一项基于应用程序的数字符号替换测试用于评估重度抑郁症成年人的认知缺陷：评估研究
An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study.
作者信息
McIntyre Roger S, Lipsitz Orly, Rodrigues Nelson B, Subramaniapillai Mehala, Nasri Flora, Lee Yena, Fehnert Ben, King James, Chrones Lambros, Kratiuk Kevin, Uddin Sharif, Rosenblat Joshua D, Mansur Rodrigo B, McCue Maggie
机构信息
University Health Network, Mood Disorders Psychopharmacology Unit, Toronto, ON, Canada.
Brain and Cognition Discovery Foundation, Toronto, ON, Canada.
出版信息
JMIR Ment Health. 2022 Oct 27;9(10):e33871. doi: 10.2196/33871.
BACKGROUND
Cognitive dysfunction is an impairing core symptom of depression. Among adults with major depressive disorder (MDD) treated with antidepressants, residual cognitive symptoms interfere with patient-reported outcomes. The foregoing characterization of cognitive symptoms provides the rationale for screening and assessing the severity of cognitive symptoms at point of care. However, clinical neurocognitive assessments are time-consuming and difficult, and they require specialist expertise to interpret them. A smartphone-delivered neurocognitive test may offer an effective and accessible tool that can be readily implemented into a measurement-based care framework.
OBJECTIVE
We aimed to evaluate the use of a smartphone-delivered app-based version of the established Cognition Kit Digit Symbol Substitution Test (DSST) neurocognitive assessment compared to a traditional paper-and-pencil version.
METHODS
Convergent validity and test-retest reliability of the 2 versions were evaluated. Patient satisfaction with the app was also assessed.
RESULTS
Assessments made using the app-based Cognition Kit DSST were highly correlated with the standard paper-and-pencil version of the test, both at the baseline visit (r=0.69, df=27; P<.001) and at the end-of-study visit (r=0.82, df=27; P<.001), and they were positively evaluated by 30 patients as being user-friendly, easy to navigate, and preferable over the paper-and-pencil version of the DSST. However, although the app-based Cognition Kit DSST was validated in patients with MDD, it still needs to be evaluated in healthy controls.
CONCLUSIONS
App-based DSST may facilitate a more personalized, convenient, and cost-effective method of cognitive assessment, helping to guide measurement-based care and psychotherapeutic and pharmacologic treatment options for patients with MDD.
TRIAL REGISTRATION
ClinicalTrials.gov NCT03999567; https://tinyurl.com/2p8pnyv7.
背景
认知功能障碍是抑郁症的核心损害症状。在接受抗抑郁药治疗的重度抑郁症（MDD）成年患者中，残留的认知症状会干扰患者报告的结局。上述认知症状的特征为在护理点筛查和评估认知症状的严重程度提供了理论依据。然而，临床神经认知评估耗时且困难，并且需要专业知识来解读结果。基于智能手机的神经认知测试可能提供一种有效且易于使用的工具，可轻松应用于基于测量的护理框架中。
目的
我们旨在评估与传统纸笔版相比，基于智能手机应用程序的既定认知套件数字符号替换测试（DSST）神经认知评估的使用情况。
方法
评估了两个版本的收敛效度和重测信度。还评估了患者对该应用程序的满意度。
结果
使用基于应用程序的认知套件DSST进行的评估与标准纸笔版测试高度相关，在基线访视时（r = 0.69，自由度= 27；P <.001）和研究结束时访视时（r = 0.82，自由度= 27；P <.001）均如此，并且30名患者对其给予了积极评价，认为其用户友好、易于操作且优于纸笔版的DSST。然而，尽管基于应用程序的认知套件DSST已在MDD患者中得到验证，但仍需要在健康对照中进行评估。
结论
基于应用程序的DSST可能有助于实现更个性化、便捷且具有成本效益的认知评估方法，有助于指导对MDD患者的基于测量的护理以及心理治疗和药物治疗选择。
试验注册
ClinicalTrials.gov NCT03999567；https://tinyurl.com/2p8pnyv7 。
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