Videoconference-integrated, computer-assisted cognitive testing improves the remote assessment of processing speed...

Area of Science:

• Neuropsychology
• Digital Health
• Cognitive Assessment

Background:

• Remote neuropsychological assessments are underutilized.
• Teleneuropsychology (TeleNP) offers accessible cognitive testing solutions.
• Evaluating TeleNP-suitable versions of Symbol Digit Modalities Task (SDMT) and Trail Making Test (TMT) is crucial.

Purpose of the Study:

• To assess the validity of oral and digital SDMT and TMT for remote videoconference administration.
• To compare TeleNP-suitable versions against traditional in-person written tests.
• To determine the suitability of TeleNP for cognitive speed and attention measures.

Main Methods:

• 321 adult participants with epilepsy completed in-person written SDMT and TMT.
• 144 participants completed oral SDMT and TMT via videoconference.
• 177 participants completed novel digital SDMT (Symbol Decoding) and TMT via custom software.

Main Results:

• Oral SDMT and digital Symbol Decoding showed strong correlations with in-person written SDMT (r=0.77, r=0.76).
• Digital TMT demonstrated better correlation with written TMT-B (r=0.71) than oral TMT (r=0.52).
• Digital TMT better reflected cognitive demands compared to oral TMT.

Conclusions:

• Oral SDMT and digital Symbol Decoding are valid remote alternatives to in-person SDMT.
• Digital TMT is a more accurate remote assessment tool than oral TMT.
• Videoconference-integrated digital assessments offer standardization, automation, and rich metadata for future development.