Ecological Momentary Mobile Cognitive Screening for Cancer-Related Cognitive Impairment Among Patients With Lung Cancer

Cancer Nurs. 2025 Jul 24. doi: 10.1097/NCC.0000000000001530. Online ahead of print.

ABSTRACT

BACKGROUND: Accessible, real-time cancer-related cognitive impairment (CRCI) assessments remain limited.

OBJECTIVES: The aims of this study were to develop and validate the Single Item Mobile Cognitive Screening (SIM-Cog Screening) tool to detect CRCI, establish its concurrent validity and test-retest reliability, and assess feasibility through momentary assessments.

METHODS: A secondary analysis was conducted on data from 175 newly diagnosed patients with non-small cell lung cancer. Participants completed in-person assessments, including the Montreal Cognitive Assessment Hong Kong version 5-Min Protocol and Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) measures, and a mobile survey with SIM-Cog Screening and ratings of anxiety, depression, fatigue, pain, and sleep disturbance. A subgroup of 10 participants completed the ecological mobile survey twice daily for 7 days. Receiver operating characteristic curve analysis used the Montreal Cognitive Assessment Hong Kong version 5-Min Protocol and FACT-Cog measures as reference standards.

RESULTS: The receiver operating characteristic curve analysis revealed the area under the curve values of 0.928 when referenced against the FACT-Cog Perceived Cognitive Impairment-18. The optimal cutoff score of 4 on the FACT-Cog Perceived Cognitive Impairment-18 yielded a sensitivity of 88% and a specificity of 83.7%. Single Item Mobile Cognitive Screening scores correlated with measures of anxiety, depression, fatigue, and sleep disturbance. The test-retest reliability coefficient was 0.724, and participants reported high satisfaction with the ecological mobile survey.

CONCLUSIONS: This brief, ecological mobile cognitive screening measure can transform how CRCI is detected, monitored, and managed, enabling timely interventions.

IMPLICATIONS FOR PRACTICE: Utilizing tools like SIM-Cog Screening can facilitate timely interventions tailored to individual patient needs, ultimately enhancing quality of life and treatment outcomes.

PMID:40711466 | DOI:10.1097/NCC.0000000000001530