U.S. patent application number 10/809443 was filed with the patent office on 2005-06-30 for high-precision cognitive performance test battery suitable for internet and non-internet use.
Invention is credited to Martin, Rolf John.
Application Number | 20050142523 10/809443 |
Document ID | / |
Family ID | 28456811 |
Filed Date | 2005-06-30 |
United States Patent
Application |
20050142523 |
Kind Code |
A1 |
Martin, Rolf John |
June 30, 2005 |
High-precision cognitive performance test battery suitable for
internet and non-internet use
Abstract
A system and method for internet-based cognitive performance
measurement is provided. Furthermore, a method is provided whereby
improvements in statistical accuracy is obtained.
Inventors: |
Martin, Rolf John; (Sherman,
CT) |
Correspondence
Address: |
CONNOLLY BOVE LODGE & HUTZ LLP
SUITE 800
1990 M STREET NW
WASHINGTON
DC
20036-3425
US
|
Family ID: |
28456811 |
Appl. No.: |
10/809443 |
Filed: |
March 26, 2004 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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10809443 |
Mar 26, 2004 |
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09861768 |
May 22, 2001 |
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6712615 |
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60206072 |
May 22, 2000 |
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Current U.S.
Class: |
434/236 |
Current CPC
Class: |
G09B 5/00 20130101; G09B
7/00 20130101; G09B 19/0092 20130101 |
Class at
Publication: |
434/236 |
International
Class: |
G09B 019/00 |
Claims
1-116. (canceled)
117. A computer based method for testing the cognitive performance
of at least one examinee comprising; providing to at least one
examinee at least one measurement-session comprising a plurality of
response-series comprising a plurality of responses; and providing
a computer-generated instruction that said examinee respond rapidly
to a test stimulus so that at least a minimum number of errors is
made:
118. The computer based method for testing the cognitive
performance of at least one exaninee, according to claim 117,
wherein said instruction is provided prior to a
response-series.
119. The computer based method for testing the cognitive
performance of at least one examinee, according to claim 117,
further comprising: determining a number of errors made by said
examinee in a response-series; and displaying a computer-generated
instruction to increase a response speed of said examinee when said
number of errors is less than a minimum number of errors within
said response-series.
120. The computer based method for testing the cognitive
performance of at least one examinee, according to claim 117,
wherein said response-series comprises from about 15 to about 30
responses.
121. The computer based method for testing the cognitive
performance of at least one examinee, according to claim 117,
wherein said minimum number of errors is an integer selected from
the group consisting of 1,2,3,4, and 5.
122. The computer based method for testing the cognitive
performance of at least one examinee, according to claim 117,
wherein said minimum number of errors is from about 10% to about
20% of said responses.
123. The computer-based method for measuring the cognitive
performance of at least one examinee, according to claim 117,
further comprising displaying a warning message when a
response-series includes less than said minimum number of errors,
wherein said warning instructs said examinee to proceed more
rapidly during remaining response-series within said
measurement-session.
124. A computer based method for testing the cognitive performance
of at least one examinee comprising: reading at least one word
input by an examinee; determining a performance score by said
examinee; and correlating said score with said at least one
health-related word.
125. The computer based method for testing the cognitive
performance of at least one examinee, according to claim 124,
further comprising: ranking said words by a magnitude of change of
said performance score after input of said word.
126. The computer based method for testing the cognitive
performance of at least one examinee, according to claim 124,
further comprising: determining at least one time period after
input of said word; correlating said word and performance in said
at least one time period.
127. The computer based method for testing the cognitive
performance of at least one examinee, according to claim 124,
further comprising: displaying a list of words input by said
examinee; and displaying for each said word a correlation between
said word and a change of said performance score for said
examinee.
128. The computer based method for measuring the cognitive
performance of at least one examinee, according to claim 126,
wherein said correlation comprises a function including a time
differential between an input of a word and a performance
score.
129. The computer-based method for measuring the cognitive
performance of at least one examinee, according to claim 125,
further comprising: providing said examinee with a list of words
rated by their correlation with positive changes in performance;
and providing said examinee an explanation that words given highest
ratings are most likely to represent beneficial foods and other
health-related items.
130. The computer-based method for measuring the cognitive
performance of at least one examinee, according to claim 124,
further comprising: providing said examinee with means to obtain a
health rating for any word entered at the time of measurement.
131. The computer-based method for measuring the cognitive
performance of at least one examinee, according to claim 124,
further comprising: providing first and second health ratings for
each said word; and providing said examinee with means to obtain
each said first and second healthy ratings.
132. The computer-based method for measuring the cognitive
performance of at least one examinee, according to claim 124,
further comprising: providing said examinee with means to search
for said entered words with the highest and lowest health
ratings.
133. The computer-based method for measuring the cognitive
performance of at least one examinee, according to claim 123,
further comprising: providing said examinee with means to obtain a
health rating for any word combination by concatenating words
within the combination.
134. A computer-based method for word analysis comprising:
providing a user with means to obtain a ranking of at least one
previously-input word; and ranking said at least one word by a
health or performance change subsequent to said input.
135. The computer-based method for word analysis, according to
claim 134, wherein said at least one word is selected from the
group of words consisting words describing health-factors,
performance factors, and cognitive factors.
136. The computer-based method for measuring the cognitive
performance of at least one examinee, according to claim 134,
further comprising: providing said examinee with means to select a
time-period covered by the analysis.
Description
TECHNICAL FIELD
[0001] The present invention relates generally to a system and
method for internet-based cognitive performance testing.
BACKGROUND OF THE INVENTION
[0002] Systems and methods for computer based testing (CBT) are
known to the art. For example U.S. Pat. No. 5,827,070 to Kershaw et
al. discloses CBT means for administration of standardized test,
e.g. SATs, LSAT, GMATs, etc. The system and method of Kershaw et
al. does not depend on the speed and accuracy of the individual
examinee's keystroke responses to the test stimuli. Lewis et al.
(U.S. Pat. No. 5,059,127) disclose a computerized mastery testing
system providing for the computerized implementation of sequential
testing. This disclosure also does not relate to the speed and
accuracy of the individual examinee's keystroke responses to the
test stimuli. Swanson et al. (U.S. Pat. No. 5,657,256) disclose a
method and apparatus for administration of computerized adaptive
tests. Swanson is similarly unconcerned about the examinee response
time.
[0003] When people measure their response time, recall or other
cognitive skills using computer-based test systems, they typically
press number or letter keys (or keys representing other symbols
like circles and squares) in response to visual or auditory or
other sensory signals presented to them. The average time they take
to press the correct keys is their response time.
[0004] This type of measurement is subject to a number of errors
that make response time results relatively imprecise. The effects
of recent foods and beverages, medicines, amount of sleep and other
factors that affect alertness or drowsiness all influence response
speed and accuracy, so that measurements on any single day may not
represent actual average performance level.
[0005] A key source of measurement error is change in motivation to
respond quickly. One day a person may try quite hard to reduce
their response speed. The next day they may relax and perform more
slowly simply because they care less about their "score" that day.
Typically the error rate increases (incorrect responses are made
more frequently) when people try harder to react quickly.
Investigators commonly measure error rate to determine the
"response speed/accuracy tradeoff" for each person or group of
people.
[0006] While the response speed/accuracy tradeoff is usually
discussed in connection with relatively simple responses, a similar
tradeoff can occur during memory measurements when speed is only a
secondary consideration. Response speed is intrinsically linked
with recall accuracy because transient memory traces fade if the
response (e.g. typing a list of words) is not completed
rapidly.
[0007] Response speed may also vary from second to second and
minute to minute as a result of boredom with the test, short-term
fatigue from repeated motion, eye strain from staring at the
computer screen, and stimulus patterns that confuse the user and
cause response errors. Different types of transitions such as
shifts between responses involving one hand and the other, or one
finger and the corresponding finger on the other hand, can also
affect response speed and accuracy for individual responses.
[0008] All of these factors together make precise performance
measurement all but impossible. Even under controlled laboratory
conditions, the correlation between test scores on one occasion and
scores by the same individuals at a later time, averages only 0.63
(Salthouse & Babcock, 1991; Lowe & Rabbitt, 1998; Versavel
et al., 1997; Wetherell, 1996). In other words, performance results
can vary by plus or minus 20% from one day or week to the next.
[0009] The correlation between test results on separate days,
called "test-retest reliability," is perhaps the most widely used
indicator of measurement reliability. The average value of 0.63 has
not changed appreciably during the last two decades, indicating
that attempts to improve measurement reliability have generally met
with little success.
[0010] Perhaps the best way to describe the need for measurement
precision, and the need for this invention, is to discuss the
circumstances of an individual who participated in a recent study
to determine whether blueberries can reduce multiple sclerosis
symptoms (Pappas et al., 2001).
[0011] SF is one of hundreds of thousands of people in the U.S. who
have chronic, neurodegenerative diseases for which there is no
cure. He cannot drive and cannot find work because his coordination
and memory are affected. He must sell the home he, his wife and
children live in because they need the money for his medical and
dental expenses. His relatively expensive medicines give no
apparent benefit. The medicines do however dry his mouth and cause
his teeth to crack, causing him to lose three teeth during the last
several months. Concerned about his dental bills, SF asked his
dentist to remove his remaining teeth so he would not have to pay
to have them repaired when he would lose them anyway. (His dentist
refused.) His physician advised him to take a recommended
performance test battery just once a year because he cannot afford
the cost of more frequent evaluations. He must therefore wait for
very long periods of time before obtaining objective evidence that
his medications are or are not helping him--time he can ill afford
since his disease is growing steadily worse. And of course after
such long waiting periods, any performance benefits provided by his
medications may be cancelled by the steady decline from his chronic
illness.
[0012] SF can expect to decline at a rate which reduces his
performance scores by roughly 4% to 10% each year. If his medicines
are effective, his annual decline may be decreased by half a
percentage point or perhaps several percentage points--however he
most probably cannot measure this benefit because once-a-year
testing is not accurate enough to measure changes smaller than 5%.
Once-a-year testing will always be incapable of measuring changes
of 5% or less simply because he may perform 5% or 10% better or
worse than his average on the day when measurement is
performed.
[0013] So the test results for which SF must wait so long, and pay
so much for, are largely worthless to him and his physician since
they will not be precise enough to indicate whether his medicines
helped him.
[0014] SF clearly needs, and many thousands of other people in
similar circumstances need, a test system that is accurate to
within 1% or 2% so that effective treatments can be identified. He
also needs a measurement system that is far less expensive than
that recommended by his physician, so that he can obtain results
many times each year. And he needs a test that can be taken at
home, so that he is spared the effort and/or the cost of
transportation to a test center.
