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The validity and reliability of a digital Ruff Figural Fluency Test (RFFT).

J Vrijsen¹, C L van Erpecum², S E de Rooij³

¹University Medical Centre Groningen, Department of Epidemiology, University of Groningen, Hanzeplein 1, FA40, P.O. Box 30 001, 9700 RB, Groningen, The Netherlands. j.vrijsen@umcg.nl.

|April 29, 2021

Summary

This summary is machine-generated.

A new digital Ruff Figural Fluency Test (RFFT) shows good criterion validity and is a feasible alternative for large-scale cognitive assessments. However, scores from the digital and paper-and-pencil RFFT are not interchangeable.

Keywords:

Cognition Cognitive dysfunction Executive function Neuropsychological test Reproducibility of results Ruff Figural Fluency Test Software Validation study

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Area of Science:

Cognitive Psychology
Neuroscience
Digital Health

Background:

The Ruff Figural Fluency Test (RFFT) is a validated cognitive assessment but is time-consuming and labor-intensive.
A digital version of the RFFT was developed for independent administration on an iPad with automatic score computation.

Purpose of the Study:

To investigate the validity and reliability of the digital RFFT.
To compare the digital RFFT with the traditional paper-and-pencil version.

Main Methods:

A cross-over design was used, with participants randomly assigned to either the digital or paper-and-pencil RFFT first, followed by the other version.
Test-retest reliability was assessed with a second digital RFFT administration one week later.
Automatic and manual scoring (two raters) were compared for the digital RFFT, alongside comparisons between digital and paper-and-pencil RFFT using Intraclass Correlation Coefficients (ICC), sensitivity, specificity, and Bland-Altman plots.

Main Results:

Automatic scoring of the digital RFFT demonstrated high agreement with manual scoring for unique designs (UD) and perseverative errors (PE), indicating excellent criterion validity.
Agreement between the digital and paper-and-pencil RFFT was moderate for UD and poor for PE, with fewer UD observed on the digital version.
Test-retest reliability for the digital RFFT was moderate (ICC = 0.74).
Digital RFFT performance correlated with education level and younger age, supporting its ability to discriminate between groups.

Conclusions:

The automatically scored digital RFFT exhibits good criterion and convergent validity.
Moderate test-retest reliability and low agreement with the paper-and-pencil RFFT suggest potential learning effects.
The digital RFFT is a valid and reliable tool for measuring executive cognitive function in large-scale studies, but its scores are not interchangeable with the traditional version.