Cognitive dysfunction in multiple sclerosis (MS) patients is common, and routine/efficient screening for cognitive dysfunction is commonly not feasible in a real-world setting for a variety of reasons.
To determine patient satisfaction with the CogEval app using the Processing Speed Test (PST), a validated analog of the Symbol Digit Modalities Test (SDMT) as well as time it takes to complete the PST, and clinical decision making as a result of PST testing.
30 established or new MS patients in our clinic were followed over a period of 64 weeks, and at each visit, PST was administered. Upon consent, patients were administered a single seven-question satisfaction survey using a 5-point Likert scale (1-strongly disagree, 2-disagree, 3-neutral, 4-agree, 5-strongly agree) during one of these visits. Time to complete practice test and PST was captured. Retrospective chart review was performed to determine clinical decision making as a result of performing the PST.
The average time to complete PST was 4 minutes 23 seconds. Likert scale scores were as follows: I liked using the app (4.6/5), The directions on the app were easy to understand (4.8/5), I was familiar with the risk of cognitive dysfunction in MS before using the app (4.5/5), I like the fact that my provider is testing my cognitive status (4.9/5), Because of this app, I’ll be more motivated to learn about the potential effects of MS on my cognition (4.6/5), The app did not take too long to complete (4.8/5), I am willing to repeat cognitive testing at future visits (4.7/5).
Retrospective chart review regarding medical decision making as a result of performing PST are as follows: Discussion about cognitive dysfunction in MS-30 patients, MRI brain-11 patients, labs to rule out other potential causes of cognitive dysfunction-9 patients, initiate high efficacy therapy-9 patients, switch to high efficacy therapy-4 patients.
Based on Likert Scale scores, patient satisfaction with PST testing was high, instructions were easy for patients to understand, patients appreciated the fact that routine cognitive screening was performed at their clinic visits, and the time to complete PST testing was not burdensome. The average time for PST practice test/test completion was 4 minutes 23 seconds. The PST is an efficient, rapid, and repeatable tool to assess for cognitive dysfunction in MS patients longitudinally.