The California Cognitive Assessment Battery (CCAB)
IntroductionWe are developing the California Cognitive Assessment Battery (CCAB) to provide neuropsychological assessments to patients who lack test access due to cost, capacity, mobility, and transportation barriers.MethodsThe CCAB consists of 15 non-verbal and 17 verbal subtests normed for telemed...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Human Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnhum.2023.1305529/full |
| _version_ | 1797357449139716096 |
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| author | David Woods Peter Pebler David K. Johnson Timothy Herron Timothy Herron Kat Hall Mike Blank Kristi Geraci Garrett Williams Jas Chok Sandy Lwi Brian Curran Krista Schendel Maria Spinelli Juliana Baldo |
| author_facet | David Woods Peter Pebler David K. Johnson Timothy Herron Timothy Herron Kat Hall Mike Blank Kristi Geraci Garrett Williams Jas Chok Sandy Lwi Brian Curran Krista Schendel Maria Spinelli Juliana Baldo |
| author_sort | David Woods |
| collection | DOAJ |
| description | IntroductionWe are developing the California Cognitive Assessment Battery (CCAB) to provide neuropsychological assessments to patients who lack test access due to cost, capacity, mobility, and transportation barriers.MethodsThe CCAB consists of 15 non-verbal and 17 verbal subtests normed for telemedical assessment. The CCAB runs on calibrated tablet computers over cellular or Wi-Fi connections either in a laboratory or in participants’ homes. Spoken instructions and verbal stimuli are delivered through headphones using naturalistic text-to-speech voices. Verbal responses are scored in real time and recorded and transcribed offline using consensus automatic speech recognition which combines the transcripts from seven commercial ASR engines to produce timestamped transcripts more accurate than those of any single ASR engine. The CCAB is designed for supervised self-administration using a web-browser application, the Examiner. The Examiner permits examiners to record observations, view subtest performance in real time, initiate video chats, and correct potential error conditions (e.g., training and performance failures, etc.,) for multiple participants concurrently.ResultsHere we describe (1) CCAB usability with older (ages 50 to 89) participants; (2) CCAB psychometric properties based on normative data from 415 older participants; (3) Comparisons of the results of at-home vs. in-lab CCAB testing; (4) We also present preliminary analyses of the effects of COVID-19 infection on performance. Mean z-scores averaged over CCAB subtests showed impaired performance of COVID+ compared to COVID- participants after factoring out the contributions of Age, Education, and Gender (AEG). However, inter-cohort differences were no longer significant when performance was analyzed with a comprehensive model that factored out the influences of additional pre-existing demographic factors that distinguished COVID+ and COVID- cohorts (e.g., vocabulary, depression, race, etc.,). In contrast, unlike AEG scores, comprehensive scores correlated significantly with the severity of COVID infection. (5) Finally, we found that scoring models influenced the classification of individual participants with Mild Cognitive Impairment (MCI, z-scores < –1.50) where the comprehensive model accounted for more than twice as much variance as the AEG model and reduced racial bias in MCI classification.DiscussionThe CCAB holds the promise of providing scalable laboratory-quality neurodiagnostic assessments to underserved urban, exurban, and rural populations. |
| first_indexed | 2024-03-08T14:45:14Z |
| format | Article |
| id | doaj.art-a513f1a1bebf46e0a0a760dd461fcdd8 |
| institution | Directory Open Access Journal |
| issn | 1662-5161 |
| language | English |
| last_indexed | 2024-03-08T14:45:14Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Human Neuroscience |
