title: Processing speed test: Validation of a self-administered, iPad®-based tool for screening cognitive dysfunction in a clinic setting.
abstract: BACKGROUND
  Cognitive dysfunction is common in multiple sclerosis (MS) patients and has important consequences for daily activities, yet, unlike motor function, is not routinely assessed in the clinic setting. We developed the Processing Speed Test (PST), a self-administered iPad®-based tool to measure MS-related deficits in processing speed.
  
  
  OBJECTIVE
  To determine whether the PST is valid for screening cognitive dysfunction by comparing it to the paper-and-pencil Symbol Digit Modalities Test (SDMT).
  
  
  METHODS
  We assessed PST test-retest reliability, sensitivity of PST and SDMT in discriminating MS patients from healthy controls (HC), convergent validity between PST and SDMT, correlations between T2 lesion load and PST and SDMT, and PST performance with and without technician present during administration.
  
  
  RESULTS
  PST had excellent test-retest reliability, was highly correlated with SDMT, was slightly more sensitive than SDMT in discriminating MS from HC groups, and correlated better with cerebral T2 lesion load than did SDMT. Finally, PST performance was no different with or without a technician in the testing environment.
  
  
  CONCLUSIONS
  PST has advantages over SDMT because of its efficient administration, scoring, and potential for medical record or research database integration. PST is a practical tool for routine screening of processing speed deficits in the MS clinic.
authors.affiliation: Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Rao
authors.affiliation: Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Genna
authors.initials: G
authors.lastname: Losinski
authors.affiliation: Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Lyla
authors.initials: L
authors.lastname: Mourany
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: David
authors.initials: D
authors.lastname: Schindler
authors.affiliation: Bayer Healthcare LLC, Whippany, NJ, USA.
authors.forename: Bernadett
authors.initials: B
authors.lastname: Mamone
authors.affiliation: Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Reece
authors.affiliation: Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Kemeny
authors.affiliation: McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
authors.forename: Sridar
authors.initials: S
authors.lastname: Narayanan
authors.affiliation: Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Miller
authors.affiliation: Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Francois
authors.initials: F
authors.lastname: Bethoux
authors.affiliation: Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bermel
authors.affiliation: Biogen, Cambridge, MA, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Rudick
authors.affiliation: Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Alberts
mesh_terms: D000328:Adult; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis*; D009483:Neuropsychological Tests / Q000592:standards*; D011597:Psychomotor Performance / Q000502:physiology*; D015203:Reproducibility of Results
keywords: Multiple sclerosis; attention; cognition; magnetic resonance imaging; neuropsychology; test–retest reliability; validity of results