Assess cognitive performance.

Computer Assessment of Memory and Cognitive Impairment(CAMCI)-Research is a customizable battery of computerized tasks to assess cognitive performance. Computer-administered and self-paced, this investigative tool allows researchers to arrange a protocol of tasks to collect accuracy and reaction time data for comparison to normative data. There are 9 behavioral tasks included in the complete CAMCI-Research battery. Additionally, a series of self-report questions may be presented to gain information from the participant regarding factors that could affect the participant’s performance on the CAMCI-Research tasks (e.g., perceived memory loss, alcohol use, depression, anxiety, etc.).

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CAMCI-Research®

CAMCI-Research is a customizable battery of computerized tasks to assess cognitive performance.  Computer-administered and self-paced, this investigative tool allows researchers to arrange a protocol of tasks to collect accuracy and reaction time data for comparison to normative data.  There are 9 behavioral tasks included in the complete CAMCI-Research battery.  Additionally, a series of self-report questions may be presented to gain information from the patient regarding factors that could affect the patient’s performance on the CAMCI tasks (e.g., perceived memory loss, alcohol use, depression, anxiety, etc.).

CAMCI-Research accurately assesses cognitive performance using standard neuropsychological tests of memory, attention, and executive ability modified for computer administration. Plus – an innovative Virtual Environment task tests domains, such as incidental memory, not easily assessed using paper-pencil tests. Computer-administered tasks ensure standard administration and scoring, avoiding inter-site and inter-examiner variability.

Task Samples

The CAMCI-Research application allows the researcher to design protocols by selecting and arranging tasks to run from the battery provided. The researcher may define instructions to be presented to the examiner prior to or following a test session, or choose to present screens to welcome or dismiss the subject. Customization also allows the researcher to select events to assess the suitability of the computer’s timing for data collection and the accuracy of the input calibration, or to require a security pass code to limit the accessibility to reports after a test session is completed.

Results are available immediately following each test session, including comparison of task measures to age and/or education adjusted normative data. Performance on each CAMCI-Research task is recorded in trial-level and summary task-level data files to allow further, detailed analysis.

Intended Use

The CAMCI-Research product is for research, investigational, or educational use only. CAMCI does not offer a medical diagnosis.

Visit the CAMCI-Research Knowledge Base

CAMCI Features

• Select and reorder tasks to fit your project’s needs
• Create and run multiple protocols within a single project
• Add user-defined session variables
• Complete computer-administered tasks at the subject’s own pace
• Testing requires little to no examiner supervision
• Automatic logging and scoring of accuracy and response time measures per task
• Immediate report availability; compare results to normative data
• View or edit test session results; merge data sets for analysis
• Set security preferences for viewing or accessing data
• Collect data for multiple subjects concurrently

Report Features

• Session variables and values
• Reaction time and accuracy measures per task
• Normative group means and standard deviations per measure
• Task measure z-scores compared to normative data
• User-defined variables and values
• Self-report responses obtained from the subject
• Description of normative data set used for comparison of results

Duration

The length of time to complete depends on the tasks selected by the researcher and the pace of the subject.  During normative data collection, the average time to complete the entire battery of tasks was 25 minutes, with individual tasks ranging from 2-7 minutes to complete.

Benefits

CAMCI takes about 25 minutes to complete.  The tasks are administered via computer, so no task administration training is required. The subject completes the tasks at their own pace, requiring little to no oversight during a test session.  The test runs on a tablet computer allowing greater portability and flexibility than desktop computers. This approach ensures standardized administration and scoring, thus avoiding inter-site and inter-examiner variability. Performance is age and education adjusted (based on normative data) to provide a comprehensive summary score.

Validation

CAMCI has been used in research studies addressing cognitive assessment of primary care patients, intervention in dementia, traumatic brain injury, HIV-related cognitive decline, mobility assessment and exercise interventions, as well as in studies examining the elderly and arthritis, and neurocognitive outcomes following cardiac arrest. Thousands of participants have used the CAMCI with overwhelmingly positive results. A list of studies that have used CAMCI with brief summaries is below:

Sabedra, A.R., Kristan, J., Holm, M.B., Callaway, C.W., Guyette, F.S., Dezfulian, C., Doshi, A.A., Rittenberger, J.C. (2015). Neurocognitive outcomes following successful resuscitation from cardiac arrest. Resuscitation, May;90:67-72.

• Examination of using CAMCI in cardiac arrest survivors to evaluate cognitive injury.

Becker, J., Dew, M., Aizenstein, H., Lopez, O., Morrow, L., & Saxton, J. (2011). Concurrent validity of a computer-based cognitive screening tool for use in adults with HIV disease. AIDS Patient Care and STDs, 25(6), 351-357. doi:10.1089/apc.2011.0051

• The study examined detecting HIV-associated dementia at the earliest possible time by using cognitive screening. The examiners used the Computer Assessment of Mild Cognitive Impairment (CAMCI®) for the testing. The study demonstrated that the CAMCI was sensitive to mild forms of cognitive impairment and was stable over 24 weeks of follow-up.

