ArticleJMIR mHealth and uHealth2020
Symbol Digit Modalities Test Variant in a Smartphone App for Persons With Multiple Sclerosis: Validation Study.
Article in JMIR mHealth and uHealth, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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Who cites it
31 citing papers in PubMed, 43 citations in OpenAlex.
- A smartphone sensor-based digital outcome assessment of multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2022Trial
- Selective associations between cognitive practice effects and reactive balance adaptation in multiple sclerosis.Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists · 2026Article
- What if it is the eyes? The effect of eye movement disorders on cognitive testing in MS.Journal of neurology · 2026Article
- The practice effect of smartphone-derived cognitive processing speed assessments as a proxy of cognitive functioning in multiple sclerosis.Journal of neurology · 2026Article
- Heterogeneous Deep Gray Matter Iron Deposition Patterns across Multiple Sclerosis Subgroups Defined by the Clinico-Radiological Paradox.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2026Article
- Review
- Rationale and design of the Renal Lifecycle trial assessing the effect of dapagliflozin on cardiorenal outcomes in severe chronic kidney disease.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2025 · on this mapArticle
- Plateau of practice effects and noise with repeat SDMT testing in multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- Digital Biomarkers and AI for Remote Monitoring of Fatigue Progression in Neurological Disorders: Bridging Mechanisms to Clinical Applications.Brain sciences · 2025Article
- Differential Validity in the Written, Oral, and Electronic SDMT in Multiple Sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- Investigating Measurement Equivalence of Smartphone Sensor-Based Assessments: Remote, Digital, Bring-Your-Own-Device Study.Journal of medical Internet research · 2025Article
- Feasibility, reliability, and validity of ambulatory smartphone-administered cognitive tests in multiple sclerosis.Multiple sclerosis (Houndmills, Basingstoke, England) · 2025Article
- A New Smartphone-Based Cognitive Screening Battery for Multiple Sclerosis (icognition): Validation Study.Journal of medical Internet research · 2025Article
- Article
- CoGames: Development of an adaptive smartphone-based and gamified monitoring tool for cognitive function in Multiple Sclerosis.Journal of neurology · 2025Observational
- Measuring Situational Cognitive Performance in the Wild: A Psychometric Evaluation of Three Brief Smartphone-Based Test Procedures.Assessment · 2024Article
- Mobile Application Applied for Cognitive Rehabilitation: A Systematic Review.Life (Basel, Switzerland) · 2024Review
- Digital symbol-digit modalities test with modified flexible protocols in patients with CNS demyelinating diseases.Scientific reports · 2024Article
- Mobile Health App (DIGICOG-MS) for Self-Assessment of Cognitive Impairment in People With Multiple Sclerosis: Instrument Validation and Usability Study.JMIR formative research · 2024Article
- Reliability and Construct Validity of a Mobile Application for the Finger Tapping Test Evaluation in People with Multiple Sclerosis.Brain sciences · 2024Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe decline of cognitive processing speed (CPS) is a common dysfunction in persons with multiple sclerosis (MS). The Symbol Digit Modalities Test (SDMT) is widely used to formally quantify CPS. We implemented a variant of the SDMT in MS sherpa, a smartphone app for persons with MS.
objectiveThe aim of this study was to investigate the construct validity and test-retest reliability of the MS sherpa smartphone variant of the SDMT (sSDMT).
methodsWe performed a validation study with 25 persons with relapsing-remitting MS and 79 healthy control (HC) subjects. In the HC group, 21 subjects were matched to the persons with MS with regard to age, gender, and education and they followed the same assessment schedule as the persons with MS (the "HC matched" group) and 58 subjects had a less intense assessment schedule to determine reference values (the "HC normative" group). Intraclass correlation coefficients (ICCs) were determined between the paper-and-pencil SDMT and its smartphone variant (sSDMT) on 2 occasions, 4 weeks apart. Other ICCs were determined for test-retest reliability, which were derived from 10 smartphone tests per study participant, with 3 days in between each test. Seven study participants with MS were interviewed regarding their experiences with the sSDMT.
resultsThe SDMT scores were on average 12.06% higher than the sSDMT scores, with a standard deviation of 10.68%. An ICC of 0.838 was found for the construct validity of the sSDMT in the combined analysis of persons with MS and HC subjects. Average ICCs for test-retest reliability of the sSDMT for persons with MS, the HC matched group, and the HC normative group were 0.874, 0.857, and 0.867, respectively. The practice effect was significant between the first and the second test of the persons with MS and the HC matched group and trivial for all other test-retests. The interviewed study participants expressed a positive attitude toward the sSDMT, but they also discussed the importance of adapting a smartphone cognition test in accordance with the needs of the individual persons with MS.
conclusionsThe high correlation between sSDMT and the conventional SDMT scores indicates a very good construct validity. Similarly, high correlations underpin a very good test-retest reliability of the sSDMT. We conclude that the sSDMT has the potential to be used as a tool to monitor CPS in persons with MS, both in clinical studies and in clinical practice.
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