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New Tablet-based Application for Multiple Sclerosis Cognitive Assessment

A new study has reported on the results of a tablet-based application for multiple sclerosis cognitive assessment, demonstrating equivalency in score and improved and faster administration procedure compared to paper-based assessments.

Multiple Sclerosis (MS) is an autoimmune disease, in which the communication between neurons is disrupted due to the damage to myelin protein. Myelin covers the neurons and is necessary for smooth signal transmission in the nervous system. The main symptoms of MS are vision problems, weakness, impaired balance, emotional, and cognitive problems.

Patients’ self-reported assessments are commonly used, however in many cases self-assessment is based on a patient’s subjective evaluation (emotional state) rather than the real neurological state. To standardize assessment approaches across clinics, a Brief International Cognitive Assessment (BICAMS) was developed in 2010. The BICAMS test includes a cognitive processing speed assessment, learning abilities and visual and verbal memory tests – all are associated with the severity of MS.

Although the BICAMS test allows an accurate and sensitive assessment, it’s implementation by medical personnel is not intuitive and involves heavy paper-work such as printouts, manual scoring, and transferring of scores to the medical record.

A recent study aimed to compare an application of tablet-based BICAM, named ICAM, to the original paper-based version. The main goal of the study was to demonstrate equivalency across both tests and to show some benefits of using the technology in creating a more streamlined, and accurate assessment.

Patients with previously confirmed MS diagnosis, between the ages 18-79, with proven ability to write and read in English, were included in the study. All enrolled participants were provided with the study protocol and consented to participate in the study. A total of 100 participants took part in the study. Participants were randomly assigned to paper or tablet-based assessments.

After statistical analysis, a strong and significant correlation was found across both approaches. In total time calculation, the application saved about 10 min, probably due to the computerized score calculation.

According to the researchers, the study results should be retested in a larger sample size to demonstrate the reproducibility of outcomes. At this point the data is promising and taken together these findings demonstrated the validity and benefits of computerized approach over the paper-based version in the MS severity assessment. The ICAM application can be easily administered and the score can be processed in less than 15 min (10 min faster than the paper version). In addition, medical records can be simultaneously updated, eliminating the time needed for manual score transfer and storage arrangements. The results suggest that the initial investment in the iPads should eventually pay off in saving staff personal time in the long run.

Written by Bella Groisman, PhD


Meghan Beier, PhD; Kevin Alschuler et al.  (2019), iCAMS, Assessing the Reliability of a BICAMS Tablet Application, International Journal of MS Care Preprint.

EurekAlert (2019, Sep 9), New app offers faster and easier assessment for multiple sclerosis

Image by Niek Verlaan from Pixabay



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