[0015] For these and many other reasons, there is a clear need for
increased measurement precision
[0016] One strategy used by scientists seeking greater precision is
to reduce response time variability by discarding high and low
responses within each test or test series. For example, the slowest
half and the fastest quarter of response times may be discarded
from each 30 seconds of testing, and the average of the remaining
data obtained.
[0017] This type of data trimming certainly reduces
variability--but it also reduces the amount of useable data and
therefore reduces measurement precision, which is related to the
amount of data. (As a general rule, precision is directly
proportional to the square root of the number of data points, if
approximately random variation is the cause of imprecision.)
[0018] Discarding high response times also prevents or sharply
reduces the accuracy with which benefits or harm from different
health strategies can be measured if performance changes occur
primarily within the response times that are discarded. This
occurred recently during an Danbury MS Blueberry Study (Pappas et
al, 2001). Very slow response times were markedly reduced after
blueberry consumption for many study participants, however this was
not evident from trimmed data sets, from which all slow responses
had been removed. Only when raw data was examined did the principal
investigator see this benefit.
[0019] Scientists have also attempted to reduce measurement error
by reducing practice effects that occur when examinees take the
same or similar tests repeatedly. Gradual improvement due to
practice is different for each individual and even for each type of
response for each individual. Such gradual improvement can mask
benefits of medication or other health strategies, or can mask harm
due to exposure to pollutants, fatigue, etc.
[0020] To reduce practice effects, investigators have asked
examinees to take tests many dozens of times, so that the learning
period can be passed and further improvement due to practice will
not occur. This practice-until-no-more-improvement-occurs strategy
was not generally successful since improvement typically occurs
over hundreds or even thousands of responses. This strategy is of
course impractical for people like SF when the expense and effort
of travel and testing are high. There is a clear need for test
methods that reduce or eliminate practice effects.
[0021] Measurement precision and test-retest reliability has for
the most part been ignored by inventors interested in reaction time
and memory measurement. Only two previously patented performance
measurement methods related to "reaction time" have explicitly
addressed the issue of test-retest reliability and measurement
precision. None have evidently attempted to determine the precision
with which response time measurements are made.
[0022] Wurtman (1984) obtained a test-retest reliability of
0.65-0.74 when evaluating an amino acid mixture for improving vigor
and mood in normal human patients, however the method used to
obtain this test-retest reliability was not the subject of his
patent.
[0023] Using an electroencephalogram-based, computer-aided training
method and 4 examinees, Gevins et al (1998) obtained an average
"test set classification" of 95% (range 92%-99%) calculated by a
trained pattern-recognition network. Their "test-retest
reliability" computation algorithm apparently had little to do with
the (Pearson) correlation coefficient commonly used to determine
test-retest reliability values. Their use of the phrase
"test-retest reliability" illustrates the difficulty that can arise
when a term used to define measurement precision is given different
meanings by different investigators.
[0024] Rimland (1988; U.S. Pat. No. 4,755,140) describes a
hand-held reaction time test but does not determine either
test-retest reliability or the precision with which reaction time
is measured. His device that employs no signal sequence
restrictions and other apparent methods for improving
precision.
[0025] Reynolds et al. (1999; U.S. Pat. No. 5,991,581) developed an
interactive computer program for measuring mental ability that
automatically adjusts task complexity and selects letters or
symbols with equal probability. No discussion of performance
measurement precision or test-retest reliability is provided, and
there is no determination of the precision with which response time
measurements are made.
[0026] Buschke (1988; U.S. Pat. No. 4,770,636) describes a memory
monitor that produces challenge signals 7 or 10 digits in length.
He mentions no signal sequence restrictions that might improve
measurement precision. His choice of 7 or 10 digit sequences quite
likely results in frustration for individuals who cannot handle
such long numbers and reduced precision for individuals who can
handle 10 digits readily. His use of punctuation after three-digit
segments within these longer sequences appears to be a step in the
right direction since it will promote consistent "chunking" of
signals within and between data sets.
[0027] Buschke's 1993 "cognitive speedometer" (1993; U.S. Pat. No.
5,230,629) involves relatively sophisticated control measurements
but also does not determine measurement precision or employ
signal-sequence restrictions. He does attempt to control the
speed-accuracy ratio by keeping errors below an upper limit but
does not ask examinee's to proceed quickly enough to make at least
a minimum number of errors. This allows considerable response speed
variability since examinee's may relax or proceed with greater
vigor from time to time, without ever exceeding or even approaching
his permitted level of errors.
[0028] Perelli (1984; U.S. Pat. No. 4,464,121) has developed a
portable device for measuring fatigue effects that he did not
determine test-retest reliability or measurement precision. He does
however increase precision by blocking challenge signal repetition.
No two signals in a row can be identical. His motivation for this
restriction was not to improve measurement precision but to clearly
indicate each new trial. Nevertheless his restriction is important
since it removes trials where the signal is the same as that just
presented, and therefore prevents examinees from responding more
quickly to such signals than to others and therefore reduces
variability among response times and increases measurement
precision. He also does not encourage examinees to proceed quickly
enough to make a minimum acceptable number of errors and therefore
allows more response speed variability than optimal.
[0029] Keller's response speed and accuracy measurement device
(1992; U.S. Pat. No. 5,079,726) also does not allow the same digit
twice in a row within each 5 digit signal, and several other
restrictions are also imposed. 5-digit signals cannot begin with
the number 1. Adjacent sequential digits are forbidden. And no
digit may be used twice within the same 5-digit signal. He does not
however place any restrictions on the frequency of digits or
transitions between digits over a series of signals. Thus he
permits one digit, say the number 2, to appear a disproportionate
amount of the time during a series of measurements. If an examinee
is especially fast or slow when pressing 2, his or her average
response times will be reduced or elevated in comparison to other
measurement sessions, response time variability will be increased
and measurement precision will be decreased. He makes not effort to
limit error rates to maximum or minimum levels and does not
determine the precision with which response times are measured.
[0030] There exists a need to eliminate computer delay as a source
of error. Virtually all computers have hidden "background"
processes that occur from time to time and compete with resources
required for accurate time measurement. The problem is particularly
severe in the most powerful, modem computers, which have large
numbers of background processes. Every several minutes, one or
another task is undertaken that delays response time measurement by
approximately 5% or more--enough to increase measurement
variability beyond the accuracy needed for precise assessment of
medical benefits or performance effects from other potentially
dangerous or life-saving activities, events or conditions. If
several competing programs are active when measurement is made, as
much as 100% of the computers central processing unit ("CPU") time
may be occupied, possibly for as long as or longer than several
seconds.
[0031] FIG. 1 shows a screen shot of CPU usage in the absence of
user-initiated activity obtained from a 200 MHz Windows NT 4
Gateway computer. Periodic, transient demands on CPU capacity are
evident, including one relatively unusual spike up to 100% of CPU
capacity that lasted several seconds before receding.
[0032] During the recent Danbury MS Blueberry Study (Pappas et al.,
2001), when interference from background activities was measured
before each keystroke during choice reaction time testing,
occasional interference was recorded for all study participants,
and most had potentially significant interference clusters from
time to time (FIG. 2).
[0033] Performance results obtained during this past year during
the Danbury MS Blueberry Study indicate that measurement error was
limited to 1% or 2% (test-retest reliability was 0.991) and that
practice effects were negligible when testing (and therefore
practice) was limited to 2 minutes each week (FIGS. 3 and 4).
Analysis of response times obtained after interference was detected
indicates that apparent response times increased by roughly 7%,
depending on the severity of the interference. This 7% error is
large enough to a serious concern, but not so large that it cannot
be reduced to insignificance by frequent (twice per second)
precision checks and rejection of questionable data.
[0034] The precision improvement methods described in this patent
application and employed during the Danbury MS Blueberry Study
controlled measurement variability to a greater extent than
expected and allowed data sets for individual participants to be
split into separate performance measures for each finger used
during response time testing. FIG. 4 contains a typical
single-finger data set for one of the study participants. The
steady, parallel changes observed for each finger indicate that
measurement precision was quite sufficient for this type of
single-finger monitoring.
[0035] A thorough search of prior art has indicated that average
measurement precision among 77 different published performance
tests was surprisingly low. Test-retest reliability was only 0.63.
Results obtained this past year using the methods described herein
yielded a test-retest reliability of 0.991. Accordingly, there
exists a need for a method for increased measurement precision.
SUMMARY OF INVENTION
[0036] The present invention provides a computer based system for
testing the cognitive performance of at least one examinee
comprising: comprising: at least one source network entity (SNE)
having machine readable instructions, at least one test development
system, local memory, and a plurality of executable files stored in
said memory; a data distribution system (DDS) logically connected
to said source network entity; and at least one destination network
entity (DNE), having local memory, logically connected to said data
distribution system.
[0037] The present invention provides a system for internet-based
testing comprising a plurality of subsystem including: a test
development system; a data distribution system; a workstation; a
workstation calibration system; an examinee monitoring system; and
an examinee motivation system.
[0038] According to an aspect of the present invention, a test
development system is provided. The test development system
comprises a digital computer provided appropriate software such as
an operating system and means for generating digital
representations of challenge signals to be presented to an
examinee. Signals may be numbers, letters, words, other symbols,
sounds or combinations of these and/or other response triggers. The
signals may be presented singly or in any combination of the
plurality of possible signals. The test development system further
comprises appropriate software, databases and digital storage
means. The test development system provides a definition file
defining specific information said test development system requires
and a format in which said specific information is to be provided,
at least one examinee information file, at least one examinee
response file.
[0039] According to an aspect of the invention, the test
development system is logically connected, in computer fashion to
data transmission means. Such a connection may be for example a
modem or cable modem connection to the internet. In such case the
data transmission means comprise the internet.
[0040] According to an aspect of the present invention, a data
distribution system is provided. The data distribution system
[0041] According to an aspect of the present invention a computer
based method for testing the cognitive performance of at least one
examinee is provided. The method comprises the steps of:
[0042] (a) providing a computer based testing system comprising: at
least one source network entity (SNE) having machine readable
instructions, at least one test development system, local memory,
and a plurality of executable files stored in said memory; at least
one data distribution system (DDS) logically connected to said
source network entity; at least one destination network entity
(DNE) logically connected to said data distribution system, wherein
said DNE has local memory;
[0043] (b) generating a computer signal train comprising said at
least one set of instructions, said at least one test development
system and said plurality of executable files and transmitting said
computer signal train to said data distribution system;
[0044] (c) embodying said computer signal train in a carrier wave
using said data distribution system;
[0045] (d) distributing said carrier wave embodying said computer
signal train to said destination network entity;
[0046] (e) displaying general and motivational instructions to said
examinee;
[0047] (f) obtaining information relating to examinee health
history and cacheing said information in DNE memory;
[0048] (g) calibrating said destination network entity, wherein
said calibration is performed iteratively prior to each
response;
[0049] (h) displaying at least one softshifted challenge
signal;
[0050] (i) measuring at least a first cognitive performance of said
examinee, wherein said measurement is bounded by pre-determined
error limits;
[0051] (j) providing performance feedback to said examinee;
[0052] (k) providing motivational feedback to said examinee;
and
[0053] (l) providing summary information to said examinee.
