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Overview

The Computer Assessment of Memory and Cognitive Impairment (CAMCI®) is a portable computerized tool designed to provide a valid assessment of abnormal cognitive function in older individuals at an early stage. The CAMCI consists of 8 tasks testing multiple aspects of cognitive function, and a series of self-report questions to gain information from the patient. CAMCI is administered via tablet computer using touchscreen technology for response input, and takes about 25 minutes to complete. CAMCI includes an innovative virtual environment task (watch demo) together with traditional neuropsychological tests modified for computer administration and response input.

CAMCI Tasks Preview

In a study of 524 community-dwelling, non-demented participants, CAMCI was highly sensitive (86%) and specific (94%) in the identification of Mild Cognitive Impairment *.


Patients participate at their own pace (average time is 25 minutes). The patient’s report is then immediately generated for on-screen inspection or to be printed for the interpreting physician. Performance is age and education adjusted (based on normative data) to provide a comprehensive summary score. Task level accuracy and reaction time scores are also reported. 


CAMCI is intended as a computerized assessment tool to contribute to the clinical assessment of cognitive function in older adults**. CAMCI is designed to address the challenges of cognitive testing in the clinical setting, and assists in the evaluation of adult patients with suspected cognitive dysfunction. CAMCI is to be used under the direction of a healthcare professional but is administered via computer, self-paced (i.e., the patient proceeds from task to task at their own pace), automatically scored, and thus does not require the continuous presence of a trained examiner after initial set-up. The interpretation of the report must be performed by a qualified health care professional.


Current reporting features use normative data collected from elderly subjects ages 60+.


CAMCI is billable under CPT code 96120 (Neuropsychological testing administered by a computer). The reimbursement covers the neuropsychological testing by a computer and the interpretation and reporting time for the physician or clinical psychologist.

Effective 01-01-06: Medicare Part B coverage of neuropsychological tests is authorized under section 1861(s)(2)(C) of the Social Security Act. Payment for neuropsychological tests is authorized under section 1842 (b)(2)(A) of the Social Security Act.

This product is currently in the research, development, and pre-market stage. It is currently only available to researchers with an IRB approved protocol.

*Saxton et al. Computer assessment of mild cognitive impairment. Postgraduate Medicine. 2009; 121(2):177-185.

**Intended Use
CAMCI is intended as a computerized assessment tool to contribute to the clinical assessment of cognitive function in older adults. CAMCI does not offer a medical diagnosis. The results of the CAMCI, when interpreted by a qualified healthcare professional, will assist in the identification of patients with suspected cognitive impairment for whom further evaluation may be appropriate. 

Indications for use
CAMCI is indicated for the assessment of cognitive functioning in adults aged 60 or over.

Contraindications
CAMCI should not be used by patients who have uncorrectable visual and/or auditory impairments which would prohibit adequate perception of instructions or stimuli, who have insufficient knowledge of English to understand the instructions or stimuli, or who have a physical disability that would prohibit their ability to respond using the touchscreen/stylus. CAMCI is not approved for in-home use.

Device description
The Computer Assessment of Memory and Cognitive Impairment (CAMCI®) is a portable computerized tool designed to provide a valid assessment of abnormal cognitive function in older individuals at an early stage. The CAMCI consists of 8 tasks testing multiple aspects of cognitive function including, attention, verbal memory, nonverbal memory, executive function, processing speed.  Additionally, a series of self-report questions are included to gain information from the patient regarding factors that could affect the patient’s performance on the CAMCI tasks (e.g., perceived memory loss, alcohol use, depression, anxiety). CAMCI is administered via tablet computer using touchscreen technology for response input, and takes about 25 minutes to complete. The test runs on a tablet computer allowing greater portability and flexibility than desktop computers. This approach ensures standardized administration and scoring, thus avoiding inter-site and inter-examiner variability. Performance is age and education adjusted (based on normative data) to provide a comprehensive summary score. Task level accuracy and reaction time scores are also reported. CAMCI does not provide a medical diagnosis, however it assists the physician in making a diagnosis by identifying, quantifying, and characterizing cognitive symptoms.

These statements have not yet been evaluated by the Food and Drug Administration.

