Accuracy of Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) when scored by Multiple Sclerosis (MS) healthcare professionals (HCPs) and impact on MS HCPs’ perception of patients’ cognitive impairment.

Hannah Potticary

Research output: ThesisDoctoral Thesis

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Abstract

Cognitive impairment is a common clinical feature of multiple sclerosis (MS) which negatively impacts quality of life, yet it is often overlooked by healthcare professionals (HCPs). The Brief Cognitive Assessment for Multiple Sclerosis (BICAMS) is an international cognitive screening tool for people with MS (PwMS), designed to be utilised as part of routine clinical MS practice by a range of HCPs. The primary aim of the study was to investigate the level of agreement on scoring between a trainee clinical psychologist (TCP) and UK HCPs to confirm feasibility of this measure and thus facilitate its clinical use. Our exploratory aim was to evaluate whether HCPs perceptions of patients’ cognitive impairment change following BICAMS administration and feedback, using the Multiple Sclerosis Neuropsychological Questionnaire-Informant (MSNQ-I) across three time points.

Six HCPs (all female, mean age 51.33) and 18 PwMS (11 females, mean age 51, 12 diagnosed with relapsing-remitting form of MS) took part in the study. HCPs were trained on BICAMS scoring, administration and feedback before completing this assessment with PwMS. HCP scores on BICAMS were checked by the TCP and level of agreement between scorers was analysed using intraclass correlation coefficient (ICC). For the exploratory aim, HCPs completed the MSNQ-I, at three time points, which were interspersed with BICAMS completion and feedback on BICAMS scores. Difference scores between totalled BICAMS z-scores and MSNQ-I z-scores, for the three time points, were compared using repeated measures ANOVA.

The level of agreement between scorers indicated excellent reliability on all three BICAMS subscales (intraclass correlation coefficients: SDMT= 0.999, CVLT-II= 1.000 and BVMT-R= 0.980). No significant change was observed on the statistical accuracy of MSNQ-Is, compared to patient objective cognitive tests scores, across the time points. Future research should aim to acquire a larger sample size to evaluate separately the effects of completing BICAMS and receiving feedback. Our findings suggest that BICAMS is a feasible assessment tool for MS cognition that can be successfully completed by HCPs in routine clinical practice to optimise further monitoring and management.
Original languageEnglish
QualificationPh.D.
Awarding Institution
  • Royal Holloway, University of London
Supervisors/Advisors
  • Langdon, Dawn, Supervisor
Publication statusUnpublished - 2023

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