New App May Help Measure Cognitive Function in MS Patients, Study Reports

A new app might make it easier for healthcare providers to assess cognitive function in people with multiple sclerosis (MS).

The app was described in the study, “iCAMS: Assessing the Reliability of a BICAMS Tablet Application,” published in the International Journal of MS Care.

As many as two-thirds of people with MS experience a decline in cognitive function. This can be managed, to some extent, with certain kinds of rehabilitation and other approaches, but healthcare providers need to be able to assess the decrease in cognitive function, and that means they need a way to measure it objectively.

Currently, measurements of cognitive function are typically done with paper-based tests, but these can take a long time and/or require an expert to administer them.

Researchers at Johns Hopkins Medicine wanted to make it easier for healthcare providers to obtain these measurements by adapting one of those paper tests into an easy-to-use app.

“Our goal is to reduce barriers for patients to receive the testing that may benefit their treatment and health through the use of digital technology,” Abbey Hughes, PhD, assistant professor at Johns Hopkins University and co-author of the study, said in a press release.

The team used the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS), which has been thoroughly validated as a tool to measure cognitive function in people with MS. Based on this, researchers called their app iCAMS.

BICAMS has three sections. For two of these — processing speed (how quickly the brain can respond to new information, like hitting the brakes upon seeing a red light) and visual learning (being able to create a mental map of an unfamiliar room, for example) — researchers directly adapted the BICAMS into an app format. For copyright reasons, they used a different subtest for the third section — verbal learning (retaining details from a story, for example).

Researchers then tested their app by having 100 MS patients undergo measurements via BICAMS and iCAMS. The participants were predominantly female (74%), their average age was 46 years, and most (78%) had relapsing-remitting MS.

The results of BICAMS and iCAMS showed excellent agreement, getting the same result 93% of the time or more, with none of the measurements differing significantly between the two tests. Furthermore, the researchers estimated that iCAMS would usually take about 10 minutes less to administer, and it required minimal expertise to use.

“It was quick and very easy to learn how to administer. Participants enjoyed testing on an iPad and often told me how much fun it was,” said Katie Rutter, a medical assistant who participated in the study.

Overall, the “results suggest that using the iCAMS app may make cognitive assessments of multiple sclerosis more convenient in a clinic setting, and therefore will be used more often to identify learning and memory problems,” said Meghan Beier, PhD, a Johns Hopkins University professor and study co-author.

Beier also emphasized that having tests administered electronically might make it easier to store and transfer data, and the app may also reduce the rate of errors in calculating scores.

The team’s future plan is to test the app on a larger scale in more diverse patient populations, and make it more user-friendly.