Bicams Tablet Application: A Reliable and Fast Way to Assess Cognitive Functioning

Background: Up to 70% of individuals with multiple sclerosis (MS) experience cognitive dysfunction. Many clinicians use self-report as a way to screen for cognitive impairment. However, self-reported cognitive symptoms are highly correlated with emotional distress, rather than neuropsychological data making objective tests the best way to detect and track cognition. Unfortunately, neuropsychological evaluations are time consuming, expensive, and not universally available. The Brief International Cognitive Assessment for MS (BICAMS) was developed by a team of cognition experts to give MS medical personnel a way to quickly assess and track cognitive symptoms. Although the intent of the BICAMS was to create a fast, intuitive assessment, the scoring and interpretation require precious clinic time and necessitate an understanding of psychometric information such as z-scores and percentiles. We, therefore, created a BICAMS tablet application (“app”) to streamline and simplify administration and scoring. 

Objectives: To (1) test the reliability of a BICAMS app against the traditional paper version, (2) compare the time it takes to administer and score both forms, and (3) compare performance on the Rey Auditory Verbal Learning Test (RAVLT) and the California Verbal Learning Test – II (CVLT-II).

Methods: This CMSC-funded pilot study is in the process of enrolling 100 participants with MS. The study utilized 2 test administrators scoring participant responses simultaneously – one on the paper BICAMS and one on the BICAMS app. Half of the testing sessions are led by the paper administrator (Group A) and half by the app administrator (Group B). Although only exposed to the material once, participant responses are recorded on both administration methods. Unfortunately, Pearson would not grant permission for use of the CVLT-II in the app. We replaced it with the RAVLT, but also administered a paper CVLT-II to every participant. We will compare both list learning tasks to determine if the RAVLT is an efficacious substitution. 

Results: This study is underway. Unfortunately study assessments were not completed at the time of abstract submission, but will be completed by the CMSC conference. Preliminary analyses demonstrate promising results. No significant differences were found for scores obtained from either method of administration (tablet vs. paper), and there were no significant differences between the standard scores from the list learning tasks. However, there was a significant difference in total administration time (minutes) between the app (M = 27.09, SD = 8.14) and paper-based (M = 14.17, SD = 3.27) administrations; t (34) = 11.03, p <0.0001. Including scoring, administration of the paper-based BICAMS takes nearly double the amount of time as the app version. 

Conclusions: Preliminary findings suggest that the tablet application is a reliable and fast method for administering the BICAMS.