P3‐228: Cognitive testing on computer (C‐TOC): Design, usability evaluation and validation of a novel computerized testing tool
Bibliographic record
Abstract
Computer-based cognitive testing offers an important alternative to current approaches in facing the growing demand for evaluation of cognitive concerns. We report on the design and initial validation studies of C-TOC, a test battery created at the interface of cognitive and computer science, neuropsychology, and neurology. C-TOC was developed to satisfy three a priori criteria: high validity for the detection of cognitive impairment, a usable human-computer interface and culturally fair test contents. We designed the C-TOC prototype to have comprehensive domain coverage. Test paradigms were developed to engage both receptive and productive skills. The latter include sentence production, free recall, and visuo-construction and are often not assessed on computer. C-TOC was designed iteratively in 3 cycles of consultation with representatives of end users and of a cultural advisory panel. Convergent validity was investigated by computing correlation coefficients between C-TOC subtests and comparable neuropsychological tests (NPT). Concurrent validity was examined by using ANOVA and Student Newman Keuls (SNK) post hoc to compare test scores of clinic patients with No Cognitive Impairment (NCI), Mild Cognitive Impairment (MCI) and Alzheimer Disease (AD). Usability evaluations with 27 participants aged 55 to 87, with a mix of diagnoses (7 normal controls, 6 NCI, 8 MCI, 6 mild dementia) and computer knowledge (1 none, 8 low, 14 moderate, 4 high) revealed problems with instructions, practice trials, screen layout, consistency and intuitiveness of navigation buttons. Cultural advisors identified test format, use of language, and lack of computer skills as challenges. Based on this input, we refined test content and interface from C-TOC.v1 to C-TOC.v4. Validation was undertaken with 26 participants (5 NCI, 15 MCI, 6 AD). Correlations with NPT ranged from r=0.4 to 0.8. C-TOC test scores discriminated the diagnostic groups on visual memory, language, visuo-spatial and executive function tests (NCI>MCI>AD, ANOVA p<.05, SNK 2 subsets). C-TOC has been carefully designed to have a highly usable interface for seniors and those with cognitive impairment. The battery's test paradigms are sensitive to mild levels of cognitive impairment. Future research will determine the battery's utility in a variety of settings including clinic offices and the home environment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".