Abstract
Objective: Remote mobile cognitive testing (MCT) is an expanding area of research, but psychometric data supporting these measures are limited. We provide preliminary data on test–retest reliability and reliable change estimates in four MCTs from SWAY Medical, Inc. Methods: Fifty-five adults from the U.S. Midwest completed the MCTs remotely on their personal mobile devices once per week for 3 consecutive weeks, while being supervised with a video-based virtual connection. The cognitive assessment measured simple reaction time (“Reaction Time”), go/no-go response inhibition (“Impulse Control”), timed visual processing (“Inspection Time”), and working memory (“Working Memory”). For each cognitive test except Working Memory, we analyzed both millisecond (ms) responses and an overall SWAY composite score. Results: The mean age of the sample was 26.69years (SD=9.89; range=18–58). Of the 55 adults, 38 (69.1%) were women and 49 (89.1%) used an iPhone. Friedman’s ANOVAs examining differences across testing sessions were nonsignificant (ps>0.31). Intraclass correlations for Weeks 1–3 were: Reaction Time (ms): 0.83, Reaction Time (SWAY): 0.83, Impulse Control (ms): 0.68, Impulse Control (SWAY): 0.80, Inspection Time (ms): 0.75, Inspection Time (SWAY): 0.75, and Working Memory (SWAY): 0.88. Intraclass correlations for Weeks 1–2 were: Reaction Time (ms): 0.75, Reaction Time (SWAY): 0.74, Impulse Control (ms): 0.60, Impulse Control (SWAY): 0.76, Inspection Time (ms): 0.79, Inspection Time (SWAY): 0.79, and Working Memory (SWAY): 0.83. Natural distributions of difference scores were calculated and reliable change estimates are presented for 70, 80, and 90% CIs. Conclusion: Test–retest reliability was adequate or better for the MCTs in this virtual remote testing study. Reliable change estimates allow for the determination of whether a particular level of improvement or decline in performance is within the range of probable measurement error. Additional reliability and validity data are needed in other age groups.
Highlights
Mobile cognitive testing (MCT) – brief, repeated cognitive tests delivered through mobile devices – is of considerable interest to the neuropsychology community
The current study provides a preliminary examination of test–retest reliability and reliable change estimates in four novel MCTs, assessing reaction time, impulse control, timed visual processing, and working memory in 55 communitydwelling adults
Other investigations have reported good convergent and discriminant validity of MCTs compared to laboratory tests, with more shared variance between tests of similar constructs than between tests of distinct constructs (Moore et al, 2017a, 2020; Dupuy et al, 2018; Sliwinski et al, 2018)
Summary
Mobile cognitive testing (MCT) – brief, repeated cognitive tests delivered through mobile devices – is of considerable interest to the neuropsychology community. MCTs have a number of advantages over traditional neuropsychological testing, including remote, automated administration and scoring, sensitivity to fluctuating physiological states (e.g., arousal and mood), and the potential for improved ecological validity (Allard et al, 2014; Moore et al, 2017a; Sliwinski et al, 2018; Koo and Vizer, 2019; Weizenbaum et al, 2020). MCTs could allow for a repeatable, dynamic, real-world assessment of cognitive functioning, which has the potential for benefits in a wide variety of healthy and clinical populations, given the importance of understanding cognitive functioning outside of controlled clinical environments. MCTs are intended as an adjunct to rather than a replacement of traditional neuropsychological testing, which has several advantages, including the precise control of an examinee’s environment, an in-depth assessment of multiple cognitive domains, and a variety of available tests with large normative datasets
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