Comprehensive Overview of Cognitive Assessment for Multiple Sclerosis
Brief Cognitive Assessment based on Consensus Standards, MS care provider and patient needs regarding cognition, various assessment tools like BICAMS, and challenges in cognitive assessment for MS are discussed. The importance of specialist training, international validation, and the role of Bayer Healthcare in sponsoring BICAMS committee meetings are highlighted.
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Brief Cognitive Assessment based on Consensus Standards in the US and Abroad Dawn Langdon PhD
MS care providers needs Most interested in receiving consultation on cognition (31.0%) Most interested in CME relating to cognition (40.1%) Highest preference for live conference Turner et al., JRRD 2006;43:25-34
MS patients information needs All those questions recommended information about cognition in MS for all patients And on average to be given earlier than they had received it Heesen et al., Acta Neurol Scand 2006;114:268-272
Assessment of Cognition MSNQ Screening tests Routine in the office BRB SEFCI Brief Batteries Routine NP exam. MACFIMS Intermediate length Batteries Differential diagnosis Disability questions Rehabilitation programs Ad hoc Comprehensive Batteries 4
Cognitive assessment for MS Requires specialist training Time-consuming Not routinely available outside specialist centres Not comparable across countries
BICAMS Brief International Cognitive Assessment for MS Identify a brief assessment tool for cognition in MS can be used by health care professionals who are not cognitive specialists has international validation Specify an international validation protocol that can be implemented in any country Agree guidelines on test-retest timing and clinically significant change BICAMS committee meetings and website are sponsored by Bayer Healthcare 6
BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMS Brief International Cognitive Assessment for MS Identify a brief assessment tool for cognition in MS 80 key scientific articles identified Each article rated by two committee members Psychometric standards Reliability Validity Sensitivity Pragmatic standards International applicability Ease of administration Feasibility in the specified context Acceptability to patients BICAMS committee meetings and website are sponsored by Bayer Healthcare 8
BICAMS Brief International Cognitive Assessment for MS No materials required beyond papers, pencil and stopwatch BICAMS committee meetings and website are sponsored by Bayer Healthcare
Neuropsychological Evaluations California Verbal Learning Test-II (CVLT II) 11 Truck Spinach Giraffe Bookcase Onion Motorcycle Cabinet Zebra Coach Lamp Celery Cow Desk Boat Squirrel Cabbage Benedict et al. Clin Neuropsychol 2002; 16: 381-97
Brief Visuospatial Memory Test (Revised) RHB Benedict (Clin Neuropsych 1994; Psychol Assess 1996; Psychol Assess Resources 1997). Benedict et al. Clin Neuropsychol 2002; 16: 381-97 12
BICAMS Brief International Cognitive Assessment for MS Battery: CVLT-II, first recall trials BVMTR, first recall trials SDMT 13BICAMS committee meetings and website are sponsored by Bayer Healthcare
MS patients compared to healthy controls on BICAMS Parmenter et al., JINS 2010;16:6-16 MS (n=395) Mean SD Mean Controls (n=100) SD P value d Age 46.28 8.99 44.79 9.43 ns 0.16 Education 14.28 2.34 14.47 1.72 ns 0.09 BDI-FS 3.39 3.40 0.90 1.40 <.001 0.96 SDMT 49.53 13.20 61.40 9.31 <.001 1.04 CVLT-II TL 48.80 10.56 55.79 9.35 <.001 0.70 BVMTR TL 20.92 7.17 26.68 5.56 <.001 0.90
Raw score to scaled score conversion Parmenter et al., JINS 2010;16:6-16 Scaled score SDMT CVLT-II (learning trials) BVMTR (learning trials) 2 <13 3 <43 <32 13 4 43-35 32-35 14-15 5 46 36-43 16 6 47-50 44-46 17-19 7 51-54 47-48 20-22 8 55-56 49-51 23-24 9 57-59 52-53 25-26 10 60-63 54-57 27-28 11 64-66 58-60 29-30 12 67-69 61-63 31 13 70-72 64-66 32 14 73-74 67-70 33 15 75-78 71-73 34-35 16 79 74 17 80-87 18 >87 >74 36
BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMS Brief International Cognitive Assessment for MS Identify a brief assessment tool for cognition in MS can be used by health care professionals who are not cognitive specialists has international validation Specify an international validation protocol that can be implemented in any country BICAMS committee meetings and website are sponsored by Bayer Healthcare 17
BICAMS Brief International Cognitive Assessment for MS international validation protocol Step 1, Standardization and Translation of Test Stimuli. Step 2, Standardization and Translation of Test Instructions Step 3, Normalization Step 4, Test-Retest Reliability Step 5, Criterion-Related Validity Benedict et al., BMC Neurology (submitted) BICAMS committee meetings and website are sponsored by Bayer Healthcare
BICAMS Brief International Cognitive Assessment for MS: National Validations Country NC n MS n Data collection started BICAMS support Data collection completed Analysis started Analysis completed Publi- cation RHB Benedict Argentina TBD TBD Pending Pending Pending Pending Pending RHB Benedict Czech Repub 92 130 Mar 2010 Ongoing Pending Pending Pending RHB Benedict Iran 158 90 Mar 2010 Sep 2011 Oct 2011 Nov 2011 Submitted RHB Benedict Argentina TBD TBD Pending Pending Pending Pending Pending DW Langdon UK 60 60 Pending Pending Pending Pending Pending D W Langdon Egypt TBD TBD Pending Pending Pending Pending Pending DW Langdon MP Amato Estonia TBD TBD Pending Pending Pending Pending Pending Italy TBD TBD Pending Pending Pending Pending Pending 19
BICAMS Brief International Cognitive Assessment for MS Identify a brief assessment tool for cognition in MS can be used by health care professionals who are not cognitive specialists has international validation Specify an international validation protocol that can be implemented in any country Agree guidelines on test-retest timing and clinically significant change BICAMS committee meetings and website are sponsored by Bayer Healthcare 20
Assessment of Cognition Routine in the office 0 mins Screening tests Screening tests Routine in the clinic 15 mins BICAMS Brief Batteries Brief Batteries 45 mins Routine NP exam 90 mins Intermediate length Batteries Differential diagnosis Disability questions Rehabilitation programs 120 mins Comprehensive Batteries 21