Elliot, C. (2011). Computerized Cognitive Testing: Screening for Mild Cognitive Impairment (MCI) and Earl Alzheimer’s Disease (p. 61). San Diego, California: MyBrainTest.

• This report describes the leading assessment devices in cognitive assessment including CAMCI. The report lists the cognitive domains tested, total testing time, and supported technology platforms of the cognitive assessments.

Nieto, M., Albert, S., Morrow, L., & Saxton, J. (2008). Cognitive Status and Physical Function in Older African Americans. Journal of the American Geriatrics Society, 56(11), 2014-2019. doi:10.1111/j.1532-5415.2008.01938.x

• The goal of the study was to investigate the relationship between cognition and lower extremity function in elderly African Americans. For the research, CAMCI was used to testattention, verbal memory, and executive function.

Rosenthal, L., Skolasky, R., Moxley, R., Vornbrock Roosa, H., Selnes, O., Eschman, A., … Sacktor, N. (2013). A novel computerized functional assessment for human immunodeficiency virus-associated neurocognitive disorder. Journal of Neurovirology, 19, 432-441. doi:10.1007/s13365-013-0195-5

• The study examined Human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) and CAMCI. The goal was to evaluate CAMCI as a functional assessment tool for HAND. The study showed that CAMCI successfully differentiated HIV+ patients from HIV? individuals.

Saxton, J., Morrow, L., Eschman, A., Archer, G., Luther, J., & Zuccolotto, A. (2009). Computer assessment of mild cognitive impairment. Postgraduate Medicine, 121(2), 177-185. doi:10.3810/pgm.2009.03.1990

• The goal of the study was to examine the sensitivity and specificity of CAMCI compared to the Mini Mental State Examination (MMSE). The study tested 524 non-demented individuals on both CAMCI and the MMSE. The results showed that the MMSE was insensitive to MCI while CAMCI was highly sensitive (86%) and specific (94%) for the identification of mild cognitive impairment.

Snyder, P., Jackson, C., Peterson, R., Khachaturian, A., Kaye, J., Albert, M., & Weintraub, S. (2011). Assessment of cognition in mild cognitive impairment: A comparative study. Alzheimer’s & Dementia, 7(3), 339-355. doi:10.1016/j.jalz.2011.03.009.

• This assessment looked at varying testing batteries for assessing cognition. The authors list CAMCI’s ease of administration, and unique incorporation of a virtual reality assessment as highlights.

Tierney, M., & Lermer, M. (2010). Computerized Cognitive Assessment in Primary Care to Identify Patients with Suspected Cognitive Impairment. Journal of Alzheimer’s Disease, 20(3), 823-832. doi:10.3233/JAD-2010-091672

• This research examined computerized cognitive assessment in primary care. It listed strengths of CAMCI as being the use of both oral and visual instructions, the testing format, use of tasks involving a virtual environment and delayed verbal recall. The study showed the potential for use in primary care.

Technical Support

Technical support is included in your purchase of a CAMCI-Research system and is valid during an active license period.  Included technical support permits up to 6 support tickets within the license period, and is limited to use of the system and trouble-shooting.

Tierney, M.C., Naglie, G., Upshur, R., Moineddin, R., Charles, J., Jaakkimainen, R.L. (2014).  Feasibility and validity of the self-administered computerized assessment of mild cognitive impairment with older primary care patients.  Alzheimer’s Disease and Associated Disorders, Octo-Dec;28(4):311-9.

• Investigation of whether CAMCI could be independently completed by older primary care patients, and determination of optimal cut-off for CAMCI score for mild cognitive impairment against an independent neuropsychological reference standard. Results support the feasibility of using CAMCI with older primary care patients.

Requirements

CAMCI-Research software was validated on and is compatible with Surface Pro 3 and Surface Pro 4 tablet devices using default operating system/configuration settings as recommended by Windows 10. The minimum CAMCI-Research machine configuration is:

• Surface Pro 3 (Minimum)/Surface Pro 4 (Recommended)
• Intel® Core™ i5 CPU
• 1.9 GHz
• 4GB RAM
• Windows 10
• USB 2.0 or 3.0 Port
• Minimum 8GB free disk space

Q: How does CAMCI work?

The CAMCI-Research system consists of the CAMCI software distributed on a USB flash drive. No test administration training required! The CAMCI tasks are computer-administered, and completed by the subjects at their own pace, using a digitized pen, a mouse, or the subject’s finger for input. Data is automatically logged, scored, and compared to normative data.  A summary report provides measures and values per task in a clear and effective report format.  The researcher customizes the selection of tasks to be presented.

Q: What does CAMCI test?

CAMCI-Research includes tests of attention, memory (verbal, non-verbal, functional and incidental), executive function, and processing speed. A virtual environment task provides an innovative approach to testing domains, such as incidental memory, not often assessed by paper-pencil tasks. Self-report questions capture additional information from the participant, such as perceived memory loss and alcohol use, that could influence interpretation of the results.

