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@ARTICLE{Schaper:283049,
      author       = {Schaper, Philipp and Hanke, Alexander and Jonas, Stephan
                      and Nissen, Leon and Reimer, Lara Marie and Schweizer,
                      Florian and Wagner, Michael and Rolke, Kristin and
                      Rosendahl, Carolin and Tillmann, Judith and Weckbecker,
                      Klaus and Thyrian, Jochen René},
      title        = {{U}sability of a {T}ablet-{B}ased {C}ognitive {A}ssessment
                      {A}dministered by {M}edical {A}ssistants in {G}eneral
                      {P}ractice: {I}mplementation {S}tudy.},
      journal      = {JMIR formative research},
      volume       = {9},
      issn         = {2561-326X},
      address      = {Toronto},
      publisher    = {JMIR Publications},
      reportid     = {DZNE-2025-01456},
      pages        = {e76010},
      year         = {2025},
      abstract     = {Digital short cognitive tests administered by medical
                      assistants (MAs) in general practitioners' (GPs) practices
                      have great potential for the timely identification of
                      patients with dementia, because they can lead to targeted
                      specialist referrals or to immediate reassurance of patients
                      regarding their perceived concerns. However, integration of
                      this testing approach into clinical practice requires good
                      usability for the test itself, especially for cognitively
                      impaired older adults.In this implementation study, the
                      digital version of the Montreal Cognitive Assessment (MoCA)
                      Duo was conducted by MAs in general practice. We tested if
                      the interaction with the test is associated with usability
                      problems for the patients and aimed to find additional
                      relevant constructs that should be considered for the
                      potential implementation of such digital tests into clinical
                      practice. We focused the study on subjective success,
                      usability, and workload as well as their association with
                      the result of the cognitive test to assess whether the MoCA
                      Duo can be implemented into general practice.In total, 10
                      GPs took part in the study. Within their practices, 299 GP
                      patients (aged 51-97 years) with cognitive concerns
                      completed the MoCA Duo administered by MAs. Subsequently,
                      patients and MAs completed digital questionnaires regarding
                      the interaction with the app. Usability was measured using
                      the adapted System Usability Scale, and perceived workload
                      using the National Aeronautics and Space Administration Task
                      Load Index. For the perceived workload, we included an
                      assessment of the patient by the MA. Results of the MoCA Duo
                      were supplied to the GPs for their consultation with the
                      patient.The results indicated good usability for the MoCA
                      Duo. Self-assessment by the patients indicated that $64\%$
                      (191/299) could perform in the test to the best of their
                      ability, affected by their MoCA score. We found significant
                      higher usability ratings by patients with better MoCA scores
                      as well as by younger patients. Furthermore, the perceived
                      workload showed overall medium workload. We found
                      significant correlations between the subjective perceived
                      workload of the patients and the assessment by MAs.
                      Self-assessments as well as assessments by the MAs were
                      significantly influenced by the MoCA scores and the age of
                      the participants.The results indicate good usability of the
                      digital MoCA within the sample, supporting the idea that the
                      resulting scores are adequate to assess cognitive status
                      without dependence on technological affinity. Furthermore,
                      the results highlight the relevance of heterogenous samples
                      for comparable evaluation studies, based on the significant
                      effect of cognitive status and age on usability and
                      workload.},
      keywords     = {Humans / Male / Female / Aged / Middle Aged / Computers,
                      Handheld: statistics $\&$ numerical data / Aged, 80 and over
                      / General Practice: methods / Mental Status and Dementia
                      Tests / Surveys and Questionnaires / Cognitive Dysfunction:
                      diagnosis / Dementia: diagnosis / Workload / Physician
                      Assistants / General Practitioners / MoCA (Other) / Montreal
                      Cognitive Assessment (Other) / computerized assessment
                      (Other) / dementia (Other) / digital assessment (Other) /
                      digital platform (Other) / mild cognitive impairment
                      (Other)},
      cin          = {AG Thyrian},
      ddc          = {610},
      cid          = {I:(DE-2719)1510800},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41429419},
      doi          = {10.2196/76010},
      url          = {https://pub.dzne.de/record/283049},
}