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Title: Validation of the iPad Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS)
Author: Corfield, Freya
ISNI:       0000 0004 8500 4712
Awarding Body: Royal Holloway, University of London
Current Institution: Royal Holloway, University of London
Date of Award: 2018
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The leading cause of neurodisability amongst young adults is Multiple Sclerosis (MS), which is a chronic inflammatory and neurodegenerative disease of the central nervous system (CNS) (Thompson, Baranzini, Geurts, Hemmer, & Ciccarelli, 2018). Cognitive impairment is amongst a constellation of symptoms in MS. Presentations vary and symptoms include fatigue, pain, vision problems, mobility difficulties, sexual problems, bladder and bowel difficulties and speech and swallowing difficulties. Diagnosis is based on the most recent McDonald criteria, which has been recommended by the International Advisory Committee on Clinical Trials in Multiple Sclerosis (Thompson et al., 2017). Cognitive impairment remains absent from the diagnostic criteria for MS because of the difficulty of differential diagnosis with dementia. However cognitive impairment is experienced by half of individuals with MS (Chiaravalloti & DeLuca, 2008) and it has major negative consequences for quality of life (Langdon, 2010). Therefore, cognitive assessment plays an important role in managing MS symptoms. Neuropsychological batteries are objective measures of cognition. Unlike patient self-report, neuropsychological batteries are not influenced by psychosocial factors like depression (Hanssen, Beiske, Landrø, & Hessen, 2014). They are more sensitive in detecting cognitive impairment in individuals with MS than clinical interviews (Romero, Shammi, & Feinstein, 2015) or Magnetic Resonance Imaging (MRI) (Rocca et al., 2015). The most widely used neuropsychological battery was the Brief Repeatable Battery (BRB) (Rao & Group, 1990), followed by the more comprehensive Minimal Assessment of Cognitive Function in MS (MACFIMS) (Benedict et al., 2002). The batteries assessed a range of cognitive domains including Information Processing Speed (IPS), verbal and visual recall, attention, language and executive function through a variety of standardised tests. While these batteries offered several advantages to the validity of cognitive assessment over other techniques, issues emerged around the length of administration and the need for specialist training. The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) (Langdon et al., 2012) was developed almost a decade ago to overcome these challenges, by maintaining sensitivity of assessment whilst reducing test duration and need for specialist training. In essence the BICAMS was designed to operate as a brief assessment of cognition for small centres without specialist expertise. The BICAMS assesses the three most common cognitive impairments in MS, which includes IPS, immediate verbal and visual recall. The BICAMS can be completed in under 15 minutes and requires only papers, pencil and a stopwatch. Most healthcare professionals could administer the BICAMS. Shortly following the development of the BICAMS was the publication of the international validation protocol (Benedict et al., 2012). Several countries embarked on validating the BICAMS within their populations. The aim of the systematic review was to summarise the findings of the studies produced as part this international collaboration. The iPad BICAMS was developed in 2018 to further improve cognitive assessment validity. The primary aim of this study was to establish the level of agreement between the BICAMS iPad and the paper form. The level of agreement was expected to be high as all the physical parameters of the test were kept constant. Factors know to be associated with cognition in MS were expected to correlate with BICAMS scores. They included premorbid functioning, mood, fatigue, dexterity and visual functioning. The iPad BICAMS was thought to improve participant experience of cognitive assessments, thus it was hypothesised that participants would prefer iPad BICAMS.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available