U.S. patent application number 12/941741 was filed with the patent office on 2012-01-26 for neurocognitive and psychomotor performance assessment and rehabilitation system.
Invention is credited to Timothy F. Elsmore, Karl E. Friedl, Dennis L. Reeves, Marie Michelle Reeves, Kathryn P. Winter.
Application Number | 20120021391 12/941741 |
Document ID | / |
Family ID | 43087218 |
Filed Date | 2012-01-26 |
United States Patent
Application |
20120021391 |
Kind Code |
A1 |
Elsmore; Timothy F. ; et
al. |
January 26, 2012 |
NEUROCOGNITIVE AND PSYCHOMOTOR PERFORMANCE ASSESSMENT AND
REHABILITATION SYSTEM
Abstract
A file system storing an executive program and a plurality of
modules such that when the executive program is executed by a
processor the executive program controls the plurality of modules.
The modules include a plurality of test modules for executing a
specific individual test to test a cognitive attribute of a user; a
plurality of test batteries having one or more specified test
modules, at least one registration module for registering each of
the plurality of users; a plurality of interpretive modules for
interpreting results of the test batteries; and at least one report
module for immediately generating a cognitive status report for
reporting the test battery results as determined by the plurality
of interpretive modules.
Inventors: |
Elsmore; Timothy F.; (Chula
Vista, CA) ; Reeves; Dennis L.; (San Diego, CA)
; Winter; Kathryn P.; (Pensacola, FL) ; Friedl;
Karl E.; (Frederick, MD) ; Reeves; Marie
Michelle; (US) |
Family ID: |
43087218 |
Appl. No.: |
12/941741 |
Filed: |
November 8, 2010 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
10340473 |
Dec 27, 2002 |
7837472 |
|
|
12941741 |
|
|
|
|
60343620 |
Dec 27, 2001 |
|
|
|
Current U.S.
Class: |
434/236 |
Current CPC
Class: |
G16H 10/20 20180101;
A61B 5/162 20130101; G16H 15/00 20180101; A61B 5/4088 20130101;
G09B 19/00 20130101; A61B 5/165 20130101; G09B 7/00 20130101; G16H
50/20 20180101 |
Class at
Publication: |
434/236 |
International
Class: |
G09B 19/00 20060101
G09B019/00 |
Claims
1. A file system storing an executive program and a plurality of
modules such that when the executive program is executed by a
processor the executive program controls the plurality of modules
comprising: a plurality of test modules for executing a specific
individual test to test a cognitive attribute of a user; a
plurality of test batteries each comprising one or more specified
test modules, the specified test modules being selectively chosen
for each test battery to test a respective cognitive attribute of
one or more of a plurality of users, at least one test battery
having at least two specified test modules for testing different
cognitive attributes, wherein the plurality of test modules
generate a test stimuli; at least one registration module for
registering each of the plurality of users; a plurality of
interpretive modules for interpreting results of the test
batteries, wherein when the interpretive modules are executed by
the processor the interpretive modules cause the processor to
compare a user's current test performance with normative data, the
user's previous test results and passing criterion for each test
module in order to determine current test results for the test
batteries; and at least one report module for immediately
generating a cognitive status report for reporting the test battery
results as determined by the plurality of interpretive modules.
2. The file system of claim 1, wherein the plurality of test
modules comprises one or more of a code substitution module, a
logical relations module, a mood scale module, a mathematical
processing module, a matrix rotation module, a matching to sample
module, a running memory module, a simple reaction time module, a
sleep scale module, and a memory search module.
3. The file system of claim 2, wherein at least one test battery is
for testing readiness to stand duty of a user of the plurality of
users.
4. The file system of claim 3, wherein the at least one test
battery is a NeuroCognitive test battery for one of diagnostic use
and medical monitoring of recovery, the NeuroCognitive test battery
comprising the sleep scale module, the mood scale module, the
simple reaction time module, the code substitution module, the
mathematical processing module, the matching to sample module, the
logical relations module, the code substitution module and the
memory search module.
5. The file system of claim 3, wherein the at least one test
battery is a commander test battery for providing a brief on-line
assessment of a user of the plurality of users, the brief on-line
assessment for testing the user's ability to sustain levels of one
or more of concentration, working memory and mental efficiency.
6. The file system of claim 5, wherein the commander test battery
comprises the sleep scale module, the simple reaction time module,
and the running memory module.
7. The file system of claim 1, wherein the at least one report
module generates a cognitive status report for immediate feedback
upon completion of at least a subset of the plurality of test
modules.
8. A non-transitory computer readable storage medium with an
executive program and a plurality of modules thereon, wherein the
executive program instructs a processor to control the plurality of
modules, the plurality of modules comprising: a plurality of test
modules with each to instruct the processor to execute a specific
individual test to test a cognitive attribute of a user; a
plurality of test batteries with each comprising one or more
specified test modules, the specified test modules being
selectively chosen for each test battery to test a respective
cognitive attribute of one or more of a plurality of users, at
least one test battery having at least two specified test modules
for testing different cognitive attributes, wherein the plurality
of test modules generate a test stimuli; at least one registration
module to instruct the processor to register each of the plurality
of users; a plurality of interpretive modules to instruct the
processor to interpret results of the test batteries, wherein when
the interpretive modules are executed by the processor the
interpretive modules cause the processor to compare a user's
current test performance with normative data, the user's previous
test results and passing criterion for each test module in order to
determine current test results for the test batteries; and at least
one report module to instruct the processor to immediately generate
a cognitive status report for reporting the test battery results as
determined by the plurality of interpretive modules.
9. The non-transitory computer readable storage medium of claim 8,
wherein the plurality of test modules comprises one or more of a
code substitution module, a logical relations module, a mood scale
module, a mathematical processing module, a matrix rotation module,
a matching to sample module, a running memory module, a simple
reaction time module, a sleep scale module, and a memory search
module.
10. The non-transitory computer readable storage medium of claim 9,
wherein at least one test battery is for testing readiness to stand
duty of a user of the plurality of users.
11. The non-transitory computer readable storage medium of claim
10, wherein the at least one test battery is a NeuroCognitive test
battery for one of diagnostic use and medical monitoring of
recovery, the NeuroCognitive test battery comprising the sleep
scale module, the mood scale module, the simple reaction time
module, the code substitution module, the mathematical processing
module, the matching to sample module, the logical relations
module, the code substitution module and the memory search
module.
12. The non-transitory computer readable storage medium of claim
10, wherein the at least one test battery is a commander test
battery for providing a brief on-line assessment of a user of the
plurality of users, the brief on-line assessment for testing the
user's ability to sustain levels of one or more of concentration,
working memory and mental efficiency.
13. The non-transitory computer readable storage medium of claim
12, wherein the commander test battery comprises the sleep scale
module, the simple reaction time module, and the running memory
module.
14. The non-transitory computer readable storage medium of claim 8,
wherein the at least one report module generates a cognitive status
report for immediate feedback upon completion of at least a subset
of the plurality of test modules.
Description
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. Ser. No.
10/340,473, filed Dec. 27, 2002; which claims benefit under 35
U.S.C. 119(e) to the provisional U.S. Patent Application No.
60/343,620, filed Dec. 27, 2001. The entire contents of each of the
above referenced patent application are hereby expressly
incorporated herein by reference.
FIELD OF THE INVENTION
[0002] This invention relates generally to a computerized test
system for assessment of cognitive status, and more specifically to
a Neuropsychological! NeuroCognitive and Psychomotor Performance
Assessment and Rehabilitation system that is designed for use on a
handheld computer system.
