@Article{info:doi/10.2196/33871,
author="McIntyre, Roger S
and Lipsitz, Orly
and Rodrigues, Nelson B
and Subramaniapillai, Mehala
and Nasri, Flora
and Lee, Yena
and Fehnert, Ben
and King, James
and Chrones, Lambros
and Kratiuk, Kevin
and Uddin, Sharif
and Rosenblat, Joshua D
and Mansur, Rodrigo B
and McCue, Maggie",
title="An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study",
journal="JMIR Ment Health",
year="2022",
month="Oct",
day="27",
volume="9",
number="10",
pages="e33871",
keywords="depression; DSST; Digit Symbol Substitution Test; smartphone; technology; measurement-based care; cognition",
abstract="Background: Cognitive dysfunction is an impairing core symptom of depression. Among adults with major depressive disorder (MDD) treated with antidepressants, residual cognitive symptoms interfere with patient-reported outcomes. The foregoing characterization of cognitive symptoms provides the rationale for screening and assessing the severity of cognitive symptoms at point of care. However, clinical neurocognitive assessments are time-consuming and difficult, and they require specialist expertise to interpret them. A smartphone-delivered neurocognitive test may offer an effective and accessible tool that can be readily implemented into a measurement-based care framework. Objective: We aimed to evaluate the use of a smartphone-delivered app-based version of the established Cognition Kit Digit Symbol Substitution Test (DSST) neurocognitive assessment compared to a traditional paper-and-pencil version. Methods: Convergent validity and test-retest reliability of the 2 versions were evaluated. Patient satisfaction with the app was also assessed. Results: Assessments made using the app-based Cognition Kit DSST were highly correlated with the standard paper-and-pencil version of the test, both at the baseline visit (r=0.69, df=27; P<.001) and at the end-of-study visit (r=0.82, df=27; P<.001), and they were positively evaluated by 30 patients as being user-friendly, easy to navigate, and preferable over the paper-and-pencil version of the DSST. However, although the app-based Cognition Kit DSST was validated in patients with MDD, it still needs to be evaluated in healthy controls. Conclusions: App-based DSST may facilitate a more personalized, convenient, and cost-effective method of cognitive assessment, helping to guide measurement-based care and psychotherapeutic and pharmacologic treatment options for patients with MDD. Trial Registration: ClinicalTrials.gov NCT03999567; https://tinyurl.com/2p8pnyv7 ",
issn="2368-7959",
doi="10.2196/33871",
url="https://mental.jmir.org/2022/10/e33871",
url="https://doi.org/10.2196/33871",
url="http://www.ncbi.nlm.nih.gov/pubmed/36301615"
}