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

Pegah Hafiz1,2, Kamilla Woznica Miskowiak3,4, Lars Vedel Kessing5

  • 1Digital Health Section, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark.

JMIR Formative Research
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Summary

The internet-based cognitive assessment tool (ICAT) shows promise as a digital alternative to the SCIP test for evaluating cognitive impairment in psychiatric patients. Its usability and accuracy in assessing verbal recall suggest potential for clinical use.

Keywords:
bipolar disordercognitive impairmentscomputer softwaredepressionexecutive functionmemoryneuropsychological testsscreeningspeech recognition software

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Area of Science:

  • Neuroscience
  • Psychiatry
  • Digital Health

Background:

  • Persistent cognitive impairment affects individuals with unipolar and bipolar disorders, impacting quality of life.
  • The Screen for Cognitive Impairment in Psychiatry (SCIP) is a validated paper-based tool, but a digital alternative is lacking.
  • There is a need for brief, accurate digital tools to assess cognitive deficits in psychiatric populations.

Purpose of the Study:

  • To design and assess the feasibility of an internet-based cognitive assessment tool (ICAT) based on the SCIP.
  • To evaluate ICAT's usability and suitability as a patient-administered tool in healthy individuals.
  • To examine the performance of automatic speech recognition (ASR) for verbal recall assessment within ICAT.

Main Methods:

  • ICAT was developed using a user-centered design, incorporating cognitive tasks like recall, working memory, and psychomotor speed.
  • Usability and feasibility were assessed in two groups of healthy participants (N=21, N=19).
  • Automatic speech recognition (ASR) evaluated verbal recall accuracy (word error rate), and correlations with SCIP scores were analyzed.

Main Results:

  • Participants reported high usability scores (PSSUQ > 4/5) for the ICAT.
  • Moderate to strong correlations were found between ICAT and SCIP total scores (r=0.63) and for immediate verbal recall (r=0.67) and psychomotor speed (r=0.71).
  • ASR demonstrated good accuracy for verbal recall, with word error rates of 17.8% (English) and 6.3% (Danish).

Conclusions:

  • ICAT is the first digital SCIP-modified tool using web technology and ASR, showing good accuracy for verbal memory.
  • The moderate correlation between ICAT and SCIP suggests ICAT's validity as a cognitive assessment tool.
  • Further validation in larger studies is recommended before widespread clinical adoption for screening cognitive impairment.