BACKGROUND OF THE INVENTION
[0003] Computerized test systems are increasingly used for
assessment of cognitive status in a wide range of situations that
produce changes in brain function. An example of a computerized
test battery is the Automated Neuropsychological Assessment Metrics
(ANAM) Battery, developed by the U.S. Armed Forces, consists of a
library of tests and batteries designed for a broad spectrum of
clinical and research applications. This library of computerized
tests was constructed to meet the need for precise measurement of
cognitive processing efficiency of military personnel in a variety
of psychological assessment contexts that include neuropsychology,
fitness for duty, neurotoxicology, pharmacology, and human factors
research. The tests assess sustained concentration and attention,
mental flexibility, spatial processing, cognitive processing
efficiency, mood, arousal/fatigue level, and short-term, long-term
and working memory.
[0004] Computerized test systems may be employed in the evaluation
of patients having traumatic head injury, stroke, various disease
conditions, rapid decompression, shift work, jet lag, sports
injuries, and exposure to toxic chemicals. Presently such test
systems are available only on costly, full-featured desktop and
notebook computers. The cost and the physical size of the systems
render their use impractical in many situations, for example, for
on-the-spot evaluation of personnel.
[0005] These systems present further disadvantages for testing
personnel in the field. Specifically, these systems save results in
computer files that must be post-processed for interpretation and
for the presentation of the results. This data analysis step
frequently delays knowledge of results for days or weeks after the
test is completed. The lag between test administration and
availability of results has largely limited computerized cognitive
testing to research applications where the time delay is not
critical. If computerized cognitive tests are to guide decision
makers, be they clinicians, industrial supervisors, military
commanders, or even the test-takers themselves, results must be
available immediately, in a form that is easily understood and that
maximizes utility.
[0006] Therefore, a need remains for a computerized, flexible,
human performance test system that can be used to guide decision
making in clinical, industrial, and field settings. A further need
remains for a system that generates point-of-use cognitive status
reports that provide immediate comparisons with appropriate
normative data and/or to the individual's past performance,
providing timely feedback to test administrators, supervisors,
clinicians, and those taking the tests so that appropriate actions
can be taken based upon the test results.
SUMMARY OF THE INVENTION
[0007] It is an advantage of the present invention to provide a
flexible computerized Neuropsychological/NeuroCognitive and
Psychomotor Performance Assessment and Rehabilitation System for
testing an individual's performance to guide decision making in
clinical, industrial, and field settings. The assessment system can
generate point-of-use Cognitive Status Reports (CSR) that provide
immediate comparisons with appropriate normative data and/or to the
individual's past performance so that timely and appropriate
actions can be taken based upon the test results.
[0008] It is another advantage to provide a handheld computer, such
as Personal Digital Assistants (PDAs), for a portable and cost
efficient platform for administration of an assessment and
rehabilitation system of the present invention. The portability and
relatively low cost of the hand held computer and the test system
software provides a highly attractive test platform.
[0009] Still another advantage is to provide a computerized
neuropsychological testing system that presents different sets of
cognitive tests (i.e., test batteries) to maximize utility and
validity of the results in order to meet the needs of many
different testing situations in varying environments, e.g.,
evaluation of stroke patients or evaluation of the fitness of a
truck driver for duty.
[0010] It is yet another advantage of the present invention to
provide a decision aid which presents immediate results in the form
of a Cognitive Status Report (CSR) to a user in an easily
understood form. The test system algorithms and procedures generate
the CSRs for two general types of situations, that is, screening
and repeated testing. Screening applications of the present
invention utilize use demographically appropriate norms for
generating a CSR. The goal of testing in these situations is to
determine whether the individual being tested is different from the
normative group, such that the individual requires a therapy or an
intervention. Repeated testing situations require a CSR that
indicates significant change from the subject's past performance to
objectively evaluate efficacy of therapies or medications.
[0011] In the exemplary embodiment of the present invention a
computerized Neuropsychological! NeuroCognitive and Psychomotor
Performance Assessment and Rehabilitation System, referred to
herein as "the assessment and rehabilitation system" or "the
system", is designed to operate on handheld computers such as Palm
Operating System (OS) and Microsoft Windows CE and Merlin
compatible Personal Digital Assistants. The assessment and
rehabilitation system also includes software utilities that allow
the handheld computer to operate in conjunction with a host desktop
or laptop computer for test battery configuration, complex data
analysis, and archival data storage.
[0012] The assessment and rehabilitation system of the exemplary
embodiment of the present invention provides point-of-use
interpretations and reports of results of an individual's test.
Components of the assessment and rehabilitation system include an
executive program, test modules, interpretive and report modules,
and supporting utilities. The assessment and rehabilitation system
includes test modules for use in medical/clinical settings,
occupational medicine, research, and forensic applications. The
assessment and rehabilitation system also may be used in medical
applications as an instrument for diagnoses, evaluation, and
treatment strategies. In industrial settings, the assessment and
rehabilitation system may be used as a fitness/readiness for work
assessment. The system may also be configured for use in forensic
mental competency, mental and emotional status examinations.
[0013] Clinical/Medical Applications. The assessment and
rehabilitation system of the exemplary embodiment may be configured
for medical applications which require diagnoses, evaluation, and
treatment. Diagnostic applications of the system may involve
neuropsychological assessments in clinical, occupational, and
sports medicine. Neuropsychological assessments include mental and
emotional evaluation in individuals with neurological disorders
such as dementia, head injury, multiple sclerosis, Parkinson's
disease, brain tumors, stroke, HIV, anoxia, hypoxia, altitude
sickness, decompression sickness, Attention Deficit Hyperactivity
Disorder, depression and other mood disorders, schizophrenia and
other psychotic disorders, normal pressure hydrocephalus,
hydrocephalus, Korsokoff's and other alcohol related disorders,
Huntington's disease, hypertension, uremia, diabetes, metabolic
disorders, neurotoxic insult, adverse effects of major surgery and
other medical procedures, effects of therapeutic pharmacological
interventions, drug dependence, and malingering of mental illness
and neurological and neuropsychological disorders and
impairments.
[0014] The system provides objective measurement and evaluation of
treatment interventions, and assesses the effectiveness and
efficacy of treatments that include surgery, pharmaceutical, and
behavioral cognitive retraining/rehabilitation, and occupational
therapy. In addition, the system may be used to monitor recovery
from neurological and mental diseases, illnesses, and disorders,
and fatigue.
[0015] Once diagnosis and treatment is completed, the system of the
exemplary embodiment may be used for treatment of the subject. The
system includes modules for rehabilitation and retraining of
cognitive skills and abilities such as attention, memory, executive
function that are commonly secondary to brain injury and
neurological and metabolic disorders, major surgery, and neurotoxin
exposures. The assessment and rehabilitation system also has
modules for retraining fine motor skills and abilities that may be
secondary to brain injuries and neurological impairment and
disease. An example of the latter would be retraining
eye-hand-psychomotor coordination for writing rehabilitation
purposes.
[0016] Research Applications. The assessment and rehabilitation
system may be configured for use in a number of research
applications such as drug, fatigue and environmental research.
Research applications include assessment of cognitive and
psychomotor effects of pharmaceuticals, homeopathic compounds and
treatments, and cancer chemotherapy and radiation. The system
provides objective measurement of recovery from acute or chronic
sleep deprivation, and transmeridian desynchronization or "jet
lag". The system of the exemplary embodiment also is suitable for
use in other environments such as microgravity spaceflight, high
altitude hypobaric, underwater hyperbaric. cold and isolated
Antarctic, high-g centrifuge and jet cockpit environments, and
sports arenas and fields.
