Abstract P4-09-09: Internationalization of the Amsterdam cognition scan: A validated set of online cognitive tests for (neuro-)oncological studies
Authors: Kjoe Philippe Lee Meeuw , van der Wall Elsken , Schagen Sanne 
Published: March 2022

Abstract
Background: Studies show that breast cancer (BC) patients treated with systemic therapy may develop cognitive problems. More research is needed to better define the incidence, determinants and risk factors for cognitive problems, as well as targets for interventions. The Amsterdam Cognition Scan (ACS) was developed to facilitate this research. The ACS is a set of reliable and validated online neuropsychological tests that can be completed by patients at home without supervision. It measures a broad spectrum of cognitive domains including attention, memory, and executive functioning. The ACS currently runs in more than 15 oncological (observational and intervention) studies. To enable wider international application of the ACS, we developed international versions of the ACS (US, UK, Swedish and Danish). For this purpose, we created cross-lingual word criteria to measure learning and memory in a similar manner across studies. In another project, we examined the validity of the US version of the ACS. Project 1: Development of standardized word criteria: Aim: For translations of the verbal memory task of the ACS, we presented cross-lingual word criteria. Methods: We identified word criteria and developed a new Dutch word list for the memory task. Bayesian correlations and analyses of variance were conducted to compare the new word list with the traditional Dutch version of the memory task on trial scores and serial-position effects. Additionally, we compared the proportions of correct responses per item, corrected for serial-position. Results: We found similar trial scores, serial-position effects and proportions of correct responses per item corrected for serial-position in the new and traditional Dutch word list. Conclusion: Application of the word criteria led to a comparable word list to the word list of the traditional Dutch memory task. Item-level analyses provided concrete leads for direct improvement of the word list. The availability of word criteria will improve (inter)national standardization of one of the most frequently used neuropsychological tests. Project 2: Validation of American-English version of the ACS: Aim: We examined the usability and validity of the US version of the ACS in a group of North American non-CNS cancer patients. Methods: Based on the Dutch ACS, we developed the ACS-US. Concurrent validity was studied in 35 cancer patients (54% female; mean age 57.1 (SD=10.6) years) who completed both the ACS and equivalent traditional neuropsychological tests. Correlations were used to assess consistency between online and traditional tests. Results were compared to those of a previously performed Dutch validation study. Usability was assessed based on online debriefing and technical reports. Results: Concurrent validity of the ACS-US was moderately-high to high, similar to the Dutch ACS. The usability was excellent, instructions and practice were rated as clear. Conclusion: The ACS-US is ready for use. In the near future, normative data will be collected. Future directions: To enable incorporation of the ACS in BC studies worldwide, additional language versions of the ACS will continue to be developed. The ACS will include parallel versions of tests for repeated (longitudinal) testing and normative data will be collected for each language area separately. The ACS is a patient-friendly, cost-efficient, reliable and validated test battery that can be easily implemented in BC trials, and that can assist in answering important questions on the impact of BC and its treatment on the cognitive functioning of our patients.
Citation Format: Philippe Lee Meeuw Kjoe, Elsken van der Wall, Sanne Schagen. Internationalization of the Amsterdam cognition scan: A validated set of online cognitive tests for (neuro-)oncological studies [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-09-09.