adaptive capacities to environmental variability, such as flexibility and generalisation capacities as this is a good start to approach more complex cognitive capacities. We implemented a serial reversal learning task, categorised as a simple cognitive test, and a delayed matching-to-sample (dMTS) task on an identity concept, followed by a generalisation test, categorised as more complex. In the serial reversal learning task, the hens performed equally for the two changing reward contingencies in only three reversal stages. In the dMTS task, the hens increased their performance rapidly throughout the training sessions. Moreover, to the best of our knowledge, we present the first positive result of identity concept generalisation in a dMTS task in domestic hens. Our results provide additional information on the behavioural flexibility and concept understanding of domestic hens. They also support the idea that fully automated devices would improve knowledge of farm animals' cognition.