Remote Digital Self-Testing of Cognitive Impairment: Results of the re.cogni.ze Study on Feasibility and Acceptance with the NeotivCare App
Gereon Nelles1, Emrah Düzel2, Claudia Bartes3, Dirk Czesnik4, Thomas Duning5, Andreas Lüschow6, Gerd Reifschneider7, Michael Schöttler8, Björn Henrik Schott3, Martin Griebe9
1Neuromed-Campus, Neurologische Praxis, 2Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Magdeburg, 3Klinik für Psychiatrie und Psychotherapie, Universitätsmedizin Göttingen, Deutsche Zentrum für Neurodegenerative Erkrankungen (DZNE), Göttingen, 4Gemeinschaftspraxis für Neurologie, Göttingen, 5Klinikum Bremen-Ost, 6MVZ Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, 7NeuroCentrum Erbach, 8Roche Pharma AG, Grenzach-Wyhlen, 9Neurologische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg
Objective:
To assess the feasibility, added value and satisfaction of remote digital self-assessment for mild cognitive impairment in primary and specialized routine care setting with a digital app certified as a medical device (neotivCare).
Background:
Cognitive tests provide key information for the diagnosis of mild cognitive impairment (MCI) and Alzheimer’s disease. In routine care, these tests are time-consuming and require trained personnel. Limited access to these assessments may delay timely diagnosis. We therefore developed a new digital remote self-assessment tool to address this challenge.
Design/Methods:
The multicentric study evaluated the usability of remote digital self-assessment neotivCare. neotivCare was installed on each patient’s own digital device. The application uses 3 different clinically and psychometrically validated tests of episodic memory. Each test is repeated once a week, four times in total, leading to an assessment period of 12 weeks. neotivCare calculates a composite score produces a summary of results.
Results:
Of the 765 individuals with subjective cognitive impairment 574 patients (75%) followed the recommendation (mean age 67 - SD 10; 50.2% female) to use the app. 40% of participants with a composite score fell below the prevalidated cut-off for MCI while 60% performed within normal limits. Specialists reported a higher satisfaction with the app compared to standard paper-pencil tests (5.2 versus 4.4 on a 7 point Likert scale). 80% saw an added value in using the app and would use the app again. 71.5 % of the patients felt that the app was easy to use. 52% of the patients reported a reduction of previously experienced concerns and in 27% of all cases these concerns were unchanged.
Conclusions:
Digital self-assessment in routine care is feasible and well accepted by health care providers and patients. neotivCare facilitates early diagnosis of cognitive impairment.
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