[0017] Occupational and Forensic Applications. The assessment and
rehabilitation system of the exemplary embodiment of the present
invention may be utilized to determine fitness and/or readiness for
work. The immediate interpretive results provided by the system
make it useful for fitness for duty assessments in military field
operations, factories, hospitals, the transportation industry
including railroad engines, airliner cockpits, and long-haul truck
cabs and other workplaces. For example, a pilot may utilize the
system in a cockpit to determine whether he or she is sufficiently
alert to pilot a plane. The system may also be used in accident
investigations by employing the modules of the system that are
designed for detection of malingering and forensic mental health
and neuropsychological investigations. For example, the system may
be used in an investigation of fainting and memory problems
following a motor vehicle accident. The system further includes
modules to determine emotional and mental status in cases where
competency to stand trial is in question.
[0018] The exemplary embodiment of the assessment and
rehabilitation system is modular and configurable. The system
utilizes a number of software modules including the executive
program, a registration module, test modules, interpretive modules,
report modules, and supporting utilities modules. As discussed
briefly above, the test modules may be configured to form any
number of test batteries. The test and rehabilitation system
collects detailed data on test performance, and utilizes the
detailed data to provide immediate Cognitive Status Reports when a
test battery is completed. The system also is useful for research
with nonhuman primates.
[0019] The executive program of the exemplary embodiment controls
all critical system functions of the system including test
administration, data collection, system security, data encryption,
access to restricted system features, and communication with a host
computer using radio frequency, serial, USB, IR, or dial-up modem.
The executive program further permits recording of notes before and
after test administration and allows responses to be recorded using
a stylus, response buttons, or voice recognition modalities.
[0020] A subject registration module permits secure use of the same
test and rehabilitation system by multiple subjects through the use
of a Personal Identification Number (PIN) system. For example, a
system that is loaded onto a PDA can be available to a workplace
employee group to determine whether each of the employees are fit
for a particular work assignment. Each employee may use the system
utilizing his or her PIN, and the test results are associated with
a particular employee each time he or she utilizes the system. The
PIN prevents accidental or deliberate manipulations of test results
associated with a particular employee. In addition to the immediate
report received by the employee, data for the employee is collected
over time to evaluate the test results of each employee, as well as
the employee group.
[0021] The assessment and rehabilitation system of the exemplary
embodiment utilizes independent test modules similar to those found
in the Automated Neuropsychological Assessment Metrics (ANAM)
system and in general mental status examinations. The test modules
of the exemplary embodiment are designed to allow specified test
options to be modified. For example, the number and spacing of
stimulus presentations, the stimulus durations, the task
difficulty, etc., may be customized for a particular application.
Test modules of the assessment and rehabilitation system include
sleep/fatigue scale, mood scale, simple and two-choice reaction
time, four choice reaction time, procedural reaction time,
Sternberg memory search task, running memory continuous performance
task, mathematical processing task, digit set comparison task,
logical reasoning-symbolic, Tower of Hanoi (Tower Puzzle), Stroop
color/word interference, code substitution (learning and recall),
spatial processing task (simultaneous and successive), matching to
sample (simultaneous and successive), matrix rotation (simultaneous
and successive), tracking (unstable and adaptive), pursuit
tracking, switching task, dual task, synthetic work task, tapping
(left and right index finger), mental status test, and Aphasia
test.
[0022] The interpretive and report modules of the exemplary
embodiment of the present invention are customized for specific
test batteries and applications. The interpretive modules use a
variety of criteria for evaluating test performance including
demographic norms, clinical subgroup norms, and the subject's own
past performances. The Cognitive Status Report (CSR) reports
provide immediate feedback when a test battery is completed.
[0023] The assessment and rehabilitative system is accompanied by a
set of associated component utilities that may be utilized on a
host computer. These utilities include communications and data
archiving modules and test battery authoring modules. The
communications and data archiving modules include programs for
retrieving data from the hand held computer, for archiving data in
formats compatible with Microsoft Access, Excel, and Oracle, for
providing functions for assessing data quality and integrity, and
for installing and managing test batteries on the hand held
computer. The test battery authoring modules are utilized for
configuration of customized test batteries for specific
applications. The test battery authoring modules select tests from
available test modules, set test sequences and set test options.
These customized test batteries are then installed on the handheld
computer using a special-purpose utility program.
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] The present invention will be better understood from the
following detailed description of a preferred embodiment of the
invention, taken in conjunction with the accompanying drawings in
which like reference numerals refer to like parts and in which:
[0025] FIG. 1 is a block diagram of the
Neuropsychological/NeuroCognitive and Psychomotor Assessment and
Rehabilitation Performance System of the preferred embodiment of
the present invention;
[0026] FIG. 2 is an illustration of a personal digital assistant
(PDA) for use with an ANAM Readiness Evaluation System (ARES) of a
preferred embodiment;
[0027] FIG. 3 is a diagram of a log in view screen for a preferred
embodiment of an ANAM Readiness Evaluation System;
[0028] FIG. 4 shows an options screen for a preferred embodiment of
an ANAM Readiness Evaluation System;
[0029] FIG. 5 illustrates an ARES subject database view screen;
[0030] FIG. 6 illustrates an ARES edit subject view screen;
[0031] FIG. 7 illustrates a mathematical processing instruction
view screen;
[0032] FIG. 8 illustrates an identification view screen;
[0033] FIG. 9 shows a password view screen;
[0034] FIG. 10 shows an administration functions view screen;
[0035] FIG. 11 shows a demonstration single test view screen;
[0036] FIG. 12 shows a database manager view screen;
[0037] FIG. 13 illustrates stimulus sets of a code substitution
test of an assessment and rehabilitation system of the preferred
embodiment;
[0038] FIG. 14 shows symbol digit pairings for the code
substitution test;
[0039] FIG. 15 illustrates a default parameters table for the ARES
tests of a preferred embodiment;
[0040] FIG. 16 illustrates a desktop window display of the ARES
data management data;
[0041] FIG. 17 illustrates a desktop window display of the ARES
data management subject information;
[0042] FIG. 18 illustrates an ARES data management battery manager
screen; And
[0043] FIG. 19 shows an ARES data management data plotting
screen.
DESCRIPTION OF THE PREFERRED EMBODIMENT
[0044] The following detailed description utilizes a number of
acronyms which definitions are typically provided with the first
instance of each acronym. For convenience, Table 1 below provides a
list of the acronyms and abbreviations and their respective
definitions.
TABLE-US-00001 TABLE 1 ACRONYMS AND ABBREVIATIONS ACRONYM
DEFINITION ANAM Automated Neuropsychologic Assessment Metrics ARES
ANAM Readiness Evaluation System CSR Cognitive Status Report IMP
Impulsive Responses ISI Interstimulus Interval OS Operating System
PDA Personal Digital Assistant PIN Personal Identification
Number
[0045] FIG. 1 illustrates a computerized
Neuropsychological/NeuroCognitive and Psychomotor Performance
Assessment and Rehabilitation System 100 which is a cognitive
testing system designed for use on a handheld computer system 102.
Components of the system 100 include an executive program 104, test
modules 106, registration modules 108, interpretive modules 110,
report modules 112, and supporting utilities 114. The system 100 is
designed for point-of-use interpretations and reports of results in
clinical settings, occupational medicine, and research. The system
100 is used in medical applications as a diagnostic, evaluation,
and treatment instrument. In industrial settings, the system 100
can be used as a fitness/readiness for work assessment. The system
100 also contains modules for use in forensic mental competency,
mental and emotional status examinations.
[0046] The system 100 is designed to operate on handheld computers
102 such as Palm Operating System (OS) and Microsoft Windows CE and
Merlin compatible Personal Digital Assistants (PDAs). The handheld
computer 102 of the preferred embodiment is a PDA that utilizes the
Palm Operating System (OS), Version 3.5, or later. The system 100
is designed to run on any of the Palm compatible systems, including
Visor systems, and on either color or black and white PDA
units.
