Reliability and equivalence of alternate forms for the Symbol Digit Modalities Test: implications for multiple sclerosis clinical trials

Background: Cognitive impairment is common in multiple sclerosis (MS), but is seldom assessed in clinical trials investigating the effects of disease-modifying therapies. The Symbol Digit Modalities Test (SDMT) is a particularly promising tool due to its sensitivity and robust correlation with brain...

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Bibliographic Details
Published in:Multiple sclerosis Vol. 18; no. 9; pp. 1320 - 1325
Main Authors: Benedict, Ralph HB, Smerbeck, Audrey, Parikh, Rajavi, Rodgers, Jonathan, Cadavid, Diego, Erlanger, David
Format: Journal Article
Language:English
Published: London, England SAGE Publications 01.09.2012
Sage Publications
Sage Publications Ltd
Subjects:
Adult
Analysis of Variance
Biological and medical sciences
Cognition
Cognition Disorders - diagnosis
Cognition Disorders - etiology
Cognition Disorders - psychology
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Female
Humans
Male
Medical sciences
Middle Aged
Multiple Sclerosis - complications
Multiple Sclerosis - diagnosis
Multiple Sclerosis - psychology
Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis
Neurology
Neuropsychological Tests
New York
Predictive Value of Tests
Psychometrics
Reproducibility of Results
Research Design
New York
Multiple sclerosis
symptomatic treatment
cognition
outcome measurement
Nervous system diseases
Prognosis
Cognition
Inflammatory disease
Treatment
Equivalence
Central nervous system disease
Clinical trial
Degenerative disease
Reliability
ISSN:1352-4585, 1477-0970, 1477-0970
Online Access:Get full text
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Summary:Background: Cognitive impairment is common in multiple sclerosis (MS), but is seldom assessed in clinical trials investigating the effects of disease-modifying therapies. The Symbol Digit Modalities Test (SDMT) is a particularly promising tool due to its sensitivity and robust correlation with brain magnetic resonance imaging (MRI) and vocational disability. Unfortunately, there are no validated alternate SDMT forms, which are needed to mitigate practice effects. Objective: The aim of the study was to assess the reliability and equivalence of SDMT alternate forms. Methods: Twenty-five healthy participants completed each of five alternate versions of the SDMT – the standard form, two versions from the Rao Brief Repeatable Battery, and two forms specifically designed for this study. Order effects were controlled using a Latin-square research design. Results: All five versions of the SDMT produced mean values within 3 raw score points of one another. Three forms were very consistent, and not different by conservative statistical tests. The SDMT test–retest reliability using these forms was good to excellent, with all r values exceeding 0.80. Conclusions: For the first time, we find good evidence that at least three alternate versions of the SDMT are of equivalent difficulty in healthy adults. The forms are reliable, and can be implemented in clinical trials emphasizing cognitive outcomes.
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ISSN:1352-4585
1477-0970
1477-0970
DOI:10.1177/1352458511435717