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Digital Health App Could Provide Faster, More Accurate Assessment for Patients with MS


The app-based test reduced testing time by approximately 10 minutes.


Nearly 1 million people in the U.S. live with multiple sclerosis (MS). Previous research has found that many common conditions are frequently mistaken for MS.

That’s why researchers at Johns Hopkins Medicine developed a tablet-based app that offers a more accurate way for providers who don’t have specialized training to assess the cognition of patients with MS.

Providers who used the app, called iCAMS, reduced MS test time from about 23 minutes to 14, according to the findings published in International Journal of MS Care.

Researchers compared iCAMS to a standard, paper-based assessment tool and found that the app produced highly accurate results, all while reducing test time by approximately 10 minutes.

"This tablet app makes a tool that is recommended by MS organizations, like the National MS Society and Consortium of MS Centers, more efficient for clinics to administer, thereby raising the standard of care for patients in line with national recommendations," lead author Meghan Beier, Ph.D., assistant professor of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine, said in a statement to Inside Digital Health™.

Paper testing tools, which are used currently, are time consuming and require a trained psychometrist to administer them. And a U.K.-based study showed that only 8% of MS specialists are using validated cognition assessment teams.

So researchers adapted the Brief International Cognitive Assessment for MS, an internationally validated assessment tool, to a digital tablet format. BICAMS measures brain processing speed, the ability to learn verbal information and the ability to learn visual information.

iCAMS uses automatic prompts and written instructions to help providers guide patients through instructions to complete the assessment. The digital version included the BICAMS version of processing and visual learning but used an alternative test to assess verbal learning ability.

The study included 100 adults with a physician-confirmed MS diagnosis from the University of Washington Medicine MS Center. Participants had MS for an average of 10 to 11 years and 78% had relapsing-remitting MS.

Research assistants administered papers and iPad tests to participants. The answers were the same on both the paper and digital tests 93% of the time, validating the accuracy of the app-based test, according to the researchers.

The scoring time for the digital test was 40% shorter than the paper version.

Providers who administered the app-based test reported that it was quick and very easy to learn, according to one medical assistant.

The tablet-based test eliminates the need for paper-based records, which could make it easier to share information on electronic health records, Beier said.

“Our goal is to reduce barriers for patients to receive the testing that may benefit their treatment and health through the use of digital technology,” said co-author Abbey Hughes, Ph.D., assistant professor of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine.

The research team plans for a larger-scale testing of the app in more diverse patient populations.

The study, titled iCAMS: Assessing the Reliability of a BICAMS Tablet Application, can be found here.

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