[0054] According to an aspect of the invention, a computer-based
performance measurement system is provided that provides more
precise results than previously available, for at least some
measures of performance.
[0055] According to an aspect of the invention means are provided
for obtaining more precise performance data than previously
possible, so people, and/or their physicians, can determine how to
improve their health, so that scientists can conduct more precise
performance research, and so that other people interested in their
performance can obtain more reliable, more convenient and more
affordable performance measurements.
[0056] An aspect of this invention is the linked storage of
information about 1) performance, 2) computer measurement accuracy,
3) health and 4) health-related activities and events, including
foods, beverages and medications consumed, exercise, sleep, social
events and any activity or event that may possibly affect health or
performance. Storage may be in one or more data files but must be
accomplished to enable information in each of these four categories
to be linked together so that logical conclusions can be reached. A
key aspect of the information stored in each category is the date
and time of each measurement, aspect of health, activity or
event.
[0057] Time stamps allow performance results to be rejected or
corrected if measurement precision calibration results obtained
immediately before or afterward raise doubts about measurement
accuracy at that time. Computer measurement error typically occurs
when other background processes ("interference") prevent timely
execution of the measurement software commands. Such interference
usually occurs for relatively short periods of time, so performance
data can be rejected if it was obtained at approximately the same
time interference was detected. Rejecting just some data while
keeping results obtained when calibration results are satisfactory
allows more data to be used and therefore increases measurement
precision, even for computers subject to relatively high levels of
transient background interference.
[0058] Time stamps also allow performance, health and health
activity information to be related.
[0059] According to an aspect of the invention, changes in examinee
response time and short-term memory are measured. Changes in
examinee response time and short-term memory may have important
medical-diagnostic value, indicating for example local areas of
hypoxia (low oxygen) or other transient or progressive health
problems, and may provide a relatively precise measure of the
effectiveness of different doses and combinations of medications
and health supplements for the individual examinee.
[0060] A further aspect of the invention provides measures of
cognitive performance having precision sufficient to measure
changes in the performance of individual examinees, rather than
just changes among groups of examinees.
[0061] According to an aspect of the invention, means are provided
for relating ingestion of dietary components or supplements,
medications or other drugs, or alcohol to changes in cognitive
performance.
[0062] According to an aspect of the invention, means are provided
for increasing the number of performance measurements obtained per
unit time per examinee and means are provided for increasing the
precision of those measurements. Therefore, also is provided means
to decrease proportionately the cost of long-term experiments and
to enable research protocols that otherwise would be too expensive
to be funded.
[0063] According to an aspect of the invention, a response time
measurement system is provided that instructs users to remain above
a minimum error rate and/or specifies a relatively narrow range of
recommended error rates.
[0064] According to an aspect of the present invention, methods for
reducing measurement error are applied to virtually any
computer-based performance measurement system, whether the
challenge signals comprise numbers, letters, words, other symbols,
sounds or combinations of these and/or other response triggers or
whether single responses or a series of different responses are
required.
[0065] According to an aspect of the present invention, methods are
provided applicable to a variety of response time measurements
(such as simple and choice response time, digit-symbol substitution
tests and memory scanning tests) and also to memory measurements
(such as number recall, word recall and word pair recall).
[0066] According to an aspect of the present invention, use of the
Internet for repeated and more precise performance measurement may
provide scientists with both an opportunity and a previously
missing spark for development of global standards for performance
tests that will speed many different areas of health research.
[0067] Still other objects and advantages of the present invention
will become readily apparent by those skilled in the art from the
following detailed description, wherein it is shown and described
preferred embodiments of the invention, simply by way of
illustration of the best mode contemplated of carrying out the
invention. As will be realized the invention is capable of other
and different embodiments, and its several details are capable of
modifications in various obvious respects, without departing from
the invention. Accordingly, the description is to be regarded as
illustrative in nature and not as restrictive.
BRIEF DESCRIPTION OF DRAWINGS
[0068] FIG. 1 is screen shot showing central processing unit usage
for a Windows NT 4.0 200 MHz Gateway 2000 computer in the absence
of user-initiated activity occurred,
[0069] FIG. 2 is a graph of percent measurement error for one of
the participants during the Danbury MS Blueberry Study,
[0070] FIG. 3 shows the test-retest reliability of choice reaction
time measurements during the Danbury MS Blueberry Study,
[0071] FIG. 4 contains choice reaction time results for one of the
Blueberry Study participants,
[0072] FIG. 5 is a flow chart outlining instructions presented to
examinee prior testing,
[0073] FIG. 6 is a flow chart outlining signal generation, computer
calibration, and feedback,
[0074] FIG. 7 is a flow chart outlining keystroke capture,
processing, and feedback,
[0075] FIG. 8 is a flow chart outlining data storage, processing,
and feedback,
[0076] The invention is best understood from the following detailed
description when read in connection with the accompanying drawing.
It is to be noted, however, that the appended drawings illustrate
only typical embodiments of this invention and are therefore not to
be considered limiting of its scope, for the invention may admit to
other equally effective embodiments.
DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT
[0077] Reference is made to the figures to illustrate selected
embodiments and preferred modes of carrying out the invention. It
is to be understood that the invention is not hereby limited to
those aspects depicted in the figures.
[0078] The unique methods that make the performance measurement
system described in this application effective are a combination of
measurement error reduction methods and variability monitoring
systems designed to reduce sources of variation in response speed
and response accuracy that operate from one fraction of a second to
the next, one second to the next, one minute to the next, one day
to the next, and even one week, month and year to the next.
[0079] The intent is not only to reduce measurement variation that
occurs in subsecond to monthly and yearly cycles but to monitor the
variation at each time scale and make immediate announcements to
the user, within each measurement session, to ensure that all
sources of variability and measurement error are within acceptable
boundaries or at least that all possible adjustments are made to
minimize sources of measurement variation the moment they are
detected.
[0080] To reduce measurement error due changes in alertness or
drowsiness or changes in motivation to respond rapidly (e.g. to
match or beat previous scores) for any reason, measurements are
obtained with repeated feedback concerning past and present
response times and error rates, so that people taking measurements
can see even within each series of responses whether they are
performing as quickly and as accurately as they were before. They
can quickly adjust to match previous response speeds and error
rates even before a significant portion of the present test series
has passed, so that much more reliable results (at consistent error
rates) are obtained.
[0081] If users cannot reduce response times to match those
obtained previously because they are in fact slower during the
present measurement session, they invariably try harder and their
error rate increases, so that different points on the
speed/accuracy tradeoff curve are explored within each measurement
session. Trying different speeds and error rates, back and forth
until previous error rates are matched, with explicit instructions
that error rates should never be less than a minimum or greater
than a maximum, essentially ensures that at least some data are
obtained during past and present measurement sessions with the same
or very similar degrees of accuracy. Much more precise comparison
of past and present results is consequently possible.
Concentration, alertness, determination to succeed typically rise
sharply when users realize they are not performing up to par--so
decrements due to reduced alertness are overcome and differences
from previous sessions are reduced.
[0082] To reduce measurement error due to factors that vary from
day to day, week to week and month to month, results from previous
measurement sessions are displayed as a graph or bar chart several
times during each measurement session so that response speed and
error rate can be adjusted to approximate response times achieved
weeks or months earlier. Display of previous results several times
during each session allows corrective adjustment to occur
repeatedly before the measurement session is completed.
[0083] To reduce measurement error due to eye strain, fatigue and
boredom within each measurement session, each session is
interrupted several times and data from the present and previous
measurement sessions are graphed, percentage changes, standard
deviations and error rates are displayed, and statistical
significance of changes is calculated. Several types of warnings
are also displayed if response time has slowed significantly in
comparison with previous results. Delays while data are displayed
after each 10 to 15 seconds of testing serve as important rest
periods, for hands, fingers, eyes and those parts of the brain that
may become fatigued after repeated use.
[0084] To reduce measurement error due to second by second and
minute by minute changes other than fatigue, measurements are
obtained over several minutes during each test session and pooled
to obtain a more representative score for each test session.
[0085] To reduce response time measurement error due to short-term
changes in speed and accuracy from confusing patterns of signals
and other factors that change every several seconds, signal images
are presented so rapidly and responses are triggered and measured
so rapidly (two or more times per second) that changes in response
speed and error rate are detected within seconds, testing is
interrupted and corrective instructions can be displayed.
Corrective messages allow individuals to change their speed and/or
error rate so that they remain within lower and upper acceptable
limits.
[0086] To reduce error due to repeated signals or to exceptionally
common or memorable ("salient") signal patterns, the probability
that the same signal or salient signal patterns will be chosen more
than once in a row is reduced but not entirely eliminated. This
probability reduction decreases response time variation due to
signal repetition and salient signal patterns, but does not allow
the user to rule out the possibility of repetition and anticipate
and execute unusually rapid responses based upon anticipation.
[0087] Two examples will clarify the importance of reducing the
occurrence of repeated signals and salient signal patterns:
EXAMPLE 1
[0088] Two series of signals, chosen randomly, are presented during
consecutive "choice response time" measurement sessions: 1, 1, 2,
2, 3, 3 and 4, 2, 1, 4, 3, 2. The correct response is to press the
same key (1, 2, 3 or 4) as the signal. The first series almost
invariably yields significantly lower response times because the
same finger is used repeatedly and is primed for more rapid
responses after the first use.
EXAMPLE 2
[0089] During a number recall experiment, two series are presented:
1, 2, 3, 4, 4, 4 and 8, 2, 5, 1, 6, 9. The first is much easier to
recall because of the obvious pattern, enabling users who normally
cannot recall 6-digit series to score higher than their usual
maximum of 5 digits. Each of these examples may seem far-fetched
but in practice salient patterns appear quite frequently even when
signals (numbers) are selected randomly, and they can cause quite
noticeable performance shifts if relatively few responses are
performed.