| spelling | doaj.art-a513f1a1bebf46e0a0a760dd461fcdd82024-01-11T13:40:37ZengFrontiers Media S.A.Frontiers in Human Neuroscience1662-51612024-01-011710.3389/fnhum.2023.13055291305529The California Cognitive Assessment Battery (CCAB)David Woods0Peter Pebler1David K. Johnson2Timothy Herron3Timothy Herron4Kat Hall5Mike Blank6Kristi Geraci7Garrett Williams8Jas Chok9Sandy Lwi10Brian Curran11Krista Schendel12Maria Spinelli13Juliana Baldo14NeuroBehavioral Systems Inc., Berkeley, CA, United StatesNeuroBehavioral Systems Inc., Berkeley, CA, United StatesDepartment of Neurology, University of California, Davis, Davis, CA, United StatesNeuroBehavioral Systems Inc., Berkeley, CA, United StatesVA Northern California Health Care System, Martinez, CA, United StatesNeuroBehavioral Systems Inc., Berkeley, CA, United StatesNeuroBehavioral Systems Inc., Berkeley, CA, United StatesNeuroBehavioral Systems Inc., Berkeley, CA, United StatesNeuroBehavioral Systems Inc., Berkeley, CA, United StatesVA Northern California Health Care System, Martinez, CA, United StatesVA Northern California Health Care System, Martinez, CA, United StatesVA Northern California Health Care System, Martinez, CA, United StatesVA Northern California Health Care System, Martinez, CA, United StatesVA Northern California Health Care System, Martinez, CA, United StatesVA Northern California Health Care System, Martinez, CA, United StatesIntroductionWe are developing the California Cognitive Assessment Battery (CCAB) to provide neuropsychological assessments to patients who lack test access due to cost, capacity, mobility, and transportation barriers.MethodsThe CCAB consists of 15 non-verbal and 17 verbal subtests normed for telemedical assessment. The CCAB runs on calibrated tablet computers over cellular or Wi-Fi connections either in a laboratory or in participants’ homes. Spoken instructions and verbal stimuli are delivered through headphones using naturalistic text-to-speech voices. Verbal responses are scored in real time and recorded and transcribed offline using consensus automatic speech recognition which combines the transcripts from seven commercial ASR engines to produce timestamped transcripts more accurate than those of any single ASR engine. The CCAB is designed for supervised self-administration using a web-browser application, the Examiner. The Examiner permits examiners to record observations, view subtest performance in real time, initiate video chats, and correct potential error conditions (e.g., training and performance failures, etc.,) for multiple participants concurrently.ResultsHere we describe (1) CCAB usability with older (ages 50 to 89) participants; (2) CCAB psychometric properties based on normative data from 415 older participants; (3) Comparisons of the results of at-home vs. in-lab CCAB testing; (4) We also present preliminary analyses of the effects of COVID-19 infection on performance. Mean z-scores averaged over CCAB subtests showed impaired performance of COVID+ compared to COVID- participants after factoring out the contributions of Age, Education, and Gender (AEG). However, inter-cohort differences were no longer significant when performance was analyzed with a comprehensive model that factored out the influences of additional pre-existing demographic factors that distinguished COVID+ and COVID- cohorts (e.g., vocabulary, depression, race, etc.,). In contrast, unlike AEG scores, comprehensive scores correlated significantly with the severity of COVID infection. (5) Finally, we found that scoring models influenced the classification of individual participants with Mild Cognitive Impairment (MCI, z-scores < –1.50) where the comprehensive model accounted for more than twice as much variance as the AEG model and reduced racial bias in MCI classification.DiscussionThe CCAB holds the promise of providing scalable laboratory-quality neurodiagnostic assessments to underserved urban, exurban, and rural populations.https://www.frontiersin.org/articles/10.3389/fnhum.2023.1305529/fullmemoryattentionagingexecutive functionautomatic speech recognitionremote assessment |
| spellingShingle | David Woods Peter Pebler David K. Johnson Timothy Herron Timothy Herron Kat Hall Mike Blank Kristi Geraci Garrett Williams Jas Chok Sandy Lwi Brian Curran Krista Schendel Maria Spinelli Juliana Baldo The California Cognitive Assessment Battery (CCAB) Frontiers in Human Neuroscience memory attention aging executive function automatic speech recognition remote assessment |
| title | The California Cognitive Assessment Battery (CCAB) |
| title_full | The California Cognitive Assessment Battery (CCAB) |
| title_fullStr | The California Cognitive Assessment Battery (CCAB) |
| title_full_unstemmed | The California Cognitive Assessment Battery (CCAB) |
| title_short | The California Cognitive Assessment Battery (CCAB) |
| title_sort | california cognitive assessment battery ccab |
| topic | memory attention aging executive function automatic speech recognition remote assessment |
| url | https://www.frontiersin.org/articles/10.3389/fnhum.2023.1305529/full |
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