A New Remote Guided Method for Supervised Web-Based Cognitive Testing to Ensure High-Quality Data: Development and Usability Study

Abstract

Background The global COVID-19 pandemic has triggered a fundamental reexamination of how human psychological research can be conducted safely and robustly in a new era of digital working and physical distancing. Online web-based testing has risen to the forefront as a promising solution for the rapid mass collection of cognitive data without requiring human contact. However, a long-standing debate exists over the data quality and validity of web-based studies. This study examines the opportunities and challenges afforded by the societal shift toward web-based testing and highlights an urgent need to establish a standard data quality assurance framework for online studies. Objective This study aims to develop and validate a new supervised online testing methodology, remote guided testing (RGT). Methods A total of 85 healthy young adults were tested on 10 cognitive tasks assessing executive functioning (flexibility, memory, and inhibition) and learning. Tasks were administered either face-to-face in the laboratory (n=41) or online using remote guided testing (n=44) and delivered using identical web-based platforms (Cambridge Neuropsychological Test Automated Battery, Inquisit, and i-ABC). Data quality was assessed using detailed trial-level measures (missed trials, outlying and excluded responses, and response times) and overall task performance measures. Results The results indicated that, across all data quality and performance measures, RGT data was statistically-equivalent to in-person data collected in the lab (P>.40 for all comparisons). Moreover, RGT participants out-performed the lab group on measured verbal intelligence (P<.001), which could reflect test environment differences, including possible effects of mask-wearing on communication. Conclusions These data suggest that the RGT methodology could help ameliorate concerns regarding online data quality—particularly for studies involving high-risk or rare cohorts—and offer an alternative for collecting high-quality human cognitive data without requiring in-person physical attendance.

In-person versus virtual administration of the American College of Rheumatology gold standard cognitive battery in systemic lupus erythematosus: Are they interchangeable?

“…Future research may find results more comparable if established computerised cognitive batteries, such as the CANTAB® and ANAM, are used instead. 23 Ultimately, the new virtual way of working is likely to remain 24 and future cognitive research needs to ensure accurate testing is available and validated.…”

Validation of a rapid remote digital test for impaired cognition using clinical dementia rating and mini-mental state examination: An observational research study

“…Reliable and easily understood remote digital screening is important for the early detection of cognitive impairment and recruitment to disease-modifying neurodegenerative studies. Digital technologies have the potential to expedite patients' assessment at scale ( 6 ). M-CogScore shows promise as a remote digital solution to replace in-person supervised cognitive screening at scale, especially for the detection of early cognitive impairment ( 7 , 8 ).…”

“…Both the MMSE and CDR additionally require certified administrators to carry out the testing. Telemedicine and digital technologies have been advocated to improve patients' assessment and support ( 6 ). There is therefore an increasing need for remote digital solutions to replace in-person supervised cognitive screening, especially for the detection of early cognitive impairment ( 7 , 8 ).…”

‘Food for Thought’—The Relationship between Diet and Cognition in Breast and Colorectal Cancer Survivors: A Feasibility Study

“…While general instructions were provided to participants to improve the similarity of test conditions, the unsupervised nature of the design relies completely on participants understanding and following instructions, as well as accurately reporting difficulties or impactful events. Future studies using remote/online cognitive assessment may consider including quantitative questions to identify specific distractions/events during test sessions, or where possible, consider supervised or partially supervised remote guided testing to improve data quality [ 37 ]. Despite potential errors arising from the uncontrolled environment, inclusion of objective neurocognitive testing was important to identify feasibility and preliminary associations.…”