Jones, C., Miguel-Cruz, A., & Brémault-Phillips, S. (2021). Technology Acceptance and Usability of the BrainFx SCREEN in Canadian Military Members and Veterans With Post traumatic Stress Disorder and Mild Traumatic Brain Injury: Mixed Methods UTAUT Study. JMIR Rehabilitation And Assistive Technologies, 8(2), e26078. doi: 10.2196/26078

Overview:

• Aim to determine the technology acceptance and usability of the BrainFx SCREEN, among Canadian Armed Forces service men and veterans with PTSD by using the Unified Theory of Acceptance and Use of Technology model

• Facilitating Conditions, which were the most notable predictors of behavioral intention, increased after using the BrainFx SCREEN, whereas Effort Expectancy decreased.

• Performance Expectancy, Effort Expectancy, and Social Influence were not factors that could predict behavioral intention.

• Participants who reported a previous MTBI were significantly more likely to report current symptoms of cognitive impairment.

• The BrainFx SCREEN is a feasible, usable, and accepted assessment tool for CAF-SMs and veterans who experience PTSD.

Searles, C., Farnsworth II, J., Jubenville, C., Kang, M., & Ragan, B. (2018). Test-retest reliability of the BrainFx 360® performance assessment. Athletic Training and Sports Health Care, 11(4), 183- 191. doi:10.3928/01913913-20181005-01

Overview:

• Overall performance of the BrainFx 360 had a high reliability  score (interclass correlation coefficient) of .85  

• The  results  of  this  study  suggest  that  the  BrainFx  360  may  have  superior  reliability  when  compared  to  commonly used computerized test batteries such as the ImPACT,  ANAM,  and  Axon/CogSport  tests 

• Deemed promising with the potential to improve concussion evaluation and management .

Sergio, L., & Gage, W. (2014). BrainFx 360 assessment: Clinical validation. York University. [White paper].

Highlights: N=22; half control; half with diagnosis. Assessment able to predict whether healthy or with dysfunction every time. >15
assessment activities statistically significant between groups.

Young, K., Perlman, C., & Hewitt, K. (2018). Neurofunction in community mental health treatment: An evaluation of the clinical utility of the brainfx assessment at the Canadian mental health association waterloo wellington [White paper].

Highlights: N= approx. 250. As presented at EPION: Assists with treatment planning and goals. Client approved. Measures impact
of medications.

Wilansky, P., Eklund, M., Milner, T., Kreindler, D., Cheung, A., Kovacs, T.,…Mills, R. (2016). Cognitive behaviour therapy for anxious and depressed youth: Improving homework adherence through mobile technology. Journal of Medical Internet Research, 5(4), 1-17.
doi:10.2196/resprot.5841

Team includes: CAMH, Hospital for Sick Children, Markham Stouffville Hospital, Sunnybrook Hospital, Ontario Shores for Mental Health Sciences, UOIT, University of Toronto, University of Manitoba, University of Alberta, University of Bristol, Bell Canada Chair for Mood & Anxiety Disorders, Child & Youth Mental Health Collaborative, Mood Disorders Association & Youth Speaks & Central LHIN.

Overview:

• Research Team members: CAMH, Hospital for Sick Children, Markham Stouffville Hospital, Sunnybrook Hospital, Ontario Shores for Mental Health Sciences, University of Ontario Institute of Technology (now Ontario Tech University) , University of Toronto, University of Manitoba, University of Alberta, University of Bristol, Bell Canada Chair for Mood & Anxiety Disorders, Child & Youth Mental Health Collaborative, Mood Disorders Association &Youth Speaks & Central LHIN.

• Purpose of study is is to improve homework adherence in Cognitive Behavioural Therapy for youth anxiety and/or depression. The objectives are to (1) design and optimize the usability of a mobile app for delivering the homework component of CBT for youth with anxiety and/or depression, (2) assess the app’s impact on homework completion, and (3) implement the app in CBT programs. We hypothesize that homework adherence will be greater in the app group than in the no-app group.

• BrainFx will lead the commercialization of the mobile app

• The app will be a unique adjunct to treatment for adolescents in CBT, focusing on both anxiety and depression, developed in partnership with end users at every stage from design to implementation, customizable for different cognitive profiles, and designed with depression symptom tracking measures for youth made interoperable with electronic medical records.

Ali, S., Bialik, C., Fang, J., Lovell, T., & Holmes, J. (2016, April). Validity of the BrainFx 360 for the assessment of standing balance. Poster presented at the meeting of Evidence-Based. Practice Conference, London.

Highlights: Psychometric properties of the balance activities in BrainFx 360 are comparable to that of the gold standard force plate.

Jerominski, A., Silverman, E., Patel, H., Volgman, A., & Aggarwal, N. (2017, April). Using technology to characterize the consequences of atrial fibrillation in female patients from the Rush Heart Center for Women (RHCW). Poster presented at the meeting of The 25th Anniversary Congress on Women’s Health, Washington.

Highlights: Utilizing BrainFx 360 Assessment, differences in functional cognitive profiles in women pre-MI and post-MI discovered

Mann, J., Bradney, D., & Bowman, T. (2018, April). The effects of environment and fatigue levels on BrainFx SCREEN scores. Poster presented at the meeting of Student Scholar Showcase, Virginia.

Highlights: BrainFx SCREEN demonstrated good reliability regardless of whether administered in the clinic or near the field/in
locker-room and despite level of reported fatigue.

