Evidence map›Paper›PMID 33470940›Full record

Observational studyJournal of medical Internet research2021

Application of an Adaptive, Digital, Game-Based Approach for Cognitive Assessment in Multiple Sclerosis: Observational Study.

Wan-Yu Hsu, William Rowles, Joaquin Anguera, Chao Zhao, Annika Anderson, Amber Alexander, Simone Sacco, Roland Henry, Adam Gazzaley, Riley Bove

Erratum issued Registry-linked trialOpen access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03569618 (Effect of a Digital Therapeutic on Processing Speed in Adults With Multiple Sclerosis), which is not on this map. Cited by 16 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
16citing papers in PubMed, 1 pooled it
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03569618 nacompletednot on this map

Effect of a Digital Therapeutic on Processing Speed in Adults With Multiple Sclerosis

TypeinterventionalSponsorUniversity of California, San FranciscoRan2018 to 2019Enrolled44ConditionsMultiple Sclerosis, Cognitive DeclineArmsTablet-based Game
3 · Its place in the literature

Who cites it

16 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
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  6. Review
  7. Article
  8. Observational
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  10. Review
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Wan-Yu HsuDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0003-1410-8429
William RowlesDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0002-5613-0483
Joaquin AngueraDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0002-7216-0674
Chao ZhaoDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0001-7192-7856
Annika AndersonDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0002-7288-6344
Amber AlexanderDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0002-3026-3077
Simone SaccoDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0001-8789-3099
Roland HenryDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0002-8232-7562
Adam GazzaleyDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0002-1232-9431
Riley BoveDepartment of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States.ORCID 0000-0002-2034-8800
University of California, San Francisco · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCognitive impairment is one of the most debilitating manifestations of multiple sclerosis. Currently, the assessment of cognition relies on a time-consuming and extensive neuropsychological examination, which is only available in some centers.

objectiveTo enable simpler, more accessible cognitive screening, we sought to determine the feasibility and potential assessment sensitivity of an unsupervised, adaptive, video game-based digital therapeutic to assess cognition in multiple sclerosis.

methodsA total of 100 people with multiple sclerosis (33 with cognitive impairment and 67 without cognitive impairment) and 24 adults without multiple sclerosis were tested with the tablet game (EVO Monitor) and standard measures, including the Brief International Cognitive Assessment for Multiple Sclerosis (which included the Symbol Digit Modalities Test [SDMT]) and Multiple Sclerosis Functional Composite 4 (which included the Timed 25-Foot Walk test). Patients with multiple sclerosis also underwent neurological evaluations and contributed recent structural magnetic resonance imaging scans. Group differences in EVO Monitor performance and the association between EVO Monitor performance and standard measures were investigated.

resultsParticipants with multiple sclerosis and cognitive impairment showed worse performance in EVO Monitor compared with participants without multiple sclerosis (P=.01) and participants with multiple sclerosis without cognitive impairment (all P<.002). Regression analyses indicated that participants with a lower SDMT score showed lower performance in EVO Monitor (r=0.52, P<.001). Further exploratory analyses revealed associations between performance in EVO Monitor and walking speed (r=-0.45, P<.001) as well as brain volumetric data (left thalamic volume: r=0.47, P<.001; right thalamic volume: r=0.39, P=.002; left rostral middle frontal volume: r=0.28, P=.03; right rostral middle frontal volume: r=0.27, P=.03).

conclusionsThese findings suggest that EVO Monitor, an unsupervised, video game-based digital program integrated with adaptive mechanics, is a clinically valuable approach to measuring cognitive performance in patients with multiple sclerosis.

trial registrationClinicalTrials.gov NCT03569618; https://clinicaltrials.gov/ct2/show/NCT03569618.

Indexed as

Cognition DisordersFemaleHumansMaleMiddle AgedMultiple SclerosisSurveys and QuestionnairesTelemedicineVideo Gamescognitioncognitive assessmentdigital healthmHealthmultiple sclerosisvideo game

Identifiers

PMID33470940
PMCPMC7840186
OpenAlexW3121896074

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.