[0090] Most performance investigators present so many trials--in
some cases testing subjects for hours--that the effect of
occasional salient signal patterns is negligible. However the goal
of the invention described here is to obtain precise results within
very brief periods of measurement. So it is quite important to
control variation due to salient signal patterns. Brief measurement
sessions are critical if users are to return frequently for
measurements at different points in their personal performance
cycles--so that day-by-day changes in performance do not cause
errors when monthly or yearly cycles are being monitored.
[0091] Simultaneously preventing measurement error due to repeated
signals or signal patterns like 1, 2, 3 . . . that lead to
anticipation of one response--and avoiding changes in anticipation
when users realize subsequent signals cannot occur, reduces two
kinds of measurement error: response times are typically lower than
average if the anticipated signal in fact occurs, and response
times are typically longer if the anticipated signal does not
occur.
[0092] Reducing the occurrence of unusually rapid responses, and
also slower than average responses has the effect of reducing the
standard deviation of a series of responses and making response
time measurement significantly more precise. Reducing response time
standard deviation (or any other measure of response time
variation) enables small average differences in response time from
one session to the next, or one day or week or month to the next,
to be measured with much greater statistical confidence after
shorter periods of measurement.
[0093] Evaluating the accuracy of measurements made by each
computer:
[0094] To reduce measurement error due to day-by-day and
second-by-second changes in computer performance and the accuracy
with which each individual computer measures response time,
computer measurement error is determined after each response is
made, throughout each test session, and testing is interrupted if
measurement error ever exceeds an acceptable upper limit.
Instructions advise the user to close other programs that may slow
computer command execution, or to phone a webmaster or other test
supervisor for further advice concerning computer performance.
[0095] Gathering More Data:
[0096] To enable more data to be gathered during each brief
measurement session, carefully chosen scoring rules have been
developed. For example, the score for the day during a number
recall session is defined in advance as the longest length number
series that is recalled correctly three times in a row. To achieve
a score of 9 for example, the user must correctly recall three
different 9-digit numbers without making any errors in between. As
people try to recall longer numbers and reach their limit for the
day, errors become more frequent until it is not possible for them
to recall three in a row. The only way to find out if they can
recall three in a row is for users to try repeatedly, generating
more data with each attempt, until they are convinced they cannot
recall that length number three times in sequence and end the
measurement session. Actual scoring by research scientists
analyzing the data may involve computing the percentage correct at
each users upper limit, however stating a simple, clear goal of
three in a row, is easier for users to understand and aim for. For
some people who are relatively impatient or older and more subject
to fatigue, a score based on two-in-a-row may be best.
[0097] Computer Accuracy:
[0098] Computer measurement accuracy must by consistent from each
measurement session to the next if results are to be precisely
compared across sessions. To ensure that each computer is
functioning properly throughout each measurement session, a
standard set of computer commands are executed and timed after
every keystroke, the performance-time measurements are stored and
averaged, and the average for each series of accuracy measurements
is displayed, so that even transient interference from other
computer activities can be seen immediately. Testing is interrupted
and automatic warnings appear if accuracy is not sufficient even
for a single accuracy measurement, so that interference can be
removed or the data set discarded. The warnings advise the user to
close other programs that may slow computer command execution, or
to phone a webmaster or other test supervisor for further advice
concerning computer performance.
[0099] Simplest Versions:
[0100] For people with disabilities that prevent them from seeing
or pressing individual keys, a version of the response time program
was prepared that allows any key to be pressed when a large X is
presented. To prevent users from anticipating the signal, there is
a variable response time prior to signal presentation for this
version of the response time test.
[0101] For people with no computer experience, a version has been
prepared that requires only that the computer be turned on. The
program is launched automatically and begins presenting signals
without requiring any start-up keys to be pressed. The session ends
when the computer is turned off.
[0102] To the best of my knowledge, no other computer program
starts without even requiring "Begin" or "Start" to be pressed.
[0103] Description of Data Records
[0104] A unique aspect of this invention is the linked storage of
information about 1) performance, 2) computer measurement accuracy,
3) health and 4) health-related activities and events, including
foods, beverages and medications consumed, exercise, sleep, social
events and any activity or event that may possibly affect health or
performance. Storage may be in one or more data files but must be
accomplished so that information in each of these four categories
is linked together so that logical conclusions can be reached. A
key aspect of the information stored in each category is the date
and time of each measurement, aspect of health, activity or event
recorded by the examinee before each performance measurement
session.
[0105] Time stamps allow performance results to be rejected or
corrected if measurement precision calibration results obtained
immediately before or afterward raise doubts about measurement
accuracy at that time. Computer measurement error typically occurs
when other background processes ("interference") prevent timely
execution of the measurement software commands. Such interference
usually occurs for relatively short periods of time, so performance
data can be rejected if it was obtained at approximately the same
time interference was detected. Rejecting just some data while
keeping results obtained when calibration results are satisfactory
allows more data to be used and therefore increases measurement
precision, even for computers subject to relatively high levels of
transient background interference.
[0106] Time stamps also allow performance, health and health
activity information to be analyzed so that the most and least
beneficial activities can be identified.
[0107] According to an aspect of the invention, changes in examinee
response time and short-term memory are measured. Changes in
examinee response time and short-term memory may have important
medical-diagnostic value, indicating for example local areas of
hypoxia (low oxygen) or other transient or progressive health
problems, and may provide a relatively precise measure of the
effectiveness of different doses and combinations of medications
and health supplements for the individual examinee.
[0108] A further aspect of the invention provides measures of
cognitive performance having precision sufficient to measure
changes in the performance of individual examinees, rather than
just changes among groups of examinees.
[0109] According to an aspect of the invention, means are provided
for relating ingestion of dietary components or supplements,
medications or other drugs, or alcohol to changes in cognitive
performance.
[0110] According to an aspect of the invention, means are provided
for increasing the number of performance measurements obtained per
unit time per examinee and means are provided for increasing the
precision of those measurements. Therefore, also is provided means
to decrease proportionately the cost of long-term experiments and
to enable research protocols that otherwise would be too expensive
to be funded.
[0111] According to an aspect of the invention, a response time
measurement system is provided that instructs users to remain above
a minimum error rate and/or specifies a relatively narrow range of
recommended error rates.
[0112] According to an aspect of the present invention, methods for
reducing measurement error are applied to virtually any
computer-based performance measurement system, whether the
challenge signals comprise numbers, letters, words, other symbols,
sounds or combinations of these and/or other response triggers or
whether single responses or a series of different responses are
required.
[0113] According to an aspect of the present invention, methods are
provided applicable to a variety of response time measurements
(such as simple and choice response time, digit-symbol substitution
tests and memory scanning tests) and also to memory measurements
(such as number recall, word recall and word pair recall).
[0114] According to an aspect of the present invention, use of the
Internet for repeated and more precise performance measurement may
provide scientists with both an opportunity and a previously
missing spark for development of global standards for performance
tests that will speed many different areas of health research.
[0115] A minimal embodiment of the invention comprises a source
network entity (SNE), a destination network entity (DNE), and a
data distribution system (DDS) logically connecting the network
entities. The network entities may be, as a non-limiting example,
PC computers. In a simple embodiment, the SNE and the DNE may be
the same physical device. In such example, the data distribution
system comprises the internal data bus.
[0116] In a second, non-limiting example, the SNE is a network
server and the DNE is a PC or workstation computer. In such
example, the DDS is the internet. The DDS may be embodied as a
local area network (LAN), or as an extranet.
[0117] The DDS in principle is any medium capable of distributing
computer readable information. Thus the DDS may comprise an
appropriately formatted diskette.
[0118] Either or both network entities may be embodied as any
computational device such as, for non-limiting example, a Palm
Pilot.
[0119] The steps of a preferred embodiment of the inventive method
is presented with reference to the flow diagrams of FIGS. 3-5, the
step numbers and titles refer to the numbered and titled boxes
within the various figures.
[0120] Step 1: Display Instructions.
[0121] The source network entity (SNE) causes a digital image of
test development system (TDS) to be embodied within a carrier wave
and passed through the data distribution system (DDS) to the
destination network entity (DNE). The DNE executes the
instructions, including a session administration routine,
comprising portions of the TDS. The Examinee receives instructions
regarding the appropriate administration of the session.
Appropriate instructions are retrieved from an instruction database
by the session administration routine and displayed to the
examinee.
[0122] This step is critical for measurement precision because
examinees are instructed to make use of response time and error
rate information during and throughout each measurement session and
to maintain a more-or-less steady error rate so that results can be
more precisely compared from one session to the next. Users are
also told how to place their fingers directly over appropriate
keyboard or other response keys so that they do not subsequently
discover that a different finger placement improves their response
time. They are instructed to use any of three alternative finger
positions--including two intended specifically to be more
comfortable for users with narrower and with wider fingers.
Examinees are instructed to take whatever measures are necessary to
obtain steady results--e.g. to test themselves until they have
passed the rapid learning phase or "practice period" and have
achieved a steady baseline, to obtain measurements at the same time
of day, and to refrain from caffeine or alcohol consumption,
etc.
[0123] Measurement system users who are instructed properly are
less likely to discover, perhaps unwittingly or unconsciously,
better strategies that change their response time and make results
less consistent and less reliable. Users are also more likely to
adjust their response speed and error rates more frequently if
instructed to check several times during each measurement session
and to use the response time and error rate information provided to
adjust their response speed and error rate during the remainder of
the measurement session so that they remain within a consistent,
limited range.
[0124] Use of lower and upper error limits specifying a narrow
range (rather than a broad range) ensures that users will
frequently fall outside the recommended range and will make speed
adjustments that will produce data on either side of the optimum
error rate, so the average error rate remains consistent and
response time data is more reliable. A single recommended error
rate is not equivalent to a narrow acceptable range, since users
will grow to accept error rates that are too high and too low and
will make up their own personal ranges of acceptability that may
change with time or mood and be less reliable than a specified
acceptable range.
[0125] Alternative finger placements are provided so that users
with large fingers need not squeeze their fingers together, ignore
the discomfort while testing, and overcome the friction caused by
squeezing. More comfortable finger placement frees users from this
distraction and impediment to rapid responses and allows them to
respond more reproducibly and reliably. A preferred embodiment
employs at least two sets of alternative finger positions. In a
preferable embodiment of the invention, test subjects are
instructed to adopt the standard "qwerty" finger position, i.e.,
"asdf ;lkj." The inventive method contemplates acceptable
alternative finger placements using adjacent keys, e.g. "zxcv" and
also non-adjacent, e.g. "axml" or "axnk" or "axbj."