[0047] The assessment and rehabilitation system 100 of the
preferred embodiment runs test modules 106 in batteries that are
designed to meet specific clinical, operational, and/or research
goals. The registration modules 108 allow multiple users on a
single system 100. The interpretive modules 110 and report modules
112 are customized for specific test batteries and applications.
The interpretive modules 110 use a variety of criteria for
evaluating test performance including demographic norms, clinical
subgroup norms, and the subject's own past performances. The
Cognitive Status Report (CSR) reports, generated from the report
modules 112, provide immediate feedback when a test battery is
completed. The system 100 also includes other utilities, such as
supporting utilities 114 on the handheld computer 102 and a desktop
data management program on the host computer 116, that facilitate
data transfer from the hand held computer 102 to a host computer
116, such as a desktop computer, and test battery installation from
the host computer 116 to the hand held computer 102 using a direct
serial link, USB, or land line and wireless modems.
[0048] Continuing with FIG. 1, the assessment and rehabilitative
system 100 of the preferred embodiment is accompanied by a set of
associated component utilities that may be utilized on a host
computer 116. These utilities include communications and data
archiving modules 118 and test battery authoring modules 120. The
communications and data archiving modules 118 include programs for
retrieving data from the hand held computer, for archiving data in
formats compatible with Microsoft Access, Excel, and Oracle, for
providing functions for assessing data quality and integrity, and
for installing and managing test batteries on the hand held
computer. The test battery authoring modules 120 are utilized for
configuration of customized test batteries for specific
applications. The test battery authoring modules 120 select tests
from available test modules, set test sequences, and set test
options.
[0049] A preferred embodiment of the assessment and rehabilitation
system 100 is the ANAM Readiness Evaluation System (ARES) which has
been designed to meet the needs for an Operational Medicine
portable field neuropsychological and readiness to stand duty
assessment instrument. The ARES system 100 utilizes test modules
106 derived from the Automated Neuropsychological Assessment
Metrics (ANAM 2001). The ARES system 100 evaluates fatigue and
energy levels, the ability to sustain attention/concentration,
working memory, spatial processing, and overall cognitive
efficiency.
[0050] FIG. 2 illustrates ARES 100 loaded onto a Personal Digital
Assistant (PDA) 10. The PDA typically has a screen area 12 which
may include separate areas for a view screen 14 and a touch screen
24 and touch buttons 20. The PDA of the preferred embodiment has a
number of buttons or keys 16, 18, and an on/off switch 22. In the
preferred embodiment of ARES 100, the buttons 16, 18 are utilized
by the user/subject to "answer" or complete the tasks presented in
the view screen 14 as explained further below.
[0051] The system of the preferred embodiment 100 implements a
subset of the ANAM test modules including Sleep Scale, Simple
Reaction Time, Running Memory CPT, Mathematical Processing, Logical
Relations, Matching To Sample, Memory Search, Mood Scale, Matrix
Rotation, and Code Substitution. These test modules 106 are
combined to form five standard test batteries for the ARES
embodiment of the invention includes the NeuroCog, the ARES
Commander, the ARES Warrior, and a Demonstration 1 and
Demonstration 2 module, as shown in Table 2. The two demonstration
batteries present a small number of stimuli to illustrate the
tests. The executive program 104 of the preferred embodiment
creates the Commander battery and the two demonstration batteries
if they do not exist when the program is launched. The other
batteries may be installed, if desired, utilizing the host computer
116 or another handheld computer 102. In another embodiment, the
executive program can create any number of standard test
batteries
[0052] Sleep Scale. Sleep scale is a scale consisting of seven
statements that describe how the user feels with respect to
alertness or sleepiness. The statement stimulus set includes the
sleep scale statements
[0053] 1. Fully alert and energetic
[0054] 2. Able to concentrate, not at peak
[0055] 3. Relaxed, not fully alert
[0056] 4. Difficulty concentrating
[0057] 5. Tired, can't concentrate
[0058] 6. Sleepy, weary, fighting sleep
[0059] 7. Very sleepy, falling asleep
A statement selection highlighter is initialized to highlight the
middle statement (Difficulty concentrating) on the view screen 14
when the test begins. The sleep score stored in the system 100 data
records 122 is the length of time, in seconds, that is used to
select a statement, and the number of times the selection buttons
16, 18 are depressed on the hand held computer.
TABLE-US-00002 TABLE 2 STANDARD TEST BATTERIES ARES NeuroCog
Commander Ares Warrior Demo 1 Demo 2 sleep scale sleep scale 1
sleep scale sleep scale code substitution (learning) mood scale 2
simple RT simple RT1 mood matching to scale sample simple RT
running math simple RT running memory processing memory code match
to math memory substitution sample processing search (learning)
math logical logical processing relations relations matching to
matrix sample rotation (simul- taneous) logical matrix relations
rotation (successive) code code substitution substitution (recall)
(recall) memory search
[0060] Simple Reaction Time (SimpleRT). Simple reaction time
provides a measure of pure reaction time as will as a means to
partial out the effects of "motor" or "peripheral nerve conduction
velocity" times from actual cognitive processing time. The test
presents a simple stimulus on the screen 14 of the hand held
computer 10. The user is instructed to press a specified response
key 16, 18 each time the stimulus is presented.
[0061] Mathematical Processing. The mathematical processing module
presents arithmetic problems to the user. The user is instructed to
read and calculate from left to right to determine whether the
answer is greater-than or less-than the number five. Fifty percent
(50%) of mathematical problems will have an answer "greater than
5", and the other fifty percent (50%) will have and answer of "less
than 5." The answer is never equal to five. The mathematical
equations are either an a+b-c combination or an a-b+c combination.
The order is randomly determined prior to stimulus generation, and
is based on an array of elements that matches the number of
problems to be presented. The mathematical equations are created
utilizing three different randomly selected digits ranging from 1
to 9. are randomly selected. If the solution to the equation is
less than one, greater than ten, or equal to five, then another set
of digits are selected. These steps are applied to construct each
problem for a given test session.
[0062] Matching to Sample. The matching to sample module is a test
in which the user is required to match a block pattern from memory.
A 4.times.4 grid (the "sample") is represented by a 16-bit word in
which each bit represents one cell, and eight of the bits are
randomly set. The sample grid is displayed to the user. After a
pre-specified time interval, two comparison grids are presented
side by side, with one of the comparison grid matching the sample
grid. Comparison grids are generated by copying the sample grid.
The non-matching comparison grid is generated by randomly
exchanging one of the set and non-set bits in the sample grid.
Therefore only two cells will be different. The sample and
comparison patterns that are one of 24 "easy" patterns, that have
been defined through trial and error alpha test trials, are
discarded from the test. Fifty percent (50%) of the trials are
selected to be correct for the left comparison box and the other
half for the right comparison box.
[0063] Logical Relations. The logical relations module is a
linguistic task that requires the ability to determine whether
various simple sentences correctly describe the relational order of
two symbols. The stimulus set of the preferred embodiment consists
of twelve relational statements and two symbol pairs for a total of
twenty-four trials as shown in Table 3. During the test, all 24
statements are presented. The order of presentation is determined
by pseudorandom selection with a random number seed that matches
the test session number, or session number plus the seed increment
number.
TABLE-US-00003 TABLE 3 LOGICAL RELATIONS Statement Symbols Correct
answer # is first #& TRUE # is first FALSE & is first
#& FALSE & is first TRUE # is second #& FALSE # is
second TRUE & is second #& TRUE & is second FALSE #
comes after & #& FALSE # comes after & TRUE &
comes after # #& TRUE & comes after # FALSE # comes
before & #& TRUE # comes before & FALSE & comes
before # #& FALSE & comes before # TRUE # is not first
#& FALSE # is not first TRUE & is not first #& TRUE
& is not first FALSE # is not second #& TRUE # is not
second FALSE & is not second #& FALSE & is not second
TRUE
[0064] Memory Search. The memory search module presents a "memory
set" of letters displayed on the screen. The user is asked to view
the memory set until it is memorized. After the memory set is
learned, the user presses a response key to begin the test. During
the test, single letters are displayed, and the user must indicated
whether the single letters match any of the memory set letters.
