Usability of a Tablet-Based Cognitive Assessment Administered by Medical Assistants in General Practice: Implementation Study
Notice bibliographique
Résumé
BACKGROUND: Digital short cognitive tests administered by medical assistants (MAs) in general practitioners' (GPs) practices have great potential for the timely identification of patients with dementia, because they can lead to targeted specialist referrals or to immediate reassurance of patients regarding their perceived concerns. However, integration of this testing approach into clinical practice requires good usability for the test itself, especially for cognitively impaired older adults. OBJECTIVE: In this implementation study, the digital version of the Montreal Cognitive Assessment (MoCA) Duo was conducted by MAs in general practice. We tested if the interaction with the test is associated with usability problems for the patients and aimed to find additional relevant constructs that should be considered for the potential implementation of such digital tests into clinical practice. We focused the study on subjective success, usability, and workload as well as their association with the result of the cognitive test to assess whether the MoCA Duo can be implemented into general practice. METHODS: In total, 10 GPs took part in the study. Within their practices, 299 GP patients (aged 51-97 years) with cognitive concerns completed the MoCA Duo administered by MAs. Subsequently, patients and MAs completed digital questionnaires regarding the interaction with the app. Usability was measured using the adapted System Usability Scale, and perceived workload using the National Aeronautics and Space Administration Task Load Index. For the perceived workload, we included an assessment of the patient by the MA. Results of the MoCA Duo were supplied to the GPs for their consultation with the patient. RESULTS: The results indicated good usability for the MoCA Duo. Self-assessment by the patients indicated that 64% (191/299) could perform in the test to the best of their ability, affected by their MoCA score. We found significant higher usability ratings by patients with better MoCA scores as well as by younger patients. Furthermore, the perceived workload showed overall medium workload. We found significant correlations between the subjective perceived workload of the patients and the assessment by MAs. Self-assessments as well as assessments by the MAs were significantly influenced by the MoCA scores and the age of the participants. CONCLUSIONS: The results indicate good usability of the digital MoCA within the sample, supporting the idea that the resulting scores are adequate to assess cognitive status without dependence on technological affinity. Furthermore, the results highlight the relevance of heterogenous samples for comparable evaluation studies, based on the significant effect of cognitive status and age on usability and workload.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,019 | 0,040 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».