[0126] Maintaining a finite, non-zero error rate is an aspect of
the invention. Subjects are instructed to maintain responses within
a limited range of error. A minimum error rate must be maintained.
For each 20 keystrokes, the minimum number of errors should be at
least three fewer than the maximum number of errors. Preferably,
the lower error rate is 2 errors per 20 keystrokes and the upper
error rate is 5 errors per 20 keystrokes. It is acceptable that the
lower error rate is as high as 5 errors per 20 keystrokes and the
upper error rate be 10 errors per 20 keystrokes so long as the
upper bound differs from the lower by at least 3 errors per 20
keystrokes. The method will tolerate a wide range of error, and in
fact, examinees are encourage to remain within a consistent and
narrow range--choosing their own comfortable upper and lower limits
so long as their upper and lower limits are 3 errors apart.
[0127] Step 2: Collect Health and Health Habit Information.
[0128] Instructions are displayed to the examinee directing the
input of certain health and habit information. Collecting this type
of information before testing begins is critical since test results
may often bias self-perceived health and distort results. The
information is collected to allow subsequent analysis of
relationships between health habits, non-cognitive health and
cognitive health that may allow users to adjust their habits to
maximize both cognitive fitness and overall health. Health
information has been collected prior to testing but never, to my
knowledge, as a regular part of repeated testing to enable health
and cognitive fitness to be optimized. Regular collection of both
cognitive performance and health/health habit information is
essential for statistical analysis of correlations between each, to
determine if changes in health behavior precede changes in
cognitive performance. The regular collection of health/health
habit information as part of each measurement session is thus an
aspect of the present inventive measurement system.
[0129] Step 3: Cache all Signals for Rapid Presentation.
[0130] "Caching" in the sense used here is the transmission of data
for signals or stimuli to be presented (e.g., images of the numbers
0 through 9, letters, sounds, etc.) via the DDS, for example the
Internet, for temporary storage on each DNE computer accessing the
performance measurement web site (SNE). Delays in Internet
transmission make it impossible to rapidly present signals without
advance caching. And rapid presentation of signals is essential for
precise response time measurement. If signals are not presented
substantially instantaneously, then users will respond prematurely,
or have their responses biased, when they see 1/8, 1/4, 1/3, 1/2
(etc.) of a multi-part challenge signal as it is gradually
displayed.
[0131] Prior art web sites require users to download and set up
performance tests on their own computers, a long and arduous task
that I believe most users will not complete, or else the sites use
code-generated changes in background color that severely limit the
possible range of challenge signals which can be employed.
[0132] Step 4: Set all Parameters to Initial Values.
[0133] Parameters are variables used in the program. Initializing
variables for past results (response time and error rates) allows
users to view constantly updated comparisons between past
performance and present performance, and to adjust present
performance to equal or improve on past results. In an alternative
embodiment such comparisons are made during delays or breaks. In a
preferred embodiment, parameter initialization allows for setting
user expectations at the beginning of each session allows for more
rapid and complete adjustment during the initial set of
responses.
[0134] Step 5: Trans Form Prior Results.
[0135] Prior results are transformed into key descriptors like
average, standard deviation, etc. for most convenient and
understandable comparisons with results obtained during the present
measurement session.
[0136] Step 6: Calibrate the Measurement Accuracy of Each Computer
(DNE) Before Each and Every Response.
[0137] Users should not waste their time obtaining unreliable
results simply because they computer is not measuring their
response time accurately. Inaccuracy may be due to very temporary
interference from other programs hidden in the "background". To
detect such interference, a series of commands is executed and the
time required for these commands to be completed is measured. If
the difference between the expected execution time and the actual
execution time (the measurement error) is too large, measurement is
halted and a warning appears, advising the user of the problem.
Whether the measurement error is acceptable or not, it is stored
for comparisons with error in future sessions, and an average for
each series of responses is computed and displayed so users can see
immediately if slight interference has occurred even if the limit
of acceptability has not been exceeded.
[0138] Step 7: Determine Acceptability of Measurement
Precision.
[0139] The limits of acceptability should be sufficiently small to
prevent statistically significant errors from occurring. Since
typical users vary from day to day by up to 10%, a measurement
error rate of 10% or less for each keystroke is acceptable provided
that errors are consistently in one direction or are randomly high
or low, and provided that the percentage error has been determined
over a time period roughly equivalent to the time period required
for a typical response. In other words the error in response time
measurement should roughly correspond to the error in computer
measurement for the following error analysis to be valid. Errors of
10% may seem unacceptably high however if 20 such errors are
averaged they generally almost completely cancel, if errors are
randomly high and low, resulting in an error of 0.5% or less. If
measurement errors are consistently high across measurement
sessions, then the change in response time between sessions will
also not be affected by measurement error if errors are
consistently high. For example, if user A requires an average of 35
centiseconds to respond on Monday, but the computer records 38.5%
due to a 10% average measurement error, and if user A returns on
Tuesday and averages 35.5% with the same measurement error of 10%,
then his average on Tuesday will be 35.5.times.1.1 or 39.05. The
observed change from Monday to Tuesday will be 39.05-38.5 or 0.55
centiseconds. The actual change was 0.5 seconds, so there was a
measurement error of 0.05 centiseconds or only 0.14% of the average
response time (0.05/35.5.times.100=0.14%) even with a 10%
measurement error. Since only changes of 10% or greater are outside
the normal day-to-day change, indicating perhaps the start of an
adverse drug reaction or a large benefit from additional vitamin E
consumed on previous days, an error of only 0.14% can certainly be
ignored since it is only one seventieth as large as changes
commonly encountered.
[0140] Some scientists may dismiss use of personal computers for
accurate response time measurement because millisecond errors occur
in transmission of keystrokes from keyboard to the computer. Such
tiny errors are too large for these scientists to tolerate.
Excessive concern about such minute errors may be one reason why
response time measurements are not more widely investigated or used
for health benefits. Given large day-to-day variations commonly
encountered when users measure their response time over weeks,
months and years, concern about errors so much smaller than
actually observed changes seem inappropriate.
[0141] For these reasons, I believe the best cutoff point for
acceptable error is relatively high (10%). Setting a high
acceptability cutoff prevents users from encountering error
warnings during every test session--an inconvenience that may add
to the time and irritation associated with measurement and reduce
use of the system, preventing fewer patient-users from monitoring
potentially life-saving improvements or life-threatening decrements
in their performance.
[0142] To ensure that errors do in fact cancel across measurement
sessions, average errors for consecutive sessions must not change
by over 2% or warnings are generated advising that measurement
errors be more tightly controlled.
[0143] Step 8: Display Accuracy Warning.
[0144] Where a measurement accuracy warning is generated, users are
advised to close other programs, to check that the change from each
session to the next is less than 2%, or to call a webmaster or
measurement advisor for additional assistance reducing measurement
errors.
[0145] Step 9: Select the Signal to be Presented.
[0146] To allow repeated use of the measurement site, challenge
signals presented to the user must be different during each
response series, random numbers are used to select from among
possible challenge signals. As used herein, the term challenge
signal may refer to a single character, for example the numeral
"1". However, the term challenge signal may refer to a sequence of
characters, for example the string "371."
[0147] Step 10: Is the Signal the Same as the Previous Signal?
[0148] The term response refers to keystroke(s) and/or mouse clicks
made by examine following presentation of a challenge signal. For
example, where the numeral "1" is displayed, a keystroke
corresponding to the numeral "2" would represent an incorrect
response, while a keystroke corresponding to the numeral "1"
represents a correct response. When preparing to response, nerve
and muscle cells may be "primed" or ready to respond more rapidly
where an identical challenge signal is presented several times in
sequence. Therefore, signal repetition is to be minimized. It is
also important to prevent alert users from anticipating a changed
challenge signal where it is known signal repetition is not
permitted. In a three-choice response time test, for example, if a
1 is presented then the user may expect a 2 or a 3, knowing 1
cannot occur again, so the number of choices is reduced from 3 to
2, causing the test to be in effect a two-choice response time
test, which has different and in some respects less desirable
properties in comparison with a three-choice test. Preventing
repetition is particularly important for number recall tests,
during which users who cannot remember whether a 5 or 6 was used in
position 4 of a 5 digit sequence may reason that the correct answer
is 6 because the third digit was 5 and the 5 could not have been
repeated. To rule out anticipation and reasoning of this kind, the
probability that a signal is repeated is reduced by three fourths
(using random numbers to determine whether repetition is allowed
each time) so that the effects of repeated numbers, anticipation
and reasoning as described are all muted.
[0149] Step 11: "Softshift" the Signal.
[0150] As used herein the term softshifting refers to the procedure
to adjust challenge signals that violate rules governing permitted
challenge signal sequences. Initially a random challenge signal is
generated and tested to determine whether the challenge signal so
generated violates a signal sequence restriction rule. Where the
challenge signal has been determined to violate a sequence
restriction rule, a softshift adjustment procedure is invoked.
Softshifting comprises the steps of (a) generating a random test
number, (b) comparing the random test number to a pre-set threshold
number, (c) where the random test number is greater than the
threshold number, generate and display an alternative random
challenge signal. Where the test number is less than the threshold
number, display the original challenge signal. The invention is not
limited to a specific softshift algorithm. The critical feature is
to change the challenge signal, some of the time, but not every
time, said challenge signal violates signal sequence
restrictions.
[0151] If a signal is repeated, or an element of a multi-component
signal is repeated, a random number is selected to indicate whether
repetition is permitted in this instance. There is no "hard" rule
that repetition is forbidden. There is only a "soft" rule, with
regular exceptions, that indicates a change is required most of the
time. If this random number indicates that a change must occur, the
signal is shifted to an equivalent alternative, perhaps to a number
one larger than the original signal or to a symbol selected at
random. This process is called a "softshift." Its purpose is to
prevent the examinee from counting signal occurrences, trying to
outguess and anticipate the signal selection system, and being
distracted and having their performance affected by guessing while
signals are being presented.
[0152] Step 12: Has the Signal Been Selected too Often?
[0153] Random choices of signals sometimes will cause one signal to
be selected within a series significantly more often than others,
distorting average response time or recall results, increasing
between-series standard deviations and reducing the level of
confidence possible for any changes observed. To prevent this from
occurring, a limit is placed on the number of times each signal can
be selected during each series--however the limit is a soft limit,
allowing exceptions, to discourage signal counting and anticipation
that frequently-used signals cannot be used again (similar to card
counting).
[0154] Step 13: Has the Difference Between the Selected Signal and
the Previous Signal Occurred too Often During the Current
Series?