Each successive administration of the test uses a unique memory
set. Memories set letters are selected pseudo-randomly based on the
session number from the list of ABCEFGHIJKLMQRSTUXYZ. The memory
set size is a maximum of eight letters, and the standard test uses
a set of six letters. Positive probe letters are equally likely to
match any of the memory set letters, i.e., fifty percent (50%) of
the test stimuli will match the memory set letters. Negative probe
letters are randomly selected from the remaining set of fourteen
(14) non-memory set letters. The negative set size is equal to the
positive set size. Further, positive and negative probes are first
presented in a random order until each letter is presented. This
procedure is continued until the test is completed. The number of
stimuli in a given test is restricted to multiples of the sum of
the number of letters in the positive and negative sets. For
example, in the standard version, there will be six (6) positive
and six (6) negative letters, the sum of which is twelve (12).
Therefore the number of stimuli presented in the test must be a
multiple of twelve.
[0065] Running Memory Continuous Performance Test. In the running
memory module, the user must monitor a randomized sequence of
stimuli digits ranging from 0 to 9. The user presses a specified
key if the number on the screen matches the number that immediately
preceded it. A different key is pressed if the number does not
match the number that immediately preceded it. The first number is
pseudo-randomly chosen from 0 to 9. On subsequent trials, if a
number has been repeated four times, then a new number is selected.
If a number has not been repeated four times, then a random number
is chosen from 0 to 999. If the number is less than 456, then a
number is displayed that does not match the number that immediately
preceded it. Otherwise the number will match the preceding number.
The above process produces fifty percent (50%) matching trials with
no more than four repetitions of a given stimulus. The executive
program counts the number of times matching numbers are
presented.
[0066] Mood Scale. The Mood Scale module asks the subject to rate
thirty-six words describing feelings on a scale from 0 to 10. The
words are presented on the view screen 14 in the order shown in
Table 4. These words represent six mood categories as shown in
Table 5. 3. A visual-analog scale is initialized to a center (5)
position when each word is presented. Each word is presented for a
minimum of 1 second. Ratings and response times for each word are
recorded.
TABLE-US-00004 TABLE 4 MOOD SCALE WORD ORDER 1. Miserable 2. Uneasy
3. Inactive 4. Energetic 5. Discouraged 6. Grouchy 7. Lively 8.
Good 9. Enraged 10. Annoyed 11. Depressed 12. Alarmed 13. Insecure
14. Weary 15. Alert 16. Lazy 17. Content 18. Cheerful 19. Sad 20.
Downcast 21. Satisfied 22. Angry 23. Gloomy 24. Afraid 25. Furious
26. Drowsy 27. Nervous 28. Irritated 29. Tired 30. Spirited 31.
Pleased 32. Active 33. Happy 34. Vigorous 35. Anxious 36.
Sluggish
TABLE-US-00005 TABLE 5 MOOD CATEGORIES Vigor Happiness Depression
Anger Fatigue Anxiety Energetic Good Miserable Grouchy Inactive
Uneasy Lively Content Discourage Enraged Weary Alarmed Alert
Cheerful Depressed Annoyed Lazy Insecure Spirited Satisfied Sad
Angry Drowsy Afraid Active Pleased Downcast Furious Tired Nervous
Vigorous Happy Gloomy Irritated Sluggish Anxious
[0067] Matrix Rotation. The Matrix Rotation module utilizes a first
4.times.4 grid that is constructed as described above for Matching
to Sample. The first grid is presented to the subject on the view
screen 14 of the PDA 10. A second grid then is constructed that is
either identical to the first, or has one cell moved, as described
above for the comparison grid in Matching To Sample. Fifty percent
(50%) of the new grids are altered. The second grid is then
rotated. After a pre-specified time period, the subject is
presented with the first grid and the rotated second grid. The
subject must then determine whether the first gird and the rotated
second grid are either the same or different.
[0068] Code Substitution Code substitution consists of from two to
nine symbols selected from the stimulus sets 130 illustrated in
FIG. 13. The default set size is nine. The set size is determined
by the value of the "difficulty" variable in a test parameter list.
In each session, each symbol is randomly paired with a digit, from
one (1) to the set size. The random number generator is seeded with
the session number. Thus, if the learning and delayed versions of
the test occur in the same battery, they will have the same
symbol/digit pairings. The session type is determined by the value
of the "sparelong 1" variable in the test parameter list 140, as
illustrated in FIG. 15, where 0=Learning, 1=Delayed.
[0069] In a "learning" version of the module, the symbol/digit
pairings are displayed on the top of the view screen 14, and remain
there for the entire session. On each trial, a single symbol/digit
pair is presented below the display 132 showing all pairs, as shown
in FIG. 14. The number of trials is set to eight times the set
size, with six correct and two incorrect symbol/digit pairs
presented for each symbol. In a "delayed (recall)" version of the
program, the correct symbol/digit pairings are not shown, and a
single pair is presented on each trial. The number of trials is set
to two times the set size, with one correct and one incorrect
symbol/digit pair presented for each symbol.
[0070] The ARES system 100 uses a standard C-language data
structure to specify parameters for all tests. The test parameters
for the preferred embodiment of the invention are summarized in
Table 6, where "char" is a text variable (string), Ulnt16 is an
unsigned 16-bit integer, and Ulnt32 is an unsigned 32-bit integer.
Feedback values are 0=none, 1=correct/error after each response,
2=RT after each response (rns), and 4=percentage correct, mean
correct RT at end of test. These values are not mutually exclusive
and may be added to produce more than one type of feedback. For
example, a feedback value of 5 will produce correct/error feedback
on each trial, and percentage correct and mean correct RT at the
end of the test. Warm-up criterion is the number of correct "y" out
of a first "x" warm-up trials. The format is "xy" is used to
indicate that x is the number of correct responses, and y is a
number less than or equal to the number of warm-up trials. Both x
and y must be less than 10, and x must be less than or equal to y.
For example, "35" would mean 3 correct of first 5 trials. Warm-up
feedback is defined as immediate stimulus feedback where 0=none,
1=Corr/Err, 2=RT (ms), 1+2=both. FIG. 16 shows the default values
for each test parameter utilized in the preferred embodiment.
TABLE-US-00006 TABLE 6 PARAMETER SPECIFICATION struct
testparameters { char' testname[25]; char testversion[5]; UInt16
trials; ||scheduled number of trials UInt16 session; ||from subject
record UInt16 feedback; // within test and end-of-test feedback''
UInt16 pauselimit; ||timeout for no response (sec) UInt16
repetition; ||within-battery rep UInt16 difficulty; ||difficulty
level UInt16 warmuptrials; ||no-data warm-ups UInt16
warmupcriterion; ||#correct out of first specified # of test
trials'' UInt16 warmupfeedback; ||immediate feedback during warmup
trials' UInt32 itimin; ||minimum intertrial interval (ms) UInt32
itimax; ||maximum intertrial interval (ms) UInt32 gapmin; ||minimum
sample-choice interval (ms) UInt32 gapmax; ||maximum sample-choice
interval (ms) UInt32 stimduration; ||maximum stimulus presentation
time (ms) UInt32 choiceduration; ||maximum choice presentation time
(ms) UInt32 seedincrement; ||added to session number UInt32
sparelong1; UInt32 sparelong2; UInt32 sparelong3; UInt32
sparelong4; char sparestring[50]; // };
[0071] A table of values is setup prior to any stimulus
presentation. This table includes one hundred (100) time periods
where each time period is equal to the minimum Interstimulus
Interval (ISI) plus a random portion ranging from 0% to 100% of the
difference between the minimum and maximum ISIs. The random number
generator is seeded at the beginning of each session by the session
number plus seed increment value which is defined in each test in
the parameters table and is usually set to 0. The ISI may be
extended by inappropriate responses that may occur between stimulus
presentations. That is, the ISI is determined as stated above, but
is reset if a response button is depressed prior to presentation of
the next stimulus. For example, if a subject continuously presses a
response button at the rate of 700 ms between a stimulus
presentations during the Simple RT test, he or she can delay the
presentation of the next stimulus indefinitely. If a response
button is held in the depressed position, the ISI will not begin
until it is released. Therefore, holding down a response button
will prevent progression of the test by preventing subsequent
display of the next stimulus. Impulsive responses (IMPs) are
defined as responses that occur less than 130 ms after stimulus
display. This applies to all tests. Inter-trial interval (ITI)
responses are those that occur between stimulus presentations, and
are also recorded. The default parameters of FIG. 15 include an
"itimin" and an "itimax" for each test excluding the sleep scale
and the mood scale.
