OS06.6.A DEVELOPING A SCREENING TOOL FOR COGNITIVE DEFICITS IN NEURO-ONCOLOGY ROUTINE CLINICAL PRACTICE

Abstract BACKGROUND Cognitive impairments are common in brain tumour patients and cause significant financial and emotional burden. Early detection is imperative for targeted neurorehabilitation, yet in clinical settings, time and resources constraints limit neurocognitive screening at admission. Computerised tools might be advantageous in this sense, but there is a lack of standardised, sensitive, and clinically feasible methods. This study aimed to (1) use an app-based computerised cognitive assessment tool (OCS-Bridge) to generate time-efficient and sensitive cognitive assessment batteries, suitable for time-constrained clinical scenarios and (2) evaluate their clinical efficiency and feasibility. MATERIAL AND METHODS Two cohorts of brain tumour patients completed the tablet OCS-Bridge assessments pre-operatively. The first cohort (n = 85) completed the full battery, based on which shorter assessments (approximately 15, 10 and 5 minutes) were generated using the most sensitive, granular and unique tests. Using the whole battery as a reference, the shortened assessments were compared to the full OCS-bridge assessment employing Receiver Operating Characteristic Curve Analysis. The abbreviated batteries were then integrated in the neruo-oncology clinic as part of patients’ routine pre-operative care, to evaluate both their integration into the clinical pathway and their effectiveness in identifying cognitive deficits in a new sample of participants (n = 111). RESULTS The OCS-Bridge abbreviated assessments detected cognitive deficits with a comparable accuracy to the full battery (Area Under Curve = 0.95, 0.96, 0.99 for the 5, 10 and 15 minutes abbreviated tests, respectively). These integrated efficiently into the service, were well engaged with by the patients, and enabled generation of rich cognitive data in as little as 5 minutes, without interrupting an already established clinical routine or requiring specialist administration. In both cohorts, around 80% of the patients exhibited cognitive issues in at least one domain. Most affected areas were perception, attention, and social cognition. CONCLUSION We present evidence supporting the need for integration of cognitive assessments pre-operatively in neuro-oncology clinics and propose OCS-Bridge (and its shortened form assessments) as a fit standardised protocol for cognitive screening in adult participants with brain tumours undergoing surgery.