[0155] Where challenge signals increase by some number, for example
1, twice in a row, a similar change may be anticipated, affecting
response time or recall accuracy. A soft limit is therefore placed
on the occurrence of identical changes between consecutive signals
and also within a series of signals. Changes may involve
consecutive responses with the left or right hand, or involve
responses with index and middle fingers. During recall
measurements, this type of limit reduces the likelihood of series
like 2, 3, 4 or 4, 6, 8 or 3, 6, 9 or corresponding descending
series, or series like 1,3,1,3 or 8,4,8,4 or red green red green
that can be easily remembered and may enable longer-than-usual
numbers to be recalled. Such series can be recognized by testing to
determine whether (i) the difference between consecutive numeric
signals is the same, (ii) a signal is the same as the signal to
slots previously and the previous signal is also the same as the
signal two slots before said previous signal
[0156] Step 14: Determine Whether the Current Challenge Signal in
Combination with Previous Signals Form a Forbidden Series.
[0157] Occurrence of a leading zero as the first digit of a series,
or of a one and a nine as the first two digits of a series, may
enable number series to be recalled more easily and distort recall
measurements. (19 . . . can be recalled as a year like 1945 or 1963
if linked with very memorable events like the end of WW II or
Kennedy's assassination.) To reduce the frequency of such
distortion, specific series can be detected and their occurrence
subjected to softshifting so they are less frequent and distortion
is reduced.
[0158] Step 15: Cache the Challenge Signal and the Frequency that
the Signal has been Presented.
[0159] This is an essential part of signal balancing (ensuring
approximately equal numbers of each possible signal in each
series).
[0160] Step 16: Select the Delay Prior to Signal Presentation.
[0161] Many response time tests incorporate a variable delay before
signal presentation to prevent anticipation of when presentation
will occur and therefore prevent a response prior to signal
presentation. Random numbers are used to control the delay time to
avoid obvious patterns. Long intermediate and short delays can be
counted and subjected to frequency limits as described above
[0162] Step 17: Determine Accuracy of Computer Response During the
Delay Prior to Presentation of Each Signal.
[0163] In a preferred embodiment of the present invention the
accuracy of computer response is determined during the delay prior
to presentation of each signal.
[0164] Step 18: Present the Signal from a Local Cache.
[0165] In a preferred embodiment of the present invention, image
and sound files, used to generate challenge signals, are cached in
the DNE local memory. Local caching allows for substantially
instantaneous retrieval and presentation.
[0166] Step 19: Measure Start Time.
[0167] In a preferred embodiment, the response time is measured
after the challenge signal has been presented. In the preferred
embodiment, the challenge signal is generated, and where necessary,
softshifted. The presentation delay time is generated, and where
necessary, softshifted. Following expiration of the delay time, the
challenge signal is presented and the response start time
determined and cached.
[0168] Step 20:Eliminate Active Commands During Dwell Period.
[0169] In a preferred embodiment, essentially immediately upon
presentation of a challenge signal, keystroke capture mode is
activated so that the next keystroke activates subsequent steps. In
order that there be minimal interference with keystroke capture
commands, it is essential that no other computations, other than
background environment chores beyond browser or RSMMS control, be
performed during the dwell period. In a preferred embodiment of the
present invention, keystroke-capture software and precise control
of active and inactive periods are used so that other keystrokes
are not misinterpreted as responses.
[0170] Step 21. Capture the Response Keystroke and Determine the
Response Time.
[0171] In a preferred embodiment, both the symbol encoded by a
responsive keystroke (or mouse click) and the elapsed time
following presentation of the challenge signal are captured. It is
preferred that the response time is determined prior to the
execution of any other commands. In a preferred embodiment, the
response and response time are cached for later analysis.
[0172] Step 22: Determine Whether Response is a Command.
[0173] In a preferred embodiment, certain keystrokes are
interpreted as commands. For example, where the letter "b" is
pressed, the program is set to recognize that the user wishes to
take a break and the response is not counted. Other commands can
conveniently be inserted here. Care must be taken not to allow
commands that may distract users and influence subsequent
responses.
[0174] Step 23: Execute the Command.
[0175] Care must be taken that executing commands input at step 22
does not start processes that may continue and interfere with
subsequent measurement accuracy. For example, other windows must
not be opened and left open since the burden of window management
will change and the additional interference may cause computer
response time measurement errors.
[0176] Step 24: Is the Response Time too High or Low?
[0177] Lucky responses occasionally occur when users start pressing
the correct key even before a signal has been presented. Responses
below a threshold are discarded. In an embodiment of he invention,
the threshold is set at 10 centiseconds. Distractions may also
cause unusually long responses that are also discarded. The longest
permitted response for a three-choice or four-choice response time
measurement system should be about 2 seconds for older users or
users with health conditions that delay response time, and should
be 1 second for younger, faster users. Thresholds for other
response time tests must be chosen specifically for each test.
[0178] Step 25: Display Response Time Out-of-Bounds Message.
[0179] It is important to indicate to users whether response times
are out of bounds so they can learn how long to wait before
pressing subsequent keys if they are temporarily distracted for any
reason or if they press keys only partly and wish to have the
response ignored rather than captured as an unusually slow response
or incorrect response. In an embodiment of the invention, users
simply wait for 2 seconds then press the correct key to continue
signal presentation for the rest of the series. No time is recorded
if users wait longer than the upper limit for responses set in set
24.
[0180] Step 26: Is the Response Correct?
[0181] In an embodiment of the invention, incorrect responses are
captured so that error patterns can subsequently be analyzed,
however in a preferred embodiment, incorrect responses do not count
toward the total number of (correct) responses required for each
series of responses. It is therefore necessary to detect incorrect
responses and make certain the corresponding response times are not
used to compute the current series average, and to decrease the
response counter so that the correct number of accurate responses
are collected during the current series.
[0182] Step 27: Display the Incorrect Response Image and Increase
the Incorrect Response Counter.
[0183] Responses are collected so rapidly that it is often
difficult for users to realize when they perform incorrect
responses. Recognizing errors is of course essential for
maintaining an error rate above a lower limit and below an upper
limit, so a brightly colored message is displayed within the signal
presentation area (where it cannot be missed) to alert users each
time an error is made.
[0184] Step 28: Is the Error Rate Among Recent Responses Over a
Threshold?
[0185] Users often hit bad streaks where responses correspond to
previous rather than current signals, or for other reasons a run of
errors are made. In a preferred embodiment of the invention, users
are helped to "snap out" of these error streaks. A message is
displayed and testing is interrupted where excessive (e.g. more
than 4) errors are made within the preceding 5 to 10 responses. Use
of "error-cluster buster" mini-breaks is an aspect of a preferred
embodiment.
[0186] Step 29: Display a "Take a Break" Message.
[0187] Where excessive errors are detected during step 28, a
preferred embodiment invokes a routine to advise users to "take a
moment to wriggle your fingers. Then press OK to continue."
[0188] Step 30: Increment the Correct Response Counter.
[0189] It is important for users to see how many responses they
have made in each series, and how many errors, to determine whether
their current error rate is acceptable, or whether more or fewer
errors should be made. It is therefore important not only to
increment the response counter after each response, but also to
display the result clearly.
[0190] Step 31: Compute and Display the Average Response Time and
Other Indicators of Error Rates and Computer Measurement
Accuracy.
[0191] In a preferred embodiment of the invention, the average
response time and other indicators of error rates and computer
measurement accuracy are computed and displayed after each
keystroke. This must be done after each keystroke if users are to
be able to adjust within each series of responses to maintain or
exceed speed and accuracy levels achieved in the past.
[0192] Step 32: Is the Average or Score for the Most Recent Series
Much Higher or Lower Than the Previous Average?
[0193] If there is a large difference between the current and the
preceding result, a notice pops up advising the user of the change,
so that they can determine if the change is reproducible by
completing additional series, and if yes so that can take
appropriate action. A preferred embodiment calculates differences
between scores achieved between consecutive response series within
each measurement session
[0194] Step 33: Display a Message Related to the Observed Change in
Score or Average.
[0195] Where a decline in health status is observed and confirmed
by additional measurement, extra cautious driving or a call to a
professional health advisor may be appropriate. Where improved
health status is noted, additional health habit adjustments to
enhance the improvement may be appropriate, again after checking
with a professional health advisor. A preferred embodiment displays
appropriate motivational messages related to improvements or
declines in health status, as determined by variations between
consecutive response series within a measurement session.
[0196] Step 34: Is the Total Number of Responses During the Current
Series Equal to the Limit for the Series?
[0197] Where, for example, 20 of 20 desired correct responses have
been obtained during the 25 current series, then the series is over
and additional reports are prepared while the user has a small rest
period. If fewer than 20 correct responses have been obtained, then
the program loops back to step 6 to obtain the required
responses.
[0198] Step 35: Increment the Series Counter.
[0199] Counting the number of series is important because users
occasionally lose track of how many series they have performed.
Reminding them may help prevent over-testing, eyestrain and mental
fatigue that will discourage the repeated testing so critical for
long-term measurement accuracy.
[0200] 36. Compute a "Cleaned" Average, Standard Deviation, Split
Half Error Rate and Other Measures of Response Speed and Accuracy
and Computer Measurement Accuracy.
[0201] In a preferred embodiment, a cleaned average is computed. In
a preferred embodiment, a cleaned average of response is determined
excluding values for the fastest and slowest responses. Since on
average more slower-than-average responses occur compared to
faster-than-average responses, more slow responses are rejected in
each series than fast responses.
[0202] In a preferred embodiment a "split half" average is
determined. Determination of the difference between the average of
odd responses minus the average of even responses ( e.g., the
average response time of responses 1, 3, 5, 7, 9, 11, 13, 15, 17
and 19 minus the average of responses 2, 4, 6, 8, 10, 12, 14, 16,
18 and 20) allows speed fluctuations due to second-by-second
changes in mental fatigue, eye strain, motivation to respond
rapidly or accurately, etc. to be canceled since both averages are
affected more or less proportionately. If the percentage difference
between these odd/even split half averages is too high, then the
results of the series may be too inconsistent for accuracy and a
message pops up advising the user to perform another series or
contain an adviser to determine what is causing the split half
error rate to be higher than acceptable.
[0203] A preferred embodiment for memory evaluation purposes
defines a score for any measurement session as longest series
recalled n-times consecutively. Where n is some pre-determined
integer, for example 2 or 3. In an embodiment score is defined as
the average of the fastest n consecutive response series. Where
such an n-series score is determined, the score should be updated
and displayed so users can see clearly where they stand compared to
previous results.
[0204] 37. Store all Results.
