To assess the performance of an electronic cognitive assessment tool in a multiple sclerosis cohort

Established in 2010, the UK MS Register (UKMSR) collects clinical data from UK hospitals and patient reported outcomes (PROs) directly from people with MS (pwMS). Over 400,000 outcomes have been collected but there are limited electronic measures that assess cognition – a major impact in MS. The UKMSR developed an electronic cognitive test inspired by the Symbol Digit Modality Test (SDMT).

All participants were consented to the UKMSR. The MSiDMT (Multiple Sclerosis interactive Digit Modality Test) was deployed to Apple iPads.  The SDMT is a symbol matching test, nine symbols are displayed with a corresponding number , the correct number must be applied to the symbol displayed. The MSiDMT preserves this symbol/number interface – symbols are randomised on app launch and only the symbol to be answered now, and the one to be answered next are displayed in the middle of the screen. Participants tap the button corresponding to the central symbol as ‘correct’ response.  There were 90s to answer as many questions as possible. 

107 pwMS completed the application and comparisons were made with their paper SDMT scores. RRMS : 89 , PPMS : 6, SPMS : 6, Other : 2. Female (68.2%), Median Age 44.1, Median EDSS 3.5. There was a strong correlation between SDMT and MSiDMT (r = 0.802, df = 104, p < 0.001, Pearson’s). 31 pwMS were retested at one month (r = 0.947, t = 15.60, df = 28, p = < 0.001)

The MSiDMT is a suitable and efficient alternative to the paper based SDMT, allowing rapid electronic assessment of pwMS in a clinical setting. Future work will look at deployment of the MSiDMT in the home setting and on a wider range of devices.