ABSTRACT NUMBER: ESOC2026A1333 TABLET OXFORD COGNITIVE SCREEN FROM ANALOGUE TO DIGITAL: EQUIVALENCE TESTING IN UK, SWEDEN AND ITALY

Abstract Background and aims Digital health technologies in stroke can improve efficiency, accuracy, and reduce demand on clinical resources in line with WSO recommendations. Oxford Cognitive Screen (OCS) is a stroke specific first line cognitive screening. The paper version uses printed test booklets and response sheets that take time to prepare and administer. We developed and validated OCS on tablet (a CE-marked digital medical device) to improve clinical efficacy and value internationally. Aim: To evaluate the equivalence, feasibility, safety and cost-effect between paper and tablet OCS in sub-acute stroke and healthy patients in UK, Italy and Sweden Methods Evaluation was performed in 151 subacute stroke survivors and 290 healthy adults across three countries, using paper and tablet versions of OCS. Performance, normative cut-offs, and incidence of impairment were compared, with equivalence t-tests appropriate to assess consistency Results Broadly equivalent scores were found between the two OCS versions, with minor deviations attributable to the shift in response modality. Internal consistency: ⍺ = .88 (SD=.17). The shift did not alter normative data cut offs nor classification of cognitive impairment across countries. Tablet OCS was quicker to administer (p<.05) than paper OCS and was safe and feasible to use. Conclusions Tablet OCS showed equivalence to paper-based OCS, supporting its use in clinic and research. Tablet OCS is time and resource efficient, providing clinical value and improved accuracy. Assessment procedure is standardised, instructions accessible continously, automatic scoring, immediate access to results improving screening efficiency. Digital OCS provides important values as an easy-to-use, resource-efficient alternative for routine cognitive screening post-stroke Conflict of interest Mauro Mancuso nothing to disclose, Benedetta Basagni nothing to disclose, Kyra Hamilton nothing to disclose, Marika Möller nothing to disclose, Eleonor Krohn nothing to disclose