Developing and user-testing the online word colour task to screen for cognitive problems in people with Multiple Sclerosis
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AbstractIntroduction: Cognitive problems affect 40-60% of people with Multiple Sclerosis (pwMS), but are not routinely screened for in MS clinics in the UK due to limited resources (including personnel to deliver cognitive tests) and finances (including payment for such tests). Consequently, those with cognitive problems are not identified early and triaged to receive the appropriate level of support. To address this gap, the NEuRoMS programme (www.neuroms. org) developed a neuropsychological pathway to routinely assess all pwMS attending MS clinics for cognitive problems. The pathway has been implemented in three UK MS clinics and has screened >3000 pwMS. Objectives/Aims: This work presents the iterative design and development process of the Word Colour Task (WCT), a free, online self-administered measure of selective attention and information processing. This has been included in the NEuRoMS cognitive screening pathway to screen pwMS for cognitive problems.
Method(s): We followed an iterative development process and conducted multiple rounds of user testing. Beginning with a prototype based on literature and previous research, we held three stakeholder meetings with Patient and Public Involvement members, researchers and clinicians working with pwMS (n=18) to make design decisions. Following stakeholder feedback, we developed product specifications for a technical team to develop the online WCT. We then tested usability and acceptability through cognitive interviews with eight pwMS and made revisions. A further round of user-testing was undertaken before deployment into the NEuRoMS screening pathway.
Result(s): User testing and cognitive interviews suggested that the WCT was acceptable, but some usability issues were identified (e.g., clarity of instructions, practice mode, repetition of stimuli) and suggestions were made to improve user experiences.
Conclusion(s): Using an iterative design approach with significant and diverse stakeholder input, we were able to develop a robust and usable online cognitive screening assessment tool. The WCT has now been deployed in three MS clinics for feasibility testing having screened 370 pwMS. Validation and norming studies are currently underway to provide further evidence of its psychometric properties and collect UK-based norms.