One of the tasks in need of faster and better quality technology is the evaluation of individuals for evidence of cognitive impairment. Obvious examples include the high school football player who may have had a mild concussion in that last play. He seems generally all right, but a little dazed. Should he be allowed to finish the game, or should he be sent to the emergency room for medical screening? Wouldn’t it be nice if there was a simple, on-the-sidelines screening test for evidence of cognitive impairment?
And what about that 60 year old executive who comes into the office for his routine checkup complaining that he doesn’t feel he is as ‘sharp’ as he used to be, and wonders if he could be getting Alzheimer’s disease? How much time is it going to take to really assess whether his perceived memory impairment is ‘normal for his age’, or if he actually has a greater cognitive deficit than expected? Recently, a computerized, portable testing technology proposes to greatly facilitate the speed and quality of such real-time assessments.
A group of collaborators at Emory University and Georgia Tech published a paper in the Journal of Medical Engineering and Technology about the use of a portable, rapid screening system for neuropsychological testing for mild cognitive impairment. The system, called DETECT(tm), uses a laptop computer and an immersive environment headset to facilitate a 15 minute screening of mTBI (mild Traumatic Brain Injury). Currently, reliable neuropsychological testing requires a quiet environment, trained personnel to administer and score the test, and several hours to complete. The DETECT(tm) (Display Enhanced Testing for Concussions and Traumatic Brain Injury) system uses a special helmet with noise canceling headphones, a built-in visual screen (the quiet environment) and computerized versions of 3 standard cognitive tests which take only 5 minutes each (administered and scored by the computer software, so no trained personnel are necessary). User input has also been simplified to just two buttons, one for each hand, for ‘Yes’ or ‘No’ responses. Click here or on the picture below to see a video of the Detect(tm) system in use for sports injuries.
Likewise, the system has been used to detect early cognition impairment in Alzheimer-type dementia. With our aging population, the need for better, faster and more reliable screening is imperative. The currently available rapid screening tools (the Mini-Mental State Exam and ‘Clock Drawing test‘) leave much to be desired, especially if the degree of impairment is mild. Right now, more accurate screening can take trained personnel one or two an hours to accomplish. If this, or similar systems could be engineered so that a nurse or medical assistant could operate the device to complete an accurate screening score in 10 or 15 minutes, patients, families and medical professionals would truly welcome the advance. Click on the picture below to see the DETECT(tm) System being used in a clinic setting at Georgia Tech.
Such a system could greatly enhance the ability to detect and (possibly) intervene in cases of mild cognitive impairment by improving the speed and accuracy of diagnosis. The details of the research and specifics of the ‘off the shelf ‘ equipment used are available from the journal article here. A commercial product using this technology is under development by Zenda Technologies. Availability is anticipated in the summer of 2008.
There is never enough time to do the things we know we should do. So, we keep trying to find faster, more reliable ways to do things. That is why we adopt certain technologies and not others. If it improves the quality of the effort and reduces the time required, we will adopt it. If a technology improves the quality but greatly increases the time needed for the task, or if the time needed for the task is reduced, but the quality suffers, the technology will end up failing us. Of course, the costs and resources required by a technology are clearly important, but are lesser imperatives than speed and improved performance if the technology is to succeed. This one looks like it has a shot..