Abstract:BackgroundNeurocognitive impairment (NCI) is one of the most common complications of HIV infection, and has serious medical and functional consequences. South Africa has 7 million people living with HIV (PLHIV) with up to three-quarters of antiretroviral therapy (ART)-naïve individuals having NCI. South Africa’s health system struggles to meet the care needs of its millions of PLHIV; screening for NCI is typically neglected due to limited clinical staff trained to administer, score, and interpret neuropsycholo… Show more
“…This raises concern about the clinical utility of these measures in LMICs, where there are few specialized staff ( Evans-Lacko et al, 2019 ; Mugisha et al, 2017 ; Semrau et al, 2015 ). mHealth apps may be more cost-efficient and feasible for delivery by non-specialized staff ( Istepanian et al, 2004 ; Nicholas et al, n.d. ; Robbins et al, 2018 ). Evidence suggests that tests delivered via mHealth applications are more efficient, accurate, accessible and interactive than assessments delivered via pen and paper ( Bakkour et al, 2014 ).…”
Introduction
Several studies of neuropsychological measures have been undertaken in patients with psychotic disorders from low- and middle-income countries (LMICs). It is, however, unclear if the measures used in these studies are appropriate for cognitive screening in clinical settings. We undertook a systematic review to determine if measures investigated in research on psychotic disorders in LMICs meet the clinical utility criteria proposed by The Working Group on Screening and Assessment.
Methods
Preferred Reporting Items for Systematic Reviews and Meta-Analyses were employed. We determined if tests had been validated against a comprehensive test battery, the duration and scope of the tests, the personnel administering the tests, and the means of administration.
Results
A total of 31 articles were included in the review, of which 11 were from Africa. The studies included 3254 participants with psychosis and 1331 controls. 3 studies reported on the validation of the test against a comprehensive cognitive battery. Assessments took 1 h or less to administer in 6/31 studies. The average number of cognitive domains assessed was four. Nonspecialized staff were used in only 3/31 studies, and most studies used pen and paper tests (17/31).
Conclusion
Neuropsychological measures used in research on psychotic disorders in LMICs typically do not meet the Working Group on Screening and Assessment clinical utility criteria for cognitive screening. Measures that have been validated in high-income countries but not in LMICs that do meet these criteria, such as the Brief Assessment of Cognition in Schizophrenia, therefore deserve further study in LMIC settings.
“…This raises concern about the clinical utility of these measures in LMICs, where there are few specialized staff ( Evans-Lacko et al, 2019 ; Mugisha et al, 2017 ; Semrau et al, 2015 ). mHealth apps may be more cost-efficient and feasible for delivery by non-specialized staff ( Istepanian et al, 2004 ; Nicholas et al, n.d. ; Robbins et al, 2018 ). Evidence suggests that tests delivered via mHealth applications are more efficient, accurate, accessible and interactive than assessments delivered via pen and paper ( Bakkour et al, 2014 ).…”
Introduction
Several studies of neuropsychological measures have been undertaken in patients with psychotic disorders from low- and middle-income countries (LMICs). It is, however, unclear if the measures used in these studies are appropriate for cognitive screening in clinical settings. We undertook a systematic review to determine if measures investigated in research on psychotic disorders in LMICs meet the clinical utility criteria proposed by The Working Group on Screening and Assessment.
Methods
Preferred Reporting Items for Systematic Reviews and Meta-Analyses were employed. We determined if tests had been validated against a comprehensive test battery, the duration and scope of the tests, the personnel administering the tests, and the means of administration.
Results
A total of 31 articles were included in the review, of which 11 were from Africa. The studies included 3254 participants with psychosis and 1331 controls. 3 studies reported on the validation of the test against a comprehensive cognitive battery. Assessments took 1 h or less to administer in 6/31 studies. The average number of cognitive domains assessed was four. Nonspecialized staff were used in only 3/31 studies, and most studies used pen and paper tests (17/31).
Conclusion
Neuropsychological measures used in research on psychotic disorders in LMICs typically do not meet the Working Group on Screening and Assessment clinical utility criteria for cognitive screening. Measures that have been validated in high-income countries but not in LMICs that do meet these criteria, such as the Brief Assessment of Cognition in Schizophrenia, therefore deserve further study in LMIC settings.
“…Sixteen studies were excluded from the present systematic review because they did not use mobile applications to train cognitive functions [20,43,[52][53][54][55][56][44][45][46][47][48][49][50][51]. Eleven studies were excluded because they used mobile applications only to assess -and not to train -cognitive functions [57,58,67,[59][60][61][62][63][64][65][66]. Our eleven selected studies focus on the cognitive domains of attention, memory, problem solving, cognitive control, executive function, visuospatial function, and language (as reported in Table 1).…”
BackgroundBreast cancer is an invalidating disease and, in particular, its treatment can bring serious side effects that have a physical and psychological impact as well. Specifically, cancer's treatment generally has a strong impact on cognitive function. In the last years, new technologies and eHealth had proved to have a growing influence on health care and innovative mobile applications can be a useful tool to deliver cognitive exercise in the patient's home.
“…As part of a larger research study (Robbins et al, 2018), 112 Black South African adult isiXhosa first language speakers (49% men) were recruited from a peri-urban primary healthcare clinic in Cape Town, South Africa. Inclusion criteria were: 1) HIV-negative status; 2) age 18 years or older; 3) isiXhosa-speaking; and 4) capacity for informed consent.…”
Section: Participantsmentioning
confidence: 99%
“…The isiXhosa version was originally used in studies characterizing the prevalence of HIV-Associated Neurocognitive Disorders (HAND) among HIV+ South African adults (Joska et al, 2011;Joska et al, 2012). More recently, the isiXhosa version of the HVLT-R has been used as part of a neuropsychological test battery to compare with a new tablet-based screening test to detect neurocognitive impairment in this population (Robbins et al, 2018). However, most adaptations of the HVLT-R, including the isiXhosa variant, have not reported on multiple, important linguistic and demographic characteristics known to influence test performance.…”
The Hopkins Verbal Learning Test-Revised (HVLT-R) has been adapted for use in many different languages and in low-and middle-income countries. However, few adaptations have evaluated performance differences between home-and acquired-language administrations. The present study examined performance on an adapted HVLT-R between multilingual South Africans who chose to be tested in a home or acquired language. The HVLT-R was administered to 112 multilingual, isiXhosa as home language, Black South African adults (49% men) with no major medical, neurological, or psychiatric problems. Sixty-one preferred to take the test in isiXhosa and 51 preferred English. We examined between-language differences in word equivalency, primary scores, learning indices, and serial position effects. We also examined language, age, education, and gender on test performance. English-examinees were significantly younger and more educated than isiXhosa-examinees (p's<.05). Although isiXhosa words had more letters and syllables than English words (p's <.001), there were no significant differences between groups on HVLT-R performance or serial recall (p's>.05). More education and being a woman predicted better Total and Delayed Recall (p's<.05). Performance on this modified HVLT-R appears similar between English and isiXhosa administrations among South African isiXhosa first language speakers, which makes comparisons between preferred language administrations appropriate.
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