Auditory test of processing speed: Further validation and test-retest reliability

Background: The Auditory Test of Processing Speed (ATOPS) is a new cognitive test for people with multiple sclerosis (PwMS). ATOPS was designed to be independent of vision and have minimal involvement of cognitive functions other than mental speed. Initial work showed promising validity and patient acceptability. Objectives: Assess an improved version of ATOPS, investigating known groups and construct validity, as well as test-retest reliability. Methods: We studied 42 PwMS and 48 healthy volunteers (HVs) using ATOPS and conventional neuropsychological tests. Comparisons examined sensitivity in discriminating PwMS from HVs, and cognitively-impaired (CI) from cognitively-preserved (CP) PwMS. Pearson correlations assessed convergent validity between ATOPS and conventional neuropsychological tests, and test-retest reliability. Results: ATOPS discriminated PwMS from HVs (d = 0.769-1.298), correlated with the Symbol Digit Modalities Test (SDMT) (|r|= 0.344-0.536), and discriminated CI from CP PwMS in the more difficult subtests (d = 0.890-0.995). Retest correlations ranged from r = 0.638-0.803 in PwMS and r = 0.488-0.773 in HVs. Conclusions: This version of ATOPS shows excellent known-groups validity and significant, if modest, test-retest reliability. One impediment to reliability may be manual entry of participant responses by the examiner. A revised edition of ATOPS using voice recognition technology is developed and undergoing psychometric evaluation.