Q: What can you edit for a test session?

An easy-to-use protocol creation wizard makes it simple to customize your study with the following features:

• Select and arrange tasks within a protocol
• Select mode of input (mouse, pen, touch)
• Add or edit session level variables
• Add and define pre- or post-test instructions for examiners
• Select to present welcome or dismissal screens
• Select form of stimuli from equivalent options
• Assess suitability of computer timing
• Access accuracy of input calibration
• Select security pass code to limit accessibility
• Set location for saving projects and data
• Define volume level for test sessions

Additionally, different forms of the same tasks exist in extended versions. During protocol creation, normative data can be selected for comparison against data collected in the study.

Q: Can experiments be customized?

CAMCI-Research experiments may not be modified.  The CAMCI-Research application allows the researcher to design protocols by selecting and arranging tasks to run from the battery provided. The researcher may define instructions to be presented to the examiner prior to or following a test session, or select to present screens to welcome or dismiss the subject. Customization also allows the researcher to select events to assess the suitability of the computer’s timing for data collection and the accuracy of the input calibration, or to require a security pass code to limit the accessibility to reports after a test session is completed.

Q: Is the test available in languages other than English?

CAMCI-Research is currently only available in US-English. The task instructions and stimuli used in CAMCI-Research are being developed in other languages, but are currently not available.

Q: What tasks are included in the CAMCI battery?

There are 9 behavioral tasks included in the complete CAMCI-Research battery.  Additionally, a series of self-report questions may be presented to gain information from the patient regarding factors that could affect the patient’s performance on the CAMCI tasks (e.g., perceived memory loss, alcohol use, depression, anxiety, etc.).

The Virtual Environment task includes three subtasks; intersection accuracy, recall, ATM accuracy

• Orientation to Date
• Simple Reaction Time
• Digit Span Forward
• Digit Span Reverse
• Go/No Go
• Word Recall
• Verbal Recognition
• Recurring Pictures
• Virtual Environment (including ATM, incidental recall, itemized recall, and decision making)

Q: Are there alternate forms?

There are currently two forms of CAMCI-Research tasks available (Form A and Form B) with base and extended versions.

Q: What normative data is available?

Form A – 60-90+ years

Form B – 60-90+ years

Form A-Extended – 18-59

The CAMCI-Research normative data was collected on a predominantly Caucasian sample of adults, with a minimum education level of 8th grade, living in Western Pennsylvania. Care should be exercised when extrapolating results to other populations. CAMCI has not been validated for use with patients suffering from major psychiatric disorders, such as schizophrenia and bipolar disorder, or for patients having a current diagnosis of dementia or other disorder causing impairment of cognitive ability sufficient to prevent understanding of task instructions.

Q: Are there any non-English versions of CAMCI-Research

CAMCI-Research was developed for distribution within the US and English-speaking areas in Canada.  There are currently no foreign language translations available.

Q: International restrictions

The following should be considered when considering use of CAMCI-Research outside of the US/English-speaking locales:

• All instructions and stimuli are presented in English
• Normative data was collected solely within a US-English speaking population
• Virtual Environment
  • This task simulates a car driving through a series of intersections on a defined path. This may not be particularly appropriate for cultures/environments in which walking is more common.
  • The images used represent a left-side driver position.
• Word Recall/Verbal Recognition
  • Word Recall task was specifically designed to use words composed of three letters. Translation of these words is often not limited to three letters, or even a single word.
  • Selection of words for these tasks and alternate versions included analysis of length, frequency, and imagability. These measures are not likely consistent across languages.

Q: What kind of information does the summary report provide?

CAMCI provides a summary report at the end of the task, including accuracy and response time measures per task run, task measure z-scores as compared to normative data, and group means and standard deviations for the selected normative data set. The report also includes subject demographic data, data for any session level measures collected, and additional information relevant to a test session, including both session notes and subject responses to screening questions.

Q: Can I get a copy/demo of CAMCI?

A demo is available for CAMCI-Research! The evaluation version of CAMCI-Research allows examination of the full system (alternate forms, normative data available, reporting, protocol design) at no charge for 60 days…..So, full functionality for a limited duration.  The shipment includes a user letter, a flash drive with the CAMCI-Research software, a serial number required to activate the license, and the Operator’s Manual. Please contact sales@pstnet.com to obtain an evaluation version.

Q: Are participant’s results kept confidential?

During creation of a protocol, the user may select to require a pass code following a test session, which prevents unauthorized access to data and reports.  This ensures both confidentiality of data and results, and prohibits subjects from viewing their own results after a test session is completed.

Q: Can visual/hearing impaired participants complete a test battery?

CAMCI-Research tasks should not be used by subjects who have uncorrectable visual and/or auditory impairments.  This may prohibit adequate perception of instructions or stimuli. Ultimately, that could potentially have an impact on receiving accurate results for that individual.