[0072] FIG. 15 is a table of the test parameters 140 for each of
the test modules utilized in the assessment and rehabilitation
system 100 of a preferred embodiment. The parameters are further
defined by footnotes (a) through (k) as follows: (a) for memory
search difficulty, the number of letters in the memory set range
from 2 to 8; (b) for matrix rotation difficulty, 1=90 degrees,
2=180 degrees, 4=random 90 or 180 degrees, and an addition of 8 to
these values converts to a successive problem; (c) for code
substitution difficulty, the set size varies from 2 to 9, with
values less than 2 or greater than 9 defaulting to 9; (d) in simple
reaction time, for a repetition=2, the seed increment is 100; (e)
mood scale bitwise options are 1=enable touch screen 20, 24 on the
PDA 10, 2=enable prompting tone (3 second intervals); (f) for
running memory CPT, the time allowed for responses is in
milliseconds (ms); (g) for memory search, the minimum memory set
observation time is in seconds (sec); (h) for code substitution,
the sparelong 1 setting determines the mode, where 0=learning,
1=delayed (i.e. recall); (i) for memory search, the maximum memory
set observation time is in seconds (sec); (j) for code
substitution, sparelong2 is a bitwise setting for extended
feedback, where 0=none, 1=visual feedback (red rectangle) for
errors, 2=auditory feedback for errors; and (k) for code
substitution, sparelong3 determines the number of presentations of
each symbol where 0=default (learning, 8, 6 correct, 2 incorrect;
recall 2, 1 correct, 1 incorrect).
[0073] Referring again to FIG. 2, the ARES embodiment of the
Neuropsychological! NeuroCognitive and Psychomotor Performance
Assessment and Rehabilitation System 100 may be installed on a
personal digital assistant 10 utilizing a personal or host computer
116. In one embodiment of the invention, a host computer data
management program includes a folder containing ARES files for
installation on the PDA 10. The ARES software of a preferred
embodiment requires a PDA with the Palm OS, version 3.5 or higher
and a Hot Sync cradle or cable.
[0074] ARES includes a number of Palm Operating System (OS) modules
as listed in Table 7. As shown in FIG. 2, only two programs, an
ARES executive program and an ARES back end program appear on the
view screen 14 of the PDA 10. In most applications that utilize the
assessment and rehabilitation system 100, only the ARES executive
program is used. The ARES executive program controls the subject
registration modules, the execution of the test batteries of test
modules, the review of data on the PDA, and the communication with
a host PC.
TABLE-US-00007 TABLE 7 ARES PALM OS MODULES PROGRAM FUNCTION
Ares.prc ARES Executive AresSub.prc Subject Registration AresBE.prc
Performance Index Calculation TEST MODULES AresCS.prc Code
Substitution AresLR.prc Logical Relations AresMO.prc Mood Scale
AresMP.prc Mathematical Processing AresMR.prc Matrix Rotation
AresMS.prc Matching to Sample AresRM.prc Running Memory AresRT.prc
Simple Reaction Time AresSS.prc Sleep Scale AresST.prc Memory
Search (Sternberg)
[0075] ARES is designed to allow more than one subject to use a
single PDA utilizing the registration modules 108. Registration of
each subject also allows different subjects to use different test
batteries. Each subject must be registered prior to running an
actual test battery. FIG. 3 illustrates a main screen of a
preferred embodiment of ARES which appears when the subject taps
the ARES executive program in the view screen 14. To register a new
subject or edit an existing subject, the subject taps the padlock
icon 32 in the lower left corner of the view screen 14. A screen
appears requesting a password. If the password is valid, an ARES
subject database screen 36 allows a user/subject to add 38, edit
42, or delete 44 subject information 46. The ID's of all currently
registered subjects will be listed in the text box 46. If all
subjects do not show in the box, tapping the arrow(s) 48 at the
right of the text box 46 scrolls the subject list. The ARES subject
database screen 36 can only be accessed through the ARES executive
module in order to maintain control over the registration process.
The required password protects subjects from viewing or modifying
the registration information or test results of other subjects
using the same PDA 10.
[0076] FIG. 6 illustrates the edit subject screen 50 and fields 54
used to register the subject, to edit the subject information, and
to select a test battery. The identification field is the subject
identification code and is used during subject Log In procedures.
The identification code also is used to identify all of the
subject's records in the database. The personal identification
number 52 (PIN) is used to verify a subject's identity when running
a test battery. Tapping the PIN button displays an easy-to-use
numeric keypad for entering PINs. The session number indicates the
latest session recorded. This variable is automatically set, and
typically is not changed. The battery is select from a list shown
by tapping a down arrow. The selected battery will be associated
with the subject so that the battery is automatically run once the
subject logs onto the system 100. The occupation field may be used
to record the occupation "other category" variables such as
military rank of the subject. The diagnosis field may be used to
record a subject's diagnosis category.
[0077] The edit subject screen 50 of the preferred embodiment also
provides access to a comment entry screen using a "Comment" button
58. Values are entered into the fields utilizing Graffiti, or the
mini-keyboard that can be displayed by tapping a keyboard icon at
the lower left corner of the graffiti screen 24, as illustrated in
FIG. 2. A done button 56 or a cancel button 60 are provided to exit
the edit subject screen 50.
[0078] Administering an ARES test battery. A subject utilizes ARES
by tapping the ARES Executive program icon displayed on the ARES
screen of FIG. 1. The subject then taps the Log In button 30 to
proceed to the subject database screen 36 which lists the
registered subjects. The subject enters his or her PIN 52, and if
the correct PIN is entered, a start screen appears (not shown).
Tapping a start button (not shown) on the start screen begins
battery administration.
[0079] The ARES tests of the preferred embodiment are designed to
use only the keys 16, 18 at the bottom of the PDA 10 for
user/subject input. However, in other embodiments of the invention,
the touch-sensitive screen may be used during the tests. The PDA 10
may be held with both hands using the thumbs to manipulate the keys
16, 18 for taking ARES tests. Each test begins with a screen
showing a brief explanation of how the test operates. FIG. 7
illustrates a view screen 14 for a mathematical processing test 70.
All of the tests provide a graphic representation 74 of the
keyboard at the bottom of the screen 14 with the active keys and
their meanings shown. In general, the top center key "3" is used to
start a test, and the keys "2" and "5" to either side of the center
are used to enter responses to the test items.
[0080] With the exception of Sleep Scale and Mood Scale, the tests
can be programmed to begin with a brief "warm-up" The "warm-up"
ensures that the instructions are understood. For two of the tests,
Mathematical Processing and Running Memory, a mastery criterion can
be specified and required to be met by the subject before allowing
administration of the test proper. If the criterion is not met, the
warm-up can be retried twice. If it is failed a third time, the
user is given the option of quitting the test or proceeding anyway.
