Orikami Digital Health Products, Nijmegen, Netherlands.
Dutch National MS Foundation, Rotterdam, Netherlands.
JMIR Mhealth Uhealth. 2020 Oct 5;8(10):e18160. doi: 10.2196/18160.
The decline of cognitive processing speed (CPS) is a common dysfunction in persons with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is widely used to formally quantify CPS. We implemented a variant of the SDMT in MS sherpa, a smartphone app for persons with MS.
The aim of this study was to investigate the construct validity and test-retest reliability of the MS sherpa smartphone variant of the SDMT (sSDMT).
We performed a validation study with 25 persons with relapsing-remitting MS and 79 healthy control (HC) subjects. In the HC group, 21 subjects were matched to the persons with MS with regard to age, gender, and education and they followed the same assessment schedule as the persons with MS (the "HC matched" group) and 58 subjects had a less intense assessment schedule to determine reference values (the "HC normative" group). Intraclass correlation coefficients (ICCs) were determined between the paper-and-pencil SDMT and its smartphone variant (sSDMT) on 2 occasions, 4 weeks apart. Other ICCs were determined for test-retest reliability, which were derived from 10 smartphone tests per study participant, with 3 days in between each test. Seven study participants with MS were interviewed regarding their experiences with the sSDMT.
The SDMT scores were on average 12.06% higher than the sSDMT scores, with a standard deviation of 10.68%. An ICC of 0.838 was found for the construct validity of the sSDMT in the combined analysis of persons with MS and HC subjects. Average ICCs for test-retest reliability of the sSDMT for persons with MS, the HC matched group, and the HC normative group were 0.874, 0.857, and 0.867, respectively. The practice effect was significant between the first and the second test of the persons with MS and the HC matched group and trivial for all other test-retests. The interviewed study participants expressed a positive attitude toward the sSDMT, but they also discussed the importance of adapting a smartphone cognition test in accordance with the needs of the individual persons with MS.
The high correlation between sSDMT and the conventional SDMT scores indicates a very good construct validity. Similarly, high correlations underpin a very good test-retest reliability of the sSDMT. We conclude that the sSDMT has the potential to be used as a tool to monitor CPS in persons with MS, both in clinical studies and in clinical practice.
认知处理速度（CPS）的下降是多发性硬化症（MS）患者常见的功能障碍。符号数字模态测试（SDMT）被广泛用于正式量化 CPS。我们在 MS sherpa 中实现了 SDMT 的变体，这是一款针对 MS 患者的智能手机应用程序。
本研究旨在探讨 MS sherpa 智能手机版 SDMT（sSDMT）的结构效度和重测信度。
我们对 25 名复发缓解型 MS 患者和 79 名健康对照（HC）受试者进行了一项验证研究。在 HC 组中，有 21 名受试者与 MS 患者在年龄、性别和教育方面相匹配，并且他们遵循与 MS 患者相同的评估时间表（“HC 匹配”组），而 58 名受试者的评估时间表不那么密集，以确定参考值（“HC 正常”组）。在相隔 4 周的 2 次测试中，确定了纸笔版 SDMT 和其智能手机版（sSDMT）之间的组内相关系数（ICC）。还根据每位研究参与者的 10 次智能手机测试确定了重测信度的其他 ICC，每次测试之间相隔 3 天。对 7 名 MS 患者进行了访谈，以了解他们对 sSDMT 的体验。
SDMT 分数平均比 sSDMT 分数高 12.06%，标准差为 10.68%。在 MS 患者和 HC 受试者的综合分析中，sSDMT 的结构效度的 ICC 为 0.838。MS 患者、HC 匹配组和 HC 正常组的 sSDMT 重测信度的平均 ICC 分别为 0.874、0.857 和 0.867。MS 患者和 HC 匹配组的第一次和第二次测试之间存在显著的练习效应，而所有其他重测测试的练习效应则微不足道。接受访谈的研究参与者对 sSDMT 持积极态度，但他们也讨论了根据 MS 患者的个体需求调整智能手机认知测试的重要性。
sSDMT 与传统 SDMT 分数之间的高相关性表明其具有非常好的结构效度。同样，高相关性也支持 sSDMT 具有非常好的重测信度。我们得出结论，sSDMT 具有作为监测 MS 患者 CPS 的工具的潜力，无论是在临床研究还是临床实践中。
Zotero 插件