[0205] If the accuracy and speed of present results are to be
compared with future results, with adjustment for variations in
computer measurement accuracy, each data set must be stored for
future retrieval and comparison. No other Internet or non-Internet
RSMMS currently stores information in packets that include the
signal, the response, the response time and the computer
measurement accuracy result obtained just before signal
presentation, so storage of this type of data packet is therefore
claimed as a unique feature of this invention.
[0206] If space is limiting and more compact storage is necessary,
then only series response time averages, total errors per series,
and the average of computer measurement accuracy for each series
need be stored. Information packets with these three items of
information are also claimed to be unique features of the RSMMS
being patented.
[0207] Step 38: Is the Most Recent Series of Results
Acceptable?
[0208] In a preferred embodiment, an acceptable series is defined
as, for example, the number of errors being within pre-defined
bounds; and/or the split half error less than a threshold value;
and/or computer measurement errors less than a pre-determined
threshold. Where results are unacceptable, a warning is displayed
recommending that the series be repeated.
[0209] Step 39. Display Appropriate Message if Data are
Acceptable.
[0210] It is important to give users encouragement and a pat on the
back for work well done, to add some fun to the process so they
will be more likely to return for follow-up measurements and build
a more accurate data set, add to their own understanding of
connections between their personal health habits and cognitive
performance, and also add to a general body of understanding that
may benefit many others. Giving users a pat on the back several
times with each measurement session concerning several independent
measures of data acceptability is to my knowledge unique to this
RSMMS and is therefore claimed as a unique feature of this
invention.
[0211] Step 40. Display Appropriate Message if Data are Borderline
Unacceptable or Acceptable.
[0212] Suggest repeating the last series, perhaps reducing
interruptions that cause attention to lapse, or calling an advisor
to discuss persistent problems with data acceptability. Giving
users messages concerning how to improve several independent
measures of data acceptability is to my knowledge unique to this
RSMMS and is therefore claimed as a unique feature of this
invention.
[0213] Step 41. Is the Series Total Prior to Comprehensive Graphing
and Evaluation Equal to the Required (Upper or Lower) Limit?
[0214] A graph of prior and current results can be prepared after
each series of responses, or after every two, three, four or five
series. If the number of series completed equals the limit needed
for graphing, then the graph and associated analysis should be
prepared. The best value for this limit is simply 1, since graph
preparation then gives users a break after each series has been
completed and reduces between-series fatigue and (proactive)
interference. This step is not a unique feature of this RSSM system
and is only claimed as part of a unique combination of features
comprising the invention being patented.
[0215] Step 42. Save, then Initialize Within Series Counters.
[0216] After each series is complete, the total errors, average
response time and average computer measurement error must be stored
for future use and the values must be initialized so the next
series begins from zero or no value for each measure of performance
determined by each series of responses. This step is not a unique
feature of this RSSM system and is only claimed as part of a unique
combination of features comprising the invention being
patented.
[0217] Step 43. Display a Graph of Previous Results.
[0218] After each series or several series, graphing results allows
users to see at a glance if their current responses are worse,
better or the same as previous responses. Response time and error
rates should be presented, or health or health habit data should be
displayed for easy examination. Giving users graphs of both past
and present results is to my knowledge unique to this RSMMS and is
therefore claimed as a unique feature of this invention.
[0219] Step 44. Display the Standard Deviation or Other Measures of
Variability for Recent Averages.
[0220] It is best to display measures of between series variability
along with the graph of past and present results so that users can
see the variability at a glance and decide whether additional data
should be obtained. Controlling measures of between-series
variability (e.g. minimizing the standard deviation among the most
recent 5 series of 20 responses) allows users to monitor and
possibly control factors that operate over many series, just as
measures of within-series variation (e.g. the standard deviation
within results from one series of 20 responses) allows users to
monitor and possibly control factors that operate within each
series, like very short term changes in concentration or
interruptions from background noise or occasional interference from
background computer programs. Giving users measures of variation
that span both past and present results is to my knowledge unique
to this RSMMS and is therefore claimed as a unique feature of this
invention.
[0221] Steps 45, 46 and 47. Are Measures of Variability Among
Recent (Past as Well as Present) Series Averages Acceptable?
[0222] If not, display appropriate messages as in steps 38-40.
Since factors that affect past vs. present results operate over
much longer time periods compared to factors that cause variation
within a series (i.e. within a ten- to 15-second period), it is
appropriate to mention possible causes of between-session variation
like changes in the amount of exercise or sleep from day to day
which can be minimized for more consistent cognitive performance.
Giving users messages concerning variation across both past and
present results is to my knowledge unique to this RSMMS and is
therefore claimed as a unique feature of this invention.
[0223] Step 48. Analyze Probability that Recent Results are or are
not Significantly Different from Previous Results.
[0224] To major goals of statistical analysis are to determine
whether a steady baseline has been obtained before a health
supplement, dietary change or medication is tried, and to determine
whether changes observed after a change has been made are in fact
statistically significant or perhaps are simply part of normal,
random variation. Both kinds of statistical tests are provided on
the RSMMS web site for visitors to conveniently use.
[0225] Baseline adequacy is determine by a t-test for paired data
performed to determine whether recent results will be statistically
different from equivalent results (with roughly the same standard
deviation) if a change of 1%, 3% or 6% occurs. Data pairing for the
"paired" t-test is based on order of series averages within each
measurement session: e.g., the first series result on Monday is
paired with the first on Tuesday, the second series result on
Monday is paired with the second on Tuesday, etc., so that the
effects of progressive fatigue and warm-up over the series within
each measurement session can be canceled to some degree.
[0226] A paired t-test for the most recent n series vs. the
previous n series is also available (where n is selected by the
user) to determine if recent series are significantly different
from the preceding series.
[0227] And a multiple t-test "Search for Significance" performs
paired t-tests on the most recent 3, 4, 5 . . . and preceding 3, 4,
5 . . . series averages (until the end of stored data is reached)
and reports any significant changes (above a cutoff provided by the
user).
[0228] The ready availability of significance tests for baseline
adequacy and evaluation of observed change is to my knowledge
unique to this RSMMS and is therefore claimed as a unique feature
of this invention.
[0229] Steps 49, 50, 51, 52, 53. Prepare Easy-to-Understand
Confidence Levels for Display and E-Mailing along with Appropriate
Messages.
[0230] Most users are not statisticians, so a percentage confidence
in any observed change is computed from the p values generated by
the t-test equations. Percent confidence=(1-pvalue).times.100. A
plain English statement about the degree of confidence is prepared,
displayed and also stored for automatic or manual e-mailing.
Preparation of easy-to-understand statistical reports based on
percent confidence is to my knowledge unique to this RSMMS and is
therefore claimed as a unique feature of this invention.
Preparation of easy-to-understand reports for e-mailing to health
advisors or personal health data centers is to my knowledge unique
to this RSMMS and is therefore claimed as a unique feature of this
invention.
[0231] Two kinds of "confidence history" are also available at the
web site, where "confidence history" means a listing of confidence
levels that the most recent 3 results are significantly different
from the previous 3, that the last 4 are significantly different
from the previous 4, that the last 5 are . . . up to the highest
number permitted by stored results--or that the most recent n
results (n=3, 4, 5 . . . ) are significantly different from the
previous n, that the n results beginning with the
2nd-most-recent-result are significantly different from the
preceding n results, that the n results beginning with the
3rd-most-recent-result are significantly different from the
preceding n results . . . back to the start of the data set.
[0232] The following sample output illustrates the kind of results
obtained by a preferred embodiment of the present inventive
RSMMS:
[0233] Your response time average was 32.83.+-.3.2% (20 correct/5
incorrect).
[0234] Your odd/even ratio for this set of 20 was 1.016.
[0235] Computer measurement errors averaged 0.13%.
[0236] Please consult a health professional before interpreting
these results.
[0237] Response Time Table for Visitor
[0238] 09/22/1999 06:55:05
1 Response Time Bar chart Date/hr/min/sec (and health ratings) [Not
shown] 1) 09/15/1999 10:10:55 29.63 (2/3) 2) 09/15/1999 10:28:14
31.61 3) 09/15/1999 10:29:02 30.82 4) 09/15/1999 10:29:59 30.24 5)
09/15/1999 10:31:16 28.8 6) 09/16/1999 08:36:30 30.83 (3/3) 7)
09/16/1999 08:37:19 30.63 (3/3) 8) 09/16/1999 08:38:47 31.66 (3/3)
9) 09/16/1999 08:39:57 31.83 (3/3) 10) 09/16/1999 08:41:32 31.61
(3/3) 11) 09/17/1999 10:40:48 30.48 (4/3) 12) 09/17/1999 10:42:03
29.43 (4/3) 13) 09/17/1999 10:47:24 29.86 (4/3) 14) 09/17/1999
10:48:29 30.85 (4/3) 15) 09/17/1999 10:49:38 29.24 (4/3) 16)
09/18/1999 10:29:20 29.24 (2/1) 17) 09/18/1999 10:30:34 31.41 (2/1)
18) 09/18/1999 10:31:42 32.01 (2/1) 19) 09/18/1999 10:32:51 31.83
(2/1) 20) 09/18/1999 10:33:48 31.83 (2/1) 21) 09/19/1999 09:20:57
31.85 (3/2) 22) 09/19/1999 09:22:42 30.02 (3/2) 23) 09/19/1999
09:24:11 31.46 (3/2) 24) 09/19/1999 09:25:29 32.23 (3/2) 25)
09/19/1999 09:26:39 31.5 (3/2) 26) 09/21/1999 09:01:51 29.26 (3/3)
27) 09/21/1999 09:03:15 32.04 (3/3) 28) 09/21/1999 09:04:22 29.66
(3/3) 29) 09/21/1999 09:05:26 31.41 (3/3) 30) 09/21/1999 09:06:41
31.05 (3/3) 31) 09/22/1999 06:49:07 28.82 (2/2) 32) 09/22/1999
06:50:42 28.26 (2/2) 33) 09/22/1999 06:52:32 30.05 (2/2) 34)
09/22/1999 06:53:49 33.05 (2/2) Most recent result: 32.83 (2/2)
[0239] Please keep a separate record of these results in case your
data "cookie" is erased.
[0240] To print these results, click on File and Print.
[0241] Avg for last 5 visits: 30.60.+-.7.29%. SDev is good.
[0242] Data cache: 1017 bytes out of 4,000.
[0243] Baseline confidence analysis: The ratio of your first 17 to
your second 17 response times is 30.48/30.96 or 0.984. This ratio
is not significantly different from 1.00 according to a split-half
t test for paired data. It thus appears that you have obtained
stable baseline data.