McWhinnie, J., Kwan, G., & Hirano, G. (2017, June). Measuring change in neurofunction with BrainFx 360 after cognitive adaptation training in schizophrenia. Poster presented at the meeting of Evidence-Based Practice Symposium Occupational Therapy, Hamilton.

Milner, T. (2013, March). The development and validation of BrainFx 360®: A tablet and web-based assessment tool for mild to moderate impairments in neurofunction. Poster presented at the meeting of Traumatic Brain Injury Conference, Washington D.C.

Highlights: >45 health professionals reviewed assessment content in detail for sensitivity to mild to moderate dysfunction.

Young, K., Hewitt, K., & Lizon, M. (2017, May). BrainFx project: Promoting mental health and participation in life activities through neurofunction. In Early Psychosis Intervention Ontario Network. In C. Cheng (Co-chair). Early Psychosis Intervention Ontario Network. Lecture conducted from Early Psychosis Intervention Ontario, Mississauga.

Young, K., Perlman, C., & Hewitt, K. (2018). Neurofunction in community mental health treatment: An evaluation of the clinical utility of the brainfx assessment at the Canadian mental health association Waterloo wellington [White paper].

Highlights: N= approx. 250. As presented at EPION: Assists with treatment planning and goals. Client approved. Measures impact of medications.

Condello, H. (2018, April). On a Mission to Eradicate Dysfunction from Brain Disorders: Our OT Journey into Digital Health. American Occupational Therapy Association National Conference, Salt Lake City, Utah.

Brain Health Screen and Risk Management Program @ Wilfred Laurier University, SE Health, Ontario Family Health Teams

Overview

• A mixed methods study comprised of a prospective observational cohort study (n=147) including psychometric testing (concurrent validation and test-retest reliability) of the BrainFx SCREENTM for detection of mild cognitive impairment (MCI) in community-dwelling older adults (+55 years) recruited from family health teams in southern Ontario.

• Psychometric evaluation, comparing the sensitivity/specificity of the SCREEN™ with a validated MCI Screening tool (Qmci) in adults aged 55+

• SCREEN sensitivity of 74-77%

• SCREEN specificity of 62-69%

• Test-Retest reliability for the overall SCREEN score is .76, suggesting reasonable stability over time.

• 57% of patients had a positive impression of the report and were pleased with receiving a copy

• Some patients expressed that having a clear cut for scoring would have been preferable; others like seeing where they were in range in comparison to others

• 38.8% took home intervention sheets

• 46.4% believed the interventions had a positive effect

• 73.8% believed they could modify their lifestyles to reduce their risk of developing cognitive impairment

• 50% said their perspective on brain health was changed by the experience

Promoting Cognitive Health for Seniors within Larger Healthcare Systems @ Atrium Health (USA), West Park Healthcare, primary care partners and in partnership with the Centre for Aging and Brain Health Innovation (CABHI, powered by Baycrest) – Research in progress

• Exploring BrainFx’ clinical utility, economic feasibility and ease of adoption in larger healthcare systems

• At West Park, BrainFx Screen to be incorporated throughout in-patient rehabilitation

• At Atrium, BrainFx Screen to be incorporated in pre and post surgical assessments and during primary care evaluations

• At primary care practices, BrainFx Screen to be administered by nurses

Validating BrainFx DRIVE screen: A tablet-based roadside screen for detection of driving impairment due to cannabis use @ University Health Network (Toronto Rehab Institute), Apollo Applied Research (Research in Progress)

• A study looking at the effects that cannabis has on cognitive function and how these skills can impact driving (n=500).

• The focus of this study is to identify the cognitive skills from BrainFx 360TM that are impaired by cannabis,and to incorporate these activities into a roadside screen(BrainFx DRIVE ScreenTM), that can be used to predict a driver’s ability to drive safely and assist police officers/employers with screening for driving impairment.

• Performance on 16 test elements was found to correlate with cannabis consumption

• Development of the BrainFx DRIVE ScreenTM prototype is underway

The Canadian Model of Cognitive Skills and Models of Neurofunction @ University of Alberta.

This paper will describe the development and methodology of the Canadian Model of Cognitive Skills and Models of Neurofunction which underpin the development of BrainFx Assessments.

Deep Dive into the Psychometric Properties of BrainFx Assessments @Texas State University. This study (n= ~5000) will examine the psychometric properties of the BrainFx 360 Assessment and BrainFx SCREEN using Classical Test Theory and Item Response Theory analyses. It will also examine the test equivalency between BrainFx 360 Performance Assessment and BrainFx SCREEN.

Early detection of Cognitive decline in a A populatioN at high-risk for vascUlar demenTia using a novEL digitaL biomarker platform (CAN U TELL) @ Wayne State University [awaiting grant funding]

This study will evaluate sensitivity of the BrainFx 360 digital biomarker to pre-clinical cognitive deficits in an at-risk population of older African Americans.  It aims to determine the functional specificity of the BrainFx 360 digital biomarker with structural brain correlates and identify the health risk profile of individuals with deficits on the BrainFx 360 digital assessment.

University of California, San Diego Health Sciences. “Current screening methods miss worrisome number of persons with mild cognitive impairment.” ScienceDaily. ScienceDaily, 24 May 2016.

Elman JA et al (2018) Underdiagnosis of mild cognitive impairment: a consequence of ignoring practice effects. Alzheimers Dement (Amst) 10:372–381