Development of a Tablet-based symbol digit modalities test for reliably assessing information processing speed in patients with stroke

Disabil Rehabil. 2016 Sep;38(19):1952-60. doi: 10.3109/09638288.2015.1111438. Epub 2016 Feb 10.

Abstract

Purpose: To develop a Tablet-based Symbol Digit Modalities Test (T-SDMT) and to examine the test-retest reliability and concurrent validity of the T-SDMT in patients with stroke.

Methods: The study had two phases. In the first phase, six experts, nine college students and five outpatients participated in the development and testing of the T-SDMT. In the second phase, 52 outpatients were evaluated twice (2 weeks apart) with the T-SDMT and SDMT to examine the test-retest reliability and concurrent validity of the T-SDMT.

Results: The T-SDMT was developed via expert input and college student/patient feedback. Regarding test-retest reliability, the practise effects of the T-SDMT and SDMT were both trivial (d=0.12) but significant (p≦0.015). The improvement in the T-SDMT (4.7%) was smaller than that in the SDMT (5.6%). The minimal detectable changes (MDC%) of the T-SDMT and SDMT were 6.7 (22.8%) and 10.3 (32.8%), respectively. The T-SDMT and SDMT were highly correlated with each other at the two time points (Pearson's r=0.90-0.91).

Conclusions: The T-SDMT demonstrated good concurrent validity with the SDMT. Because the T-SDMT had a smaller practise effect and less random measurement error (superior test-retest reliability), it is recommended over the SDMT for assessing information processing speed in patients with stroke. Implications for Rehabilitation The Symbol Digit Modalities Test (SDMT), a common measure of information processing speed, showed a substantial practise effect and considerable random measurement error in patients with stroke. The Tablet-based SDMT (T-SDMT) has been developed to reduce the practise effect and random measurement error of the SDMT in patients with stroke. The T-SDMT had smaller practise effect and random measurement error than the SDMT, which can provide more reliable assessments of information processing speed.

Keywords: Information processing speed; Symbol Digit Modalities Test; practise effect; random measurement error; stroke.

Publication types

  • Validation Study

MeSH terms

  • Aged
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Computers, Handheld*
  • Diagnostic Errors*
  • Female
  • Humans
  • Male
  • Mental Processes
  • Middle Aged
  • Neuropsychological Tests*
  • Reproducibility of Results
  • Stroke / complications*
  • Stroke / psychology*
  • Taiwan