Designing smartphone-based cognitive assessments for schizophrenia: Perspectives from a multisite study.

Area of Science:

• Neuroscience
• Psychiatry
• Digital Health

Background:

• Cognitive deficits are a primary symptom and cause of disability in schizophrenia.
• Current clinical cognitive assessments are time-consuming and not feasible for routine use.
• Smartphone-based assessments offer convenience, longitudinal tracking, and contextual data integration.

Purpose of the Study:

• To design and refine a smartphone-based battery of cognitive assessments for schizophrenia, aligned with the MATRICS Consensus Cognitive Battery (MCCB).
• To evaluate the acceptability, usability, and engagement of these novel digital cognitive tools with individuals living with schizophrenia.

Main Methods:

• Focus group discussions and interviews were conducted with individuals diagnosed with schizophrenia across three international sites (Boston, USA; Bhopal, India; Bangalore, India).
• Data were collected between December 2023 and March 2024.
• Inductive thematic analysis was employed to analyze qualitative data.

Main Results:

• Participants found the smartphone cognitive assessments acceptable, helpful, and easy to use.
• The gamified nature of the tests was particularly engaging, with suggestions for improvement including more detailed instructions and scoring information.
• Cross-site thematic similarities were observed, highlighting consistent user preferences and feedback.

Conclusions:

• Individuals with schizophrenia, across diverse geographical locations, express interest in utilizing smartphone applications for cognitive monitoring.
• Feedback and data sharing are crucial for user engagement, though standardization and validation of these novel digital measures remain challenges.