Features

  • Highly sensitive and specific assessment tool
  • Computer administered, Self-paced
  • User-friendly
  • Evaluates a range of cognitive processes, tasks include:
    • Simple Reaction Time
    • Digit Span Forward and Reverse
    • Go/No Go
    • Word Recall
    • Verbal Recognition
    • Recurring Pictures
    • Virtual Environment
  • Accuracy and response times tracked and reported
  • Report immediately available to view on-screen or to print
  • Report includes comprehensive score and individual task scores
  • Reimbursable under CPT code 96120
  • Pre-installed on a medical grade Tablet PC
    • Sealed design is easily cleaned and disinfected (UL 60601-1 certified)
    • Ergonomic
    • Portable
    • Lightweight
    • Support included to maintain angle for visual performance
    • Stylus input
    • Integrated speakers for optimal playback

Research

CAMCI has been used in research studies addressing cognitive assessment of primary care patients, intervention in dementia, traumatic brain injury, HIV-related cognitive decline, mobility assessment, and exercise interventions, as well as in studies examining the elderly and arthritis. Over 1,000 participants have used the CAMCI with overwhelmingly positive results.

Research studies involving CAMCI:

  • Pilot study on Moderate to Severe Traumatic Brain Injury

Principal Investigator: L. Morrow, Ph.D., University of Pittsburgh School of Medicine
Brain Trauma Research Center collecting pilot data on moderate to severe TBI subjects (ages 20-60 to add to the current database of ages 60+).

  • Cognitive Assessment of Primary Care Patients (NIA)

Principal Investigator: J. Saxton, Ph.D., University of Pittsburgh
The major goal of this study is to investigate the utility of cognitive testing in the Primary Care setting using CAMCI. Both clinical outcomes and clinical practice are being investigated in this five-year study involving 1,000 subjects over age 65 and 24 community Primary Care Physicians.

  • Detection, Diagnosis and Intervention in Dementia in Rural and Urban Elderly (Pennsylvania State funded Center for Excellence-4100027294)

Principal Investigator: J. Saxton, Ph.D., University of Pittsburgh
Investigating the utility of computerized testing as a screening tool for identification of persons with MCI, the stability of performance on a computerized test over 2 years, the agreement between performance on a computerized test and comprehensive diagnostic assessment at the ADRC ("gold standard"), and whether level of diagnostic certainty, as measured by computerized testing, increases with additional information, specifically results of caregiver interview and/or PCP medical chart review. Preliminary data analysis indicates we can successfully recruit rural and African American elderly to participate in research but preferably if they do not have to travel to a university setting, about 25% of individuals will be lost to follow-up each year, and a brief cognitive assessment correctly identifies ~ 80% of individuals with normal cognition and ~ 80% of individuals with borderline functioning.

  • HIV-related Cognitive Assessment Study

Principal Investigator: N. Sacktor, Ph.D., Johns Hopkins University
An HIV cognitive assessment study, with 85 HIV positive patients and 45 HIV negative controls currently enrolled, to evaluate the utility of the CAMCI for functional performance. Analysis of the baseline data is underway to investigate the relationship between CAMCI test scores and the original American Academy of Neurology (AAN) criteria for HIV associated neurocognitive disorders (HAND).

  • Pilot Study of an Internet-based Cognitive Stimulation Program in AIDS (NIMH- NCT00619567)

Principal Investigator: J.T. Becker, Ph.D., University of Pittsburgh
The neurocognitive manifestations of HIV/AIDS have long been recognized as important for the management, survival, and quality of life of affected patients and their families. Following the advent of Highly active anti-retroviral therapy (HAART) the incidence of HIV-associated dementia (HAD) has fallen, but the prevalence of the milder forms of HIV-related cognitive disorders has risen. This is important because alterations in cognitive function can have significant impact on work and social activities, mood, and perceived quality of life. To date, pharmacological management of HIV-associated cognitive disorders - apart from HAART - have met with limited success (e.g., Peptide T, Ritalin). Therefore, it appears reasonable to ask whether the use of non-pharmacological tools might help alleviate or ameliorate the symptoms of the milder forms of cognitive impairment, and thus improve mood and activities of daily living. The purpose of this application is to request funds to allow us to complete a feasibility/pilot study of the merits of using an internet-based cognitive stimulation program (CSP) to improve the cognitive functions and quality of life of individuals with HIV/AIDS, and, secondarily, to detect such changes using a computerized assessment tool designed for use in a health care practitioner's office (Computer-Based Assessment of Mild Cognitive Impairment (CAMCI)).

  • Increasing Minority Participation in Mobility Assessment and Exercise Interventions (Claude Pepper Center)

Principal Investigator: S. Albert, Ph.D., GSPH, University of Pittsburgh
In the Boosting Minority Involvement study, 96 African-American men and women aged 60 and older completed performance tests of physical and cognitive function. The mean age was 73, 78% were female, and 67% lived alone. Physical function was assessed with the Short Physical Performance Battery (SPPB), a test of gait, balance, and leg strength. Cognition was assessed with standard paper and pencil tests as well as the CAMCI. Z-score composite measures were developed from the CAMCI to assess the domains of attention, verbal memory, and executive function. In adjusted analyses, global memory and executive function explained 45% of the variability in SPPB. Gait and balance may in part depend on multifaceted higher cognitive demands, such as higher-order executive function. Nieto ML, Albert SM, Morrow LA, Saxton J. Cognitive status and physical function in older african americans. J Am Geriatr Soc. 2008;56(11):2014–2019.

