Supplementary Material for: Supervised, Self-Administered Tablet-Based Cognitive Assessment in Neurodegenerative Disorders and Stroke

Introduction: As the population ages, the prevalence of cognitive impairment is expanding. Given the recent pandemic, there is a need for remote testing modalities to assess cognitive deficits in individuals with neurological disorders. Self-administered, remote, tablet-based cognitive assessments would be clinically valuable if they can detect and classify cognitive deficits as effectively as traditional in-person neuropsychological testing. Methods: We tested whether the Miro application, a tablet-based neurocognitive platform, measured the same cognitive domains as traditional pencil-and-paper neuropsychological tests. Seventy-nine patients were recruited and then randomized to either undergo pencil-and-paper or tablet testing first. Twenty-nine age-matched healthy controls completed the tablet-based assessments. We identified Pearson correlations between Miro tablet-based modules and corresponding neuropsychological tests in patients and compared scores of patients with neurological disorders with those of healthy controls using t tests. Results: Statistically significant Pearson correlations between the neuropsychological tests and their tablet equivalents were found for all domains with moderate (r > 0.3) or strong (r > 0.7) correlations in 16 of 17 tests (p < 0.05). All tablet-based subtests differentiated healthy controls from neurologically impaired patients by t tests except for the spatial span forward and finger tapping modules. Participants reported enjoyment of the tablet-based testing, denied that it provoked anxiety, and noted no preference between modalities. Conclusions: This tablet-based application was found to be widely acceptable to participants. This study supports the validity of these tablet-based assessments in the differentiation of healthy controls from patients with neurocognitive deficits in a variety of cognitive domains and across multiple neurological disease etiologies.

引言：随着人口老龄化加剧，认知障碍（cognitive impairment）的患病率持续攀升。受近期全球大流行影响，亟需开发远程检测手段，以评估神经系统疾病患者的认知缺损情况。若基于平板电脑的自主式远程认知评估，能够达到与传统线下神经心理测试（neuropsychological testing）相当的认知缺损检测与分类效果，则其将具备重要的临床应用价值。
方法：本研究旨在验证基于平板电脑的神经认知平台Miro应用程序（Miro application）能否覆盖与传统纸笔式神经心理测试一致的认知领域。本研究共招募79例患者，按随机原则分为两组，分别优先接受纸笔式或平板电脑式认知测试；另有29名年龄匹配的健康对照者完成了平板电脑式认知评估。本研究计算了患者群体中Miro平板电脑测试模块与对应神经心理测试之间的皮尔逊相关系数（Pearson correlation），并采用t检验（t test）比较了神经系统疾病患者与健康对照者的测试得分。
结果：结果显示，所有认知领域的神经心理测试与其平板电脑对应测试之间均存在统计学意义显著的相关关系；17项测试中有16项的相关系数达到中等（r>0.3）或强相关水平（r>0.7），且差异均具有统计学意义（p<0.05）。经t检验分析，除空间广度正向测试（spatial span forward）与手指敲击模块（finger tapping modules）外，其余所有平板电脑式子测试均能有效区分健康对照者与神经系统受损患者。受试者反馈称乐于参与平板电脑式测试，未表示该测试引发焦虑情绪，且未表现出对两种测试方式的偏好。
结论：本研究显示，该平板电脑应用程序获得了受试者的广泛认可。本研究证实，基于平板电脑的认知评估具备良好的效度，能够在多种认知领域以及多种神经系统疾病病因下，有效区分健康对照者与神经认知缺损患者。