At the completion of a battery, ARES may be programmed to provide
feedback regarding how performance on the just-completed battery of
tests compares with past performance by the same subject, or with
appropriate normative data.
[0081] For demonstration purposes, ARES tests may be taken
individually, i.e., not as part of a battery, through the "Single
Test" button on the Admin Functions screen that is available
through the options pull down menu 34, as shown in FIG. 4. FIG. 11
illustrates a demo single test screen 94 of a preferred embodiment.
In this mode, the results are saved in a database, as shown in
Table 9, but the tests are not configurable. A test is selected on
the list, and is launched by tapping the "Launch the Test" button.
Although the single test option is available, most subjects will
use a pre-specified test battery.
[0082] ARES test batteries may consist of up to nine tests. For
convenience, several standard test batteries are available as shown
in Table 2. These batteries are designed to meet common needs in
settings ranging from a relatively complete neuropsychological
screen (NeuroCog) to repeated assessment of the cognitive status of
military personnel in operational settings (Commander and Warrior).
In addition, two demonstration batteries are designed to provide
brief samples of the ARES tests and test data. Each test has a
small number of trials. The Commander and the two demonstration
batteries are automatically installed the first time the ARES
program is launched. Custom built batteries can be installed using
a data manager program installed on a host computer 116, or by Hot
Synching a customized version of the battery database (ARBatDB.PDB)
onto the PDA as explained further below.
[0083] The NeuroCognitive (NeuroCog) test battery is designed for
use by a neuropsychologist who is trained in the use and
interpretation of ANAM data. This battery is designed primarily for
diagnostic use and medical monitoring of recovery following an
insult to the central nervous system. The ARES Commander is
designed to provide a brief on-line assessment of the ability to
sustain levels of concentration, working memory, and mental
efficiency. It is intended for use as a self-monitoring system and
is intended for operational commanders in command and control
centers as well in field settings. ARES Commander also may be used
for similar purposes in other military missions such as sustained
flight operations to assess flight crew alertness and readiness. A
post-session Performance Index compares performance on the
just-completed battery with the subject's prior performance. The
ARES Warrior is constructed to provide a neurocognitive screening
instrument for use by medics and other medical support personnel
who must be able to rapidly assess the mental status of military
personnel in field operational medical and combat settings.
[0084] Table 8 shows the specifications for the "Commander" test
battery Cognitive Status Report of a preferred embodiment of the
present invention. Ten scores will be used to derive a performance
index (PI) for the test battery, ranging from 0 to 10. Items marked
with an asterisk are derived by comparing the current score with
scores from three prior sessions. The first session for which a PI
will be calculated is session five, and the first four sessions are
considered "familiarization" sessions. Data from the first session
is not used in calculating the initial baseline set of scores.
Sessions two, three, and four are considered "anchor" sessions.
These three sessions that are used in deriving the scores,
designated the "baseline" sessions, will be the three immediately
preceding the current session, with restrictions.
[0085] A first restriction for deriving scores is that no session
with a performance index less than "7" will be used, and a
preceding session is substituted. For example, if the current
session is session 10, and the Pi on session 8 was 5, the baseline
sessions are 9, 7, and 6. A second restriction is that if the
average values of the variable in the immediately preceding three
sessions is worse than the average of the three anchor sessions,
the anchor sessions will be used for that variable. Scores of "9"
or greater are considered passing scores, scores of "7" and "8" are
marginal, and scores of less than "7" are failure. Other back end
specifications of alternate embodiments of the invention may be
utilized depending upon the test battery and a pre-determined
passing criterion.
[0086] PDA operating systems, unlike most computers that use file
systems to store programs and data, store all information in
"databases" 122. Table 9 lists the databases used by ARES. All ARES
tests, with the exception of the Sleep Scale and Mood Scale, use
the same format for collecting the data. Data are stored as
"records" in the ARDataDB database on the PDA. Each record contains
the data from a single test, subject, and administration (session).
Data elements (fields) stored for each test are listed in Table 10.
Each record consists of four sections. The first section contains
housekeeping data for the test, and the last three sections contain
numerical results for the entire session, including the first half
of the trials in the session and the second half of the trials.
TABLE-US-00008 TABLE 8 COMMANDER BATTERY PERFORMANCE INDEX PASSING
CRITERION TEST VARIABLE CALCULATIONS (PASS-1, FAIL = 0) Sleep
Rating none Absolute score of 4 Scale or less *Response Mb =
average of the Rc greater than 1 Time baseline response times sec
and less than (3 scores) 2 times Mb Rc = response time of current
session Simple *Median RT Mb = average median Mc less than or RT RT
of baseline sessions equal to (Mb + Sb) Sb = average SO of mean RT
of baseline sessions Mc = median RT from current session *SO RT Sb
= average SD of Sc less than or equal mean RT of baseline to 1.5
times Sb sessions Sc = SD of mean RT of current session Bad + ITI
none 1 or less Running *Accuracy Ab = average accuracy Ac greater
than or Memory of baseline sessions equal to 0.9 Ac = accuracy on
times Ab current session *Median Same as for Simple RT Mc less than
or Correct RT except only correct equal to response trials are used
(Mb + Sb) *SD Correct Same as for Simple RT Sc less than or equal
RT except only correct to 1.5 times Sb response trials are used
Lapses none 3 or less Bad + ITI none 1 or less
TABLE-US-00009 TABLE 9 ARES OPERATING SYSTEM DATABASES DATABASE
CONTENTS ARDataDB All test results ARSubDB Subject records ARLinkDB
Battery control data ARBatDB Configured batteries of ARES tests
ARKeyDB ARES access mode, start date, and stop date
[0087] Referring to Table 10, "Impulsive R's" of the "Battery
Version" row are responses within 100 ms of the stimulus onset.
These responses are too quick to be processed by the human brain
and thus, are not valid. These responses are not included in counts
of errors and/or correct responses. "Inter trial R's" located in
the "Subject 10" row of Table 10 are key presses between stimuli
when the screen is blank. The Repetition Number tracts repetition
within the same battery. Random number seed is the session number
for the preferred embodiment, but an optional increment may be
added for other embodiments. Start time and end time are seconds
since Jan. 1, 1904. Spare data variables may be used by some tests
that do not fit the normal test template, e.g., sleep scale.
"Thruput" in the "Spare5" row is the number of correct responses
per minute of available response time, i.e., excluding inter-trial
intervals.
TABLE-US-00010 TABLE 10 DATA RECORD FIELDS SECOND HOUSEKEEPING
ENTIRE FIRST HALF HALF OF INFORMATION SESSION OF TRIALS TRIALS TEST
NAME RESPONSES RESPONSES RESPONSES TEST VERSION CORRECTS CORRECTS
CORRECTS BATTERY NAME ERRORS ERRORS ERRORS BATTERY VERSION
IMPULSIVE IMPULSIVE IMPULSIVE R'S R'S R'S ARES VERSION LAPSES
LAPSES LAPSES SUBJECT ID INTER-TRIAL INTER-TRIAL INTER-TRIAL R'S
R'S R'S SESSION NO. AVG COR RT AVG COR RT AVG COR RT REPETITION NO.
AVG ERR RT AVG ERR RT AVG ERR RT RANDOM NO. SEED AVG ALL RT AVG ALL
RT AVG ALL RT START TIME SD COR RT SD COR RT SD COR RT END TIME SD
ERR RT SD ERR RT SD ERR RT SPARE1 SD ALL RT SD ALL RT SD ALL RT
SPARE2 MEDIAN COR MEDIAN COR MEDIAN COR RT RT RT SPARE3 MEDIAN ERR
MEDIAN ERR MEDIAN ERR RT RT RT SPARE4 MEDIAN ALL MEDIAN ALL MEDIAN
ALL RT RT RT SPARE5 THRUPUT THRUPUT THRUPUT
[0088] As shown in FIG. 4, the options menu 34 is viewed by tapping
the menu icon 20 at the lower left corner of the PDA OS screen 12.