[0244] If you obtain the same amount of data during the next month
and your average is shifted by 1%, then the observed change will be
significant at a confidence level of 89.21%. If the shift is 3%,
then your confidence level will be 99.8%. And f the shift is 6% or
15% your confidence will be 99.9% or 99.9%.
[0245] Significance Test: The ratio of the previous 10 response
times to your most recent 10 is 31.33/30.64 or 1.022
(confidence=91.7%). Your most recent 10 results appear to be
significantly different from the previous 10 results. Please send
this report to your professional health advisor if you wish to
discuss changes in your medication or supplements. Note: Due to
rounding and interpolation errors, calculated levels of
significance are approximate. If you have questions about this
statistical test, please send today's results to
VitaminEstudy@go.com. Be sure to include your E-mail address for a
reply.
[0246] Significance Report:
[0247] The ratio of the previous 8 response times to your most
recent 8 is 31.27/30.64 or 1.020 (confidence=74.8%).
[0248] The ratio of the previous 9 response times to your most
recent 9 is 31.22/30.79 or 1.017 (confidence=76.2%).
[0249] The ratio of the previous 10 response times to your most
recent 10 is 31.33/30.64 or 1.022 (confidence=91.7%).
[0250] The ratio of the previous 11 response times to your most
recent 11 is 31.08/30.72 or 1.011 (confidence=73.0%).
[0251] The ratio of the previous 16 response times to your most
recent 16 is 30.62/30.95 or 0.989 (confidence=82.7%).
[0252] The ratio of the previous 17 response times to your most
recent 17 is 30.62/31.00 or 0.987 (confidence=87.4%).
[0253] To send your results to a physician, pharmacist or other
health advisor, enter their E-mail address in the space below. Then
enter your code name, E-mail, phone number or other information
they require on the next line.
[0254] Send my results to this E-mail address: [input box]
[0255] My code name, E-mail, phone or other info: [input box]
[0256] Remarks: [input box]
[0257] [Send button]
[0258] [Return to Measurement Page button]
[0259] [End of sample output]
[0260] According to a preferred embodiment of the invention, the
examinee is offered the option to prepare ratings for each food,
supplement, medicine, health habit or other factor, listed by the
examinee, to indicate which are associated with improvement or
decrement in examinee performance. The result of this calculation
is a complete or partial list of all health factors mentioned
(during step 2) prior to performance measurement and an associated
score for each item on the list (e.g. a positive number indicating
the degree to which performance improvements occurred afterward, or
a negative number indicating that performance was poorer
afterward). Partial lists would include the top n (e.g. 10) foods,
etc. and the worst n (e.g. 10) foods, etc. The value of partial
lists is that most of the statistically insignificant
benefit/decrement values are omitted. The key to this
benefit-decrement rating is relatively precise time-date
information for both health factors and performance results, and
dose and frequency-of-use information for health factors whenever
possible or convenient. Time-date and dose information allows the
relative degree of association between each factor and performance
results to be adjusting in much the same way the inventor believe
collections of nerve cells form connections between potentially
related events or discharge patterns. The benefit-decrement
calculation algorithm is simply to determine the change in
performance (after vs. before each factor exerted possible
influence), add up all these changes for each factor, weight the
magnitude of the associations according to the difference in time
between performance measurement and the health factor, and also
weight the magnitude of each association according to cumulative
dose if dose information is available. Weights for each food,
medicine and other health factor need not be the same. Associations
may be weakened by the simultaneous presence of several of the
health factors under evaluation. Further description of the
benefit-decrement calculation algorithm is provided by the
"optimization" code provided below.
Sample Output Obtained from a Preferred Embodiment of the
Invention
[0261] Items listed first appear to raise the selected health
measure.
2 Food/beverage Rating EGGS 3 ORANGE-JUICE 3 TEA 1.5 APPLES 1.28
BREAD 1.28 OATMEAL 0 MILK 0
[0262] Items listed last appear to lower the selected health
measure.
[0263] Send Email copy to: [Email address box, with previous
address automatically recalled]
[0264] [End of sample output]
[0265] Importance of Health Data/Performance Data/Benefit-Decrement
Reports:
[0266] The direct linked between measurement precision and combined
collection of health habit/food data and performance data and
preparation of benefit-decrement reports should be emphasized.
RSMMS users who do not see relatively rapid results linked with
documented benefits will not return to obtain the additional data
that enables more precise measurement averages to be
determined.
[0267] How to Make the Invention:
[0268] According to a preferred embodiment of the invention,
computer code for Internet and non-Internet embodiments are
provided. Some sections will run without adaptation if the
following instructions are followed, however other sections (e.g.
those involving the CGI code) require computer specific directories
and/or Internet locations to be inserted. Those persons of
reasonable skill in the programming arts will understand from the
present disclosure how to adapt the code to a given computer
environment.
[0269] The computer code supplied is illustrative of a preferred
embodiment. The computer code should not limit in any way the scope
of the claims since it represents only one implementation of the
more general methods claimed.
[0270] 1) Type or copy into a text-format file the HTML and
JavaScript code (or equivalent code) for each web page provided
below and save each page under the exact file name provided in the
page title (or other file names provided that every page name
reference in the code has been changed accordingly) on the c: drive
of a Windows 95, 98, NT or equivalent computer system.
[0271] 2) Change the action commands for each form (<FORM . . .
ACTION=specify a database or e-mail address here>) in each of
these HTML files to specify a database or e-mail address to which
data can be sent--or else disable all submit commands.
[0272] 3) Prepare or copy images of the following or equivalent
images and save them under the names indicated below on a Windows
95, 98, NT or equivalent computer system. Signal images to be
displayed prior to each response can be prepared at the exact
height, width, color and design of images available at the
inventor's web site (to be listed on major search engines under the
key words Response Speed and Memory Measurement System after this
patent has been approved) however different sizes, colors and
designs can also be employed.
[0273] Required Images Include:
[0274] Images of the permitted challenge signals. Said images may
comprise the numbers 0 to 9 and/or other signal images, depending
on the signals desired;
[0275] An image indicating that the previous response was
incorrect;
[0276] An image requesting that the user "please wait" for
scheduled feedback to be prepared and displayed;
[0277] A blank image to be displayed before the program starts;
[0278] An image showing proper finger placement during each
response series, for the instruction page. This finger-placement
image may be different for each test within the RSSM system, and
may not be needed for some tests, like number and word recall, for
which specific finger placement is not required.
[0279] Unless the code for each page is adjusted, images should be
named:
[0280] num0.gif
[0281] num1.gif
[0282] num2.gif
[0283] num3.gif
[0284] num4.gif
[0285] num5.gif
[0286] num6.gif
[0287] num7.gif
[0288] num8.gif
[0289] num9.gif
[0290] numBlank.gif
[0291] numEnd.gif
[0292] numError.gif
[0293] numwait.gif
[0294] Site specific images and images explaining different
measurement options for the main entrance page can be named as
indicated below. In the following non-limiting embodiment, letters
represent the following: chs is for Connecticut Healthspan System
(a system for increasing each person's span of healthy years, as
well as lifespan)--these letters identify all image-links in the
central area of a general access page linking to all measurement
options currently hidden beneath the choice response time
measurement page; jts--join the study--the image that links to a
description of vitamin and herb study options; srt--simple reaction
time, a response time test that has just one signal and one
response (very simple); crt--choice reaction time, a response time
test with 2, 3, 4 or more signals and a different response for
each; pet--planning and execution time, a relatively complex
response time test that involves planning and execution of a series
of responses to each signal; ms--math speed; stm--short-term
memory, for numbers; mss--memory scanning speed; hr--health
report--this image links to a page that allows daily, weekly . . .
health reports to be filed on-line.
[0295] For Links to a Tour of the Site:
[0296] Tour.gif
[0297] Tour2.gif
[0298] For Descriptions of Each Measurement Option:
[0299] chsBlankText.gif
[0300] chsJtsText.gif
[0301] chsStudiesText.gif
[0302] chsHR1Text.gif
[0303] chsSrtText.gif
[0304] chsCrtText.gif--for Response time
[0305] chsPetText.gif
[0306] chsMsText.gif
[0307] chsMssText.gif
[0308] chsStmText.gif
[0309] For image-links to each measurement option (if you click on
each image, the web browser opens the corresponding measurement
page):
[0310] chsjts1.gif
[0311] chssrt.gif
[0312] chscrt.gif--for Response time
[0313] chspet.gif
[0314] chsms.gif
[0315] chsmss.gif
[0316] chsstm.gif
[0317] chsjts2.gif
[0318] chssrt2.gif
[0319] chscrt2.gif
[0320] chspet2.gif
[0321] chsms2.gif
[0322] chsmss2.gif
[0323] chsstm2.gif
[0324] chshr11.gif
[0325] chshr12.gif
[0326] Optional Sounds Include:
[0327] Four or more sound files in .wav format are recommended.
These sound files can be any sounds desired, each to trigger 1 or a
combination of responses, but should be short segments to avoid
unnecessary delay and annoyance while the signal sound is
completed. If only simple auditory response time is to be measured,
then just a single sound file is needed. Note: To reduce
downloading time, sound options are not included in Refcrt22.htm so
a different version, Refcrt21.htm, is also included below for those
who wish to adapt the trimmed version to include sound signals.
This version also contains softshift code for reducing repeat
signals, etc.
[0328] Sound File Names are:
[0329] sound0.wav
[0330] sound1.wav
[0331] sound2.wav
[0332] sound3.wav
[0333] sound4.wav
[0334] sound5.wav
[0335] sound6.wav
[0336] sound7.wav
[0337] sound8.wav
[0338] sound9.wav
[0339] Of course these and all other image and variable names can
be changed to equivalent, more descriptive names.
[0340] It will, therefore, be appreciated by those skilled in the
art having the benefit of this disclosure that this invention is
capable of producing A computer based system for testing the
cognitive performance of at least one examinee. Although the
illustrative embodiments of the invention are drawn from the
internet arts, the invention is not intrinsically limited to that
art. Furthermore, it is to be understood that the form of the
invention shown and described is to be taken as presently preferred
embodiments. Various modifications and changes may be made to each
and every processing step as would be obvious to a person skilled
in the art having the benefit of this disclosure. It is intended
that the following claims be interpreted to embrace all such
modifications and changes and, accordingly, the specification and
drawings are to be regarded in an illustrative rather than a
restrictive sense. Moreover, it is intended that the appended
claims be construed to include alternative embodiments.
Appendix
[0341] Program code for a preferred embodiment is included as a
floppy disk appendix. Said disk is formatted for Windows 98
operating system and the file is in Word 98 format.
* * * * *