Validity of Computer Based Administration of Cognitive Assessments compared to Traditional Paper-based Administration

Traditional pen and paper based neuropsychological tests (NPT’s) for cognition assessment have several challenges limiting their use. They are time consuming, expensive, and require highly trained specialists to administer. This leads to testing being available to only a small portion of the population and often with wait times of several months. In clinical practice, we have found results tend not to be integrated effectively into assessment and plans of the ordering provider. Here we compared several tests using BrainCheck (BC), a computer-based NPT battery, to traditional paper-based NPT’s, by evaluating individual tests as well as comparing composite scores to scores on traditional screening tools. 26 volunteers took both paper-based tests and BC. We found scores of four assessments (Ravens Matrix, Digit Symbol Modulation, Stroop Color Word Test and Trails Making A&B Test) were highly correlated. The Balance Examination and Immediate/Delayed Hopkins Verbal Learning, however, were not correlated. The BC composite score was correlated to results of the Saint Louis University Mental Status (SLUMS) exam [[1][1]], the Mini-Mental State Examination (MMSE) [[2][2]], and the Montreal Cognitive Assessment (MoCA). Our results suggest BC may offer a computer-based avenue to address the gap between basic screening and formal neuropsychological testing. ### Competing Interest Statement The following authors declare the following competing interests: SY, BF, YK, BH, RHG reports personal fees from BrainCheck, outside the submitted work; DME, BF, YK, BH, RHG reports receiving stock options from BrainCheck. ### Funding Statement Funding was provided by BrainCheck, Inc. ### Author Declarations All relevant ethical guidelines have been followed; any necessary IRB and/or ethics committee approvals have been obtained and details of the IRB/oversight body are included in the manuscript. Yes All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data may be made available by contacting the corresponding author and with a data use agreement. [1]: #ref-1 [2]: #ref-2