https://doi.org/10.1177/1352458518813287 https://doi.org/10.1177/1352458518813287 MULTIPLE SCLEROSIS MSJ JOURNAL journals.sagepub.com/home/msj 1 Multiple Sclerosis Journal 1–5 DOI: 10.1177/ 1352458518813287 © The Author(s), 2018. Article reuse guidelines: sagepub.com/journals- permissions Introduction Computerized neuropsychological assessment devices (CNADs) are increasingly utilized to screen for cognitive impairment in multiple sclero- sis (MS) patients. The Symbol Digit Modalities Test (SDMT), 1 widely utilized in tertiary care and clinical trial settings, 2 requires a human interface that may be outside the scope of routine neurologi- cal care. CNADs hold the promise of “automated” protocols, obviating professional oversight. Herein, we tested the hypothesis that technician oversight is necessary for reliable CNAD adminis- tration, using the validated Cleveland Clinic Cognitive Battery (C3B) 3,4 and the Cogstate Brief Battery (CSBB). 5,6 We aimed to assess mean perfor- mance on these batteries under both technician-pre- sent (TP) and technician-absent (TA) conditions. We also gathered qualitative data to identify areas of vulnerability in a self-administered testing environment. Methods A total of 80 MS patients and 28 healthy controls (HCs) were recruited. MS patients had relapsing remitting or secondary progressive course, an Expanded Disability Status Scale score less than 7.0, and no clinical relapses and/or changes to disease modifying therapy within 60 days prior to enrollment. Exclusionary criteria included psychiatric or neuro- logical disorder (aside from MS), developmental dis- ability, alcohol or drug dependence, and medication known to impact cognition. The study was approved by the Institutional Review Board of the University at Buffalo and informed consent was obtained from all participants. From the iPad ® -based C3B we employed the Processing Speed Test (PST) and the Visual Memory Test (VMT). The PST 4 is based on the SDMT and has total correct responses as its primary outcome. The VMT requires subjects to remember the locations of symbols placed on a 4 × 6 checkerboard (see Supplementary material), Necessity of technicians for computerized neuropsychological assessment devices in multiple sclerosis Curtis M Wojcik, Stephen M Rao, Adrian J Schembri, Allison S Drake, Paul Maruff, David Schindler, Jay Alberts, Faizan Yasin, Jeta Pol, Bianca Weinstock-Guttman and Ralph HB Benedict Abstract Objective: Determine the influence of technician supervision on computer-administered cognitive tests in multiple sclerosis (MS). Methods: Eighty MS patients underwent assessment using the CogState Brief Battery (CSBB) and the Cleveland Clinic Cognitive Battery (C3B). Each was administered twice, once with a technician guiding assessment, and once with technician-absent. Twenty-eight healthy controls were also evaluated. Results: The influence of technician guidance was not statistically significant for group means on either test. For CSBB, administration problems were more common in the technician-absent condition. Conclusion: In this MS sample, reliable and valid test results were obtained from computer-assisted cog- nitive testing without technician guidance. Keywords: Multiple sclerosis, neuropsychological tests, cognition, computerized tests, psychometric validity Date received: 12 October 2018; accepted: 17 October 2018 Correspondence to: RHB Benedict Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 1010 Main Street, Buffalo, NY 14202, USA. benedict@buffalo.edu Curtis M Wojcik Allison S Drake Faizan Yasin Jeta Pol Bianca Weinstock-Guttman Ralph HB Benedict Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY, USA Stephen M Rao Schey Center for Cognitive Neuroimaging, Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA Adrian J Schembri Cogstate Limited, Melbourne, VIC, Australia Paul Maruff Cogstate Limited, Melbourne, VIC, Australia/ The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia David Schindler Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA/Qr8 Health, Boston, MA, USA Jay Alberts Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA 813287MSJ 0 0 10.1177/1352458518813287Multiple Sclerosis JournalCM Wojcik, SM Rao brief-report 2018 Short Report