Department of Psychiatry, University of California San Diego, San Diego, CA, United States.
SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States.
J Med Internet Res. 2022 Jul 29;24(7):e36665. doi: 10.2196/36665.
As smartphone technology has become nearly ubiquitous, there is a growing body of literature suggesting that ecological momentary cognitive testing (EMCT) offers advantages over traditional pen-and-paper psychological assessment. We introduce a newly developed platform for the self-administration of cognitive tests in ecologically valid ways.
The aim of this study is to develop a Health Insurance Portability and Accountability Act-compliant EMCT smartphone-based platform for the frequent and repeated testing of cognitive abilities in everyday life. This study examines the psychometric properties of 7 mobile cognitive tests covering domains of processing speed, visual working memory, recognition memory, and response inhibition within our platform among persons with and without bipolar disorder (BD). Ultimately, if shown to have adequate psychometric properties, EMCTs may be useful in research on BD and other neurological and psychiatric illnesses.
A total of 45 persons with BD and 21 demographically comparable healthy volunteer participants (aged 18-65 years) completed smartphone-based EMCTs 3 times daily for 14 days. Each EMCT session lasted approximately 1.5 minutes. Only 2 to 3 tests were administered in any given session, no test was administered more than once per day, and alternate test versions were administered in each session.
The mean adherence to the EMCT protocol was 69.7% (SD 20.5%), resulting in 3965 valid and complete tests across the full sample. Participants were significantly more likely to miss tests on later versus earlier study days. Adherence did not differ by diagnostic status, suggesting that BD does not interfere with EMCT participation. In most tests, age and education were related to EMCT performance in expected directions. The average performances on most EMCTs were moderately to strongly correlated with the National Institutes of Health Toolbox Cognition Battery. Practice effects were observed in 5 tests, with significant differences in practice effects by BD status in 3 tests.
Although additional reliability and validity data are needed, this study provides initial psychometric support for EMCTs in the assessment of cognitive performance in real-world contexts in BD.
随着智能手机技术的普及，越来越多的文献表明，生态瞬时认知测试（EMCT）相对于传统的纸笔心理评估具有优势。我们引入了一个新的平台，用于以生态有效的方式进行认知测试的自我管理。
本研究旨在开发一种符合《健康保险流通与责任法案》的 EMCT 智能手机平台，用于在日常生活中频繁和重复地测试认知能力。本研究在有和没有双相情感障碍（BD）的人群中，考察了 7 种移动认知测试在我们的平台上的心理测量特性，涵盖了处理速度、视觉工作记忆、识别记忆和反应抑制领域。最终，如果证明具有足够的心理测量特性，EMCT 可能对 BD 及其他神经和精神疾病的研究有用。
共有 45 名 BD 患者和 21 名在人口统计学上可比的健康志愿者（年龄 18-65 岁）完成了为期 14 天、每天 3 次的基于智能手机的 EMCT。每次 EMCT 会话持续约 1.5 分钟。在任何给定的会话中，仅进行 2 到 3 次测试，每天不进行多次测试，并且在每个会话中交替使用不同的测试版本。
对 EMCT 方案的平均依从率为 69.7%（SD 20.5%），在整个样本中得到了 3965 次有效和完整的测试。参与者在较晚的研究日错过测试的可能性明显高于较早的研究日。依从性不因诊断状态而异，表明 BD 不干扰 EMCT 的参与。在大多数测试中，年龄和教育程度与 EMCT 表现呈预期的方向相关。大多数 EMCT 的平均表现与 NIH 工具包认知电池中度到高度相关。在 5 项测试中观察到练习效应，在 3 项测试中，BD 状态对练习效应有显著差异。
尽管需要更多的可靠性和有效性数据，但本研究为 EMCT 在 BD 真实环境下评估认知表现提供了初步的心理测量支持。
