The Rapid Online Cognitive Assessment

INTRODUCTION Paper-based screening examinations are well-validated but minimally scalable. If a DCA replicate paper-based screening, it would improve scalability while benefiting from their extensive validation. METHODS We developed and evaluated the Rapid Online Cognitive Assessment (RoCA) against gold-standard paper-based tests in patients with a range of cognitive integrity (n = 46). Patient perception of the RoCA was also evaluated with post-examination survey. RESULTS The RoCA classifies patients similarly to gold standard paper-based tests, with a receiver operating characteristic area under the curve of 0.81 (95%CI 0.67-0.91, p < 0.001). It achieves a sensitivity of 0.94 (95%CI 0.80-1.0, p < 0.001). This was robust to multiple control analyses. 83% of patient respondents reported the RoCA as highly intuitive, with 95% perceiving it as adding value to their care. DISCUSSION The RoCA may act as a simple and highly scalable cognitive screen.