%0 Journal Article
%@ 2368-7959
%I JMIR Publications
%V 9
%N 10
%P e33871
%T An App-Based Digit Symbol Substitution Test for Assessment of Cognitive Deficits in Adults With Major Depressive Disorder: Evaluation Study
%A McIntyre,Roger S
%A Lipsitz,Orly
%A Rodrigues,Nelson B
%A Subramaniapillai,Mehala
%A Nasri,Flora
%A Lee,Yena
%A Fehnert,Ben
%A King,James
%A Chrones,Lambros
%A Kratiuk,Kevin
%A Uddin,Sharif
%A Rosenblat,Joshua D
%A Mansur,Rodrigo B
%A McCue,Maggie
%+ Brain and Cognition Discovery Foundation, 73 Mathersfield Drive, Toronto, ON, M4W 3W4, Canada, 1 416 603 5279, roger.mcintyre@bcdf.org
%K depression
%K DSST
%K Digit Symbol Substitution Test
%K smartphone
%K technology
%K measurement-based care
%K cognition
%D 2022
%7 27.10.2022
%9 Original Paper
%J JMIR Ment Health
%G English
%X 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 
%M 36301615
%R 10.2196/33871
%U https://mental.jmir.org/2022/10/e33871
%U https://doi.org/10.2196/33871
%U http://www.ncbi.nlm.nih.gov/pubmed/36301615