Topics

• Test Battery Home

• Overview

• 8 Cognitive Tests, 3 Domains

• Demonstration Versions

• Test Measurement

• Statistical Validation

• Conclusions

 

OVERVIEW: SCREEN INC.’S TEST BATTERY (CANS-MCI)

Screen’s test battery is named the “Computer-Administered Neuropsychological Screen for Mild Cognitive Impairment” —the CANS-MCI.

The CANS-MCI continues to meets high statistical for validity and reliability.  Reliability is enhanced by limiting the response type to a simple finger touch.  Other tests that are partially self-administered require more elaborate, and therefore less reliable, response methods (e.g. keyboards and even the mouse).  The range of patients who can genuinely self-administer tests is greatly expanded by our user-friendly interactions as well as by the single touch responses.  The CANS-MCI exceeds all practitioner standards (validity, reliability, sensitivity, specificity and ease of use). Automatic item switching allows doctors assessing interventions to re-test every week without practice effects.

 

EIGHT TESTS. THREE COGNITIVE DOMAINS

The CANS-MCI test battery comprehensively measures a person’s cognitive skills in memory, symbol fluency and executive function.

Testing all of these domains enables Screen’s technicians to detect the widest range of cognitive problems and to analyze the test data for patterns that are predictive of Alzheimer’s.

The specific tests embedded within the CANS-MCI that contribute to these three cognitive domains are:

Orientation to Touching (a learning and general reaction time score within the executive function factor);

Word-to-Picture Matching (the recognition latency score is within the executive function factor);

Immediate Free and Guided Object Recall (category-guided memory acquisition);

Design Matching (visual information processing speed, spatial relations, within executive functions);

Clock Hand Placement (symbol fluency);

Stroop (complex mental control and dominant response inhibition, within executive function);

Picture Naming (word generation fluency);

Delayed Free and Guided Object Recall (category-guided memory retention).

 

DEMONSTRATION VERSIONS

If you wish to download a demonstration copy of the actual tests that can be taken with a mouse and does not take over the entire screen or collect data, you can do so for these countries and languages.

If you wish to see the tests in English or Spanish for the USA, please go to US CANS-MCI Demonstration

If you wish to see a beta version of the tests for Canada (English and French), please go to CANS-MCI_Canada_Demo

If you wish to see the Spanish version for Argentina, please go to CANS-MCI_Demonstración

If you wish to see the English version for the UK, please go to CANS-MCI_UK_Demonstration

If you wish to see the Portuguese version for Brazil, please go to CANS-MCI_demonstraçao_Brazil

If you wish to see a multimedia presentation about the CANS-MCI, click this link to download an installer for it. Screen Inc Presentation Installer.  (It is easy to uninstall after you are done with it.)

 

TEST MEASUREMENT

To determine how close the patient’s cognitive abilities are to a sub-group with similar educational backgrounds, the patient’s abilities are measured in eight ways. These results are then compared against the distribution of test results for others having similar education.

In addition, if they have previously taken Screen’s tests, the patient’s past test results are compared to the latest results and plotted over time (longitudinally) so the earliest important cognitive changes can be detected in each of the three cognitive domains. By using longitudinal analyses with scalable test scores, even if the patient’s current test results are within the “normal” range, cognitive declines within that range can be detected—providing early warnings of active decline in high functioning patients.

Taking into account test scores, longitudinal patterns, and other background information (e.g. age, education, depression, pain medication, solvent exposure, alcohol use, head injuries, and exercise), Screen develops an overall probability that, if the patient were tested by the “gold standard” of a full neuropsychological evaluation, it would confirm the presence or absence of MCI. (Note: the “gold standard” referenced here is the full battery of neuropsychological tests that Screen measured itself against in a major study: it was administered by a completely independent neuropsychologist, took hours of face-to-face time and cost approximately $2,000).

 

STATISTICAL VALIDATION OF CANS-MCI

Screen’s test battery, the CANS-MCI, has been shown to be a scientifically valid screening tool. First, the eight cognitive testing tasks used in its test battery have proven to represent strong, independent predictors of subsequent dementia of the Alzheimer's type(1).  As reported in the Journal of Neuropsychiatry and Clinical Neurosciences, (2005), Screen’s test battery was validated through an extensive research study covering over 400 people from all economic, educational and age backgrounds in Western Washington. This study showed that the CANS-MCI was highly reliable and a valid measurement technique when compared to conclusions reached with the more laborious in-person standard measures used by neuropsychologists to detect MCI.

Then, in a separate study(2), Screen explicitly evaluated its test battery against an actual, independent, full neuropsychological exam (the “gold standard” costing $2,000 per patient report) to see if it could accurately predict the people who, when given the full neuropsychological exam, would be classified as having MCI. Although Screen’s test battery only cost a small fraction of the amount, it predicted nearly identically which people would be classified by the gold standard as having MCI or as normally functioning.

Screen’s Test Battery vs. Gold Standard for 2 Education Sub-groups: ROC Analysis

Education Area Under Curve % Sensitivity % Specificity
Less Than 13 Years 1.0 100 100
13 or More Years .96 100 84.8


Over the last two years, the CANS-MCI has been consistently referenced by major journals in articles that covered computer-directed neuropsychological tests. In 2008, in a study that systematically reviewed the top 11 computer-based test batteries that are used to detect cognitive decline in aging populations, independent researchers gave Screen's CANS-MCI test battery the top overall score in all categories assessed.

 

CONCLUSIONS

Screen’s test battery, the CANS-MCI, has proved to be statistically reliable, valid, and easy to use by physicians and patients alike.

Footnotes

Jane B. Tornatore, PhD Emory Hill, PhD Jo Anne Laboff, MSW, “Self-Administered Screening for Mild Cognitive Impairment: Initial Validation of a Computerized Test Battery,” Journal of Neuropsychiatry and Clinical Neurosciences, Volume 17, No. 1, 98-105, Winter, 2005.

Jane B. Tornatore, PhD, Emory Hill, PhD, Jo Anne Laboff, MSW The CANS-MCI: Self-administered Screening for Mild Cognitive Impairment. Alzheimer's and Dementia, 1, Suppl 1, 104, 2005. (Abstract)

Wild K, Howieson D, Webbe F, Seelye A, Kaye J. Status of computerized cognitive testing in aging: a systematic review. Alzheimers Dementia. 2008; 4(6):428–437. Each test battery was rated on the availability of normative data, level of evidence for test validity & reliability, comprehensiveness and usability.