The "View Data" option allows the user to display data. When the
display data screen 80 is activated, as shown in FIG. 8, the last
record 82 to be recorded, that is, the data from the most recent
test run, is displayed first. Buttons 84 are provided to navigate
between records. The display data screen 80 of a preferred
embodiment does not display the partial-session data. This
information is available when the data are downloaded to a host
computer 116. The display data screen 80 also enables
administrators to delete individual records from the database if
ARES is "unlocked" by entering a password.
[0089] Continuing with the options menu 34 of FIG. 4, the "Connect
to Desktop" option is selected for transferring data to the host
computer 116. The "Admin Functions" option provides a
password-controlled access to selected functions. Tapping the
padlock icon 32 also accesses this function. The "About ARES"
screen shows the ARES version number and credits for the ARES
software.
[0090] The ARES Data Manager program 150 illustrated in FIG. 16 is
loaded onto the host computer 116, and has several functions. The
program 150 retrieves test and subject data from the PDA using the
button in the action field 154. The retrieved data is stored in the
ARES.MDB database, which is a Microsoft Access Database file on the
host computer 116. The data manager 150 also provides access to the
ARES.MDB database file to view and select data 156 for further
analysis. Subject information in the ARES.MDB database may be
viewed and edited. Custom test batteries may be installed on and
removed from the PDA 10. The plot data in the file menu 153,
provides access to a window for generating graphical plots of
selected variables from the ARES.MDB archive file.
[0091] All of the data in the ARDataDB and ARSubjDB databases on
the PDA 10 may be transferred to the host computer/desktop 116. The
data is displayed in a window 156 at the bottom of the screen, as
shown in FIG. 16. Each line in this table contains the data for a
single test, except that "startsec" has been converted to the
actual date and time that the test started, as shown in the "Start"
column, and the test duration in the "Dur" column is calculated by
subtracting "startsec" from "end sec". Values that are not
applicable or missing for some reason, e.g., mean error RT when no
errors were made, are coded as an asterisk "*" The "Subject" and
"Test" boxes may be used to select the data displayed in the table.
The data displayed in the table can be copied to a Windows
Clipboard as tab-delimited text by choosing Copy from the main menu
152, or by typing CTRL+C. The copied data can then be pasted into
other Windows applications, such as MS Excel, for further
processing.
[0092] Downloaded data are automatically saved to a file in the
"data" subdirectory of the directory in which the data manager
program 150 is located. The file name is the date and time of the
download (mmddyy_hhmmss), and the file type, that is, the file name
"extension", is "ARD" The .ARD file is a binary file that can be
read with the data manager program 150 by choosing File and then
Open from the main menu, or by clicking the Load File button. Both
the data and the subject information from the PDA 10 are also
inserted into the ARES.MDB Microsoft Access database when the data
are downloaded. This feature permit sophisticated users to easily
extract information of interest from large data sets, to combine
data sets, and to partition data to suit investigational or
clinical needs. If the data are already present in ARES.MDB, they
will not be duplicated, permitting repeated downloads from the same
PDA 10 without clearing the database on the PDA. The ARES.MDB
database is accessed by selecting the View Archive from the main
menu to display the entire data table from the ARES. MDB database.
This table can be sorted on any variable by selecting a column and
clicking one of the Sort buttons. The entire table, or selected
rows can be copied to the Windows clipboard and pasted into other
Windows applications.
[0093] When a subject is registered in ARES, a minimal amount of
information is required. To view and edit this information, the
Subject Database is selected from the main menu 152 of the data
manager program window 150. The panel 160 shown in FIG. 17 provides
complete access to the Subjects data table of ARES.MDB. The user
can navigate between records, i.e, subjects, using the arrow
buttons at the top of the panel. Searches can be performed for
subjects by name or 10 by selecting the appropriate option button,
and by entering the beginning characters of the name or 10 in the
Find box. Any changes made to any of the fields on this panel are
immediately transferred to the database. Until a new record is
loaded, clicking the Undo button will reverse any changes that are
made. This panel 160 provides several additional fields that can be
useful for identifying and classifying subjects. Spare1 through
Spare5 are for numerical values. The Comment field will accept up
to eighty (80) characters, and the Experiment and Group fields will
accept up to twenty-five (25) characters each. The copy button
places the contents of all the fields on the Windows Clipboard so
the data can be pasted into other Windows programs.
[0094] To install, list, or remove custom test batteries on the PDA
10, Battery Manager is selected from the main menu 152. Custom
batteries are distributed as "*.ARB" files. For example,
NeuroCog.ARB, Commander.ARB, and Warrior.ARB are placed in the ARES
folder when the data man program is installed. FIG. 18 illustrates
the battery manager window 170. The Select ARB Battery button or
the menu File and Open ARB battery is used to locate the desired
file for installation. The tests in the battery will be listed in
the "Tests" box 172. The properties of each test may be listed in
the "Test Parameters" box 174 by clicking the test name. By
selecting File and Print ARB Battery or by clicking the print
button, a hard copy of the battery with all of the test parameters
may be printed. Clicking the copy button puts a copy of the battery
with all of the test parameters on the Windows Clipboard. The
Battery Manager window 170 further provides buttons for installing
the battery on the PDA, for listing the batteries on the PDA, and
for deleting a battery from the PDA.
[0095] The data manager program 150 can produce graphical plots of
data from the ARES. MDB data table. To open the plot screen, Plot
Data is selected from the main menu 152. FIG. 19 illustrates the
graphical display of data window 180. To plot data from the
ARES.MOB archive, a Battery, Subject, Test, and Variable are
selected form from the drop-down lists 182. The Battery, Test and
Subject lists are populated with all of the instances of the
respective items from the ARES.MDB data table. The Variable
drop-down list allows variables to be selected for the entire
session, for the first half of the session (1), or for the second
half of the session (2). These variable include Mean Correct
Response Times (RT), SO of Correct RT, Median of Correct RT,
Percent correct, Lapses, and Thruput. Up to ten different variables
can be displayed on the same graph in the preferred embodiment of
the invention. Further, the plot window can be minimized, moved,
and maximized, and the properties of each variable can be changed
by right-clicking on the variable in the legend.
[0096] ARES Administration Functions, illustrated in FIGS. 9, 10,
11, and 12 are accessed through the options menu 34 of the main
ARES window shown in FIG. 4. To access the Administration
Functions, the user must enter a password on the password screen
90, as shown in FIG. 9. The password is provided to authorized
individuals, only. When this password is successfully entered, the
Admin functions are "unlocked" and need not be entered again until
ARES is closed. An open padlock 32 on the main ARES screen
indicates the unlocked state. Once a correct password is entered,
the admin functions screen 92 of FIG. 10 is activated. The first
button launches the AresSub application for registering new
subjects and for modifying the records of existing subjects. The
Demo Single Test button allows a single test module to be run for
demonstration purposes as shown in FIG. 11. The Database Manager
screen of FIG. 12 is provided for maintenance of the ARES databases
on the PDA. The clear data base button allows a data database
(ARDataDB) to be deleted from the PDA. Beam buttons use the Palm OS
"Beam" function to transfer the data and battery (ARBatDB)
databases to another PDA. These functions are used when setting up
PDA.
[0097] Although a preferred embodiment of the invention has been
described above by way of example only, it will be understood by
those skilled in the field that modifications may be made to the
disclosed embodiment without departing from the scope of the
invention, which is defined by the appended claims.
* * * * *