  • Computer Assessment of Mild Cognitive Impairment (NIH/NIA 5R44AG022792-03)

Principal Investigator: A. Eschman, MS, Psychology Software Tools, Inc.
The Computer Assessment of Mild Cognitive Impairment (CAMCI) is a self-administered, user-friendly computer test that scores automatically and can be completed independently in a quiet space, such as a doctor's examination room. The goal of this study was to compare the sensitivity and specificity of the CAMCI and the Mini Mental State Examination (MMSE) to identify mild cognitive impairment (MCI) in 524 nondemented individuals > 60 years old who completed a comprehensive neuropsychological and clinical assessment together with the CAMCI and MMSE. We hypothesized that the CAMCI would exhibit good sensitivity and specificity and would be superior compared with the MMSE in these measures. The results indicated that the MMSE was relatively insensitive to MCI. In contrast, the CAMCI was highly sensitive (86%) and specific (94%) for the identification of MCI in a population of community-dwelling nondemented elderly individuals. Saxton J, Morrow L, Eschman A, Archer G, Luther J, Zuccolotto A. Computer Assessment of Mild Cognitive Impairment. Postgrad Med. 2009 Mar; 121(2):177-85.

FAQs

Q: What research has been conducted showing the ability of CAMCI to assess cognitive function?
A: CAMCI yielded sensitivity of 86% and specificity of 94% in a study of 524 community-dwelling, non-demented participants*. This analysis compared the CAMCI results to the adjudication of each participant (performed by trained neuropsychologists) using a full neuropsychological battery.

*Saxton et al. Computer assessment of mild cognitive impairment. Postgraduate Medicine. 2009; 121(2):177-185.

In a study investigating extremity function in community-dwelling elderly African Americans, participants with poor executive function were more than four times as likely to have poor physical performance as people with better executive function.

Nieto ML, Albert SM, Morrow LA, Saxton J. Cognitive status and physical function in older african americans. J Am Geriatr Soc. 2008;56(11):2014–2019.

Q: Is CAMCI being used in any other research studies?
A:CAMCI has been used in research studies addressing cognitive assessment of primary care patients, intervention in dementia, assessment of mild cognitive impairment in underserved populations, traumatic brain injury, HIV-related cognitive decline, clinical links to fatigue. mobility assessment, and exercise interventions, as well as in studies examining the elderly and arthritis.
Q: Can elderly patients use a computer?
A: Over 1,000 elderly participants have used the CAMCI with overwhelmingly positive results. Not one participant has been unable to complete the CAMCI battery of tasks due to an inability to use a computer.
Q: What tests are involved?
A: CAMCI includes tests of simple attention, visual and verbal memory, executive abilities, and working memory. A virtual reality driving task provides an innovative approach to cognitive testing by incorporating assessments into everyday scenarios (e.g., going to the supermarket).
Q: When are the results available?
A: Results are available immediately! The patient’s report is immediately generated for on-screen inspection or to be printed for the interpreting physician.
Q: What does the report consist of?
A: The report contains the patient’s comprehensive score and an interpretation of results, as well as a thorough account of individual task performance.
Q: Does Medicare cover CAMCI testing?
A: CAMCI is billable under CPT code 96120 (Neuropsychological testing administered by a computer). The reimbursement covers the neuropsychological testing by a computer and the interpretation and reporting time for the physician or clinical psychologist.
Effective 01-01-06: Medicare Part B coverage of neuropsychological tests is authorized under section 1861(s)(2)(C) of the Social Security Act. Payment for neuropsychological tests is authorized under section 1842 (b)(2)(A) of the Social Security Act.

Pricing

CAMCI is currently in the research, development, and pre-market stage. It is currently only available to researchers with an IRB approved protocol.

Please contact us for more information.

CAMCI Interface

CAMCI Tasks

Testimonials

"Older adults in [my] study, many who had never used a computer, completed CAMCI assessments with little problem and found it one of the more satisfying parts of our research protocol."

Steven M. Albert, PhD, MSPH
Professor and Associate Chair
Department of Behavioral & Community Health Sciences
Graduate School of Public Health
University of Pittsburgh

Contact Us

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Telephone:
412.449.0078

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Email:
info@pstnet.com