D'Arcy Shona, Rapcan Viliam, Gali Alessandra, Burke Nicola, O'Connell Gloria Crispino, Robertson Ian H, Reilly Richard B
Trinity Centre for Bioengineering, Trinity College, Dublin, Ireland.
Technol Health Care. 2013;21(4):387-96. doi: 10.3233/THC-130740.
Cognitive assessments are valuable tools in assessing neurological conditions. They are critical in measuring deficits in cognitive function in an array of neurological disorders and during the ageing process. Automation of cognitive assessments is one way to address the increasing burden on medical resources for an ever increasing ageing population.
This study investigated the suitability of using automated Interactive Voice Response (IVR) technology to deliver a suite of cognitive assessments to older adults using speech as the input modality.
Several clinically valid and gold-standard cognitive assessments were selected for implementation in the IVR application. The IVR application was designed using human centred design principles to ensure the experience was as user friendly as possible. Sixty one participants completed two IVR assessments and one face to face (FF) assessment with a neuropsychologist. Completion rates for individual tests were inspected to identify those tests that are most suitable for administration via IVR technology. Interclass correlations were calculated to assess the reliability of the automated administration of the cognitive assessments across delivery modes.
While all participants successfully completed all automated assessments, variability in the completion rates for different cognitive tests was observed. Statistical analysis found significant interclass correlations for certain cognitive tests between the different modes of administration. Analysis also suggests that an initial FF assessment reduces the variability in cognitive test scores when introducing automation into such an assessment.
[corrected] This study has demonstrated the functional and cognitive reliability of administering specific cognitive tests using an automated, speech driven application. This study has defined the characteristics of existing cognitive tests that are suitable for such an automated delivery system and also informs on the limitations of other cognitive tests for this modality. This study presents recommendations for developing future large scale cognitive assessments.
认知评估是评估神经系统疾病的重要工具。它们对于测量一系列神经系统疾病以及衰老过程中的认知功能缺陷至关重要。随着老年人口不断增加，医疗资源负担日益加重，认知评估自动化是解决这一问题的一种方式。
本研究调查了使用自动化交互式语音应答（IVR）技术，以语音作为输入方式，对老年人进行一系列认知评估的适用性。
选择了几种临床有效的金标准认知评估方法在IVR应用程序中实施。IVR应用程序采用以人为本的设计原则进行设计，以确保体验尽可能用户友好。61名参与者完成了两项IVR评估以及一项与神经心理学家进行的面对面（FF）评估。检查了各个测试的完成率，以确定那些最适合通过IVR技术进行施测的测试。计算组内相关性以评估不同施测模式下认知评估自动化施测的可靠性。
虽然所有参与者都成功完成了所有自动化评估，但不同认知测试的完成率存在差异。统计分析发现不同施测模式下某些认知测试存在显著的组内相关性。分析还表明，在将自动化引入此类评估时，初始的FF评估可降低认知测试分数的变异性。
本研究证明了使用自动化语音驱动应用程序进行特定认知测试的功能和认知可靠性。本研究确定了适用于这种自动化施测系统的现有认知测试的特征，也说明了其他认知测试在此施测方式下的局限性。本研究为未来大规模认知评估的开发提出了建议。
