Abstract
Questionnaire completion is a complex task that places demands on cognitive functions subserving reading, introspective memory, decision-making, and motor control. Although computerized questionnaires and surveys are used with increasing frequency in clinical practice, few studies have examined question completion time (QCT), the time required to complete each question. Here, we analyzed QCTs in 172 control subjects and 31 patients with traumatic brain injury (TBI) who completed two computerized questionnaires, the 17-question Post-Traumatic Stress Disorder (PTSD) Checklist (PCL) and the 25-question Cognitive Failures Questionnaire (CFQ). In control subjects, robust correlations were found between self-paced QCTs on the PCL and CFQ (r = 0.82). QCTs on individual questions correlated strongly with the number of words in the question, indicating the critical role of reading speed. QCTs increased significantly with age, and were reduced in females and in subjects with increased education and computer experience. QCT z-scores, corrected for age, education, computer use, and sex, correlated more strongly with each other than with the results of other cognitive tests. Patients with a history of severe TBI showed significantly delayed QCTs, but QCTs fell within the normal range in patients with a history of mild TBI. When questionnaires are used to gather relevant patient information, simultaneous QCT measures provide reliable and clinically sensitive measures of processing speed and executive function.
Highlights
Questionnaire completion engages a set of complex cognitive processes
This suggests that question completion time (QCT) provide insights into cognitive and executive functions that are not fully captured by other common neuropsychological tests (Reitan and Wolfson, 2005)
QCTs are largely determined by reading speed, as seen in the strong correlation between the QCTs and the number of words in individual questions
Summary
Questionnaire completion engages a set of complex cognitive processes. Subjects must evaluate the responses, select the most appropriate option, and respond . All of these processes depend on executive functions and show age-related declines (Brand and Markowitsch, 2010). The overall completion time for questionnaires increases with age (Malhotra, 2008) in a manner that parallels the age-related slowing seen on neuropsychological tests of executive function and Question completion time processing speed (Salthouse, 2000; Woods et al, 2015a). We examine the use of individual question completion times (QCTs) as a measure of cognitive function
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