Performance assessment on the Korean Computerized Neurobehavioral Test using a mobile device and a conventional computer: an experimental study

BACKGROUND: The Korean Computerized Neurobehavioral Test (KCNT) is a psychological assessment tool used as part of Workers’ Special Health Examinations in Korea. Due to the spread of mobile technology, this study aimed to compare results of the KCNT administered on a tablet PC versus a desktop computer, and, therefore, assess the clinical applicability of mobile devices. METHODS: A total of 72 participants enrolled in this study. Their age, sex, and years of formal education were collected during an interview, as well as their typing speed. The test battery comprised five subtests: Simple Reaction Time test, Choice Reaction Time test, Digit Addition test, Symbol-Digit Substitution test, and Finger Tapping Speed test. Participants repeated the KCNT test battery in a randomly assigned order using four different testing systems: a desktop computer equipped with a conventional 106-key keyboard (System 1), a desktop computer equipped with a simplified keyboard (System 2), a tablet PC with a simplified 17-key on-screen keyboard (System 3), and a tablet PC equipped with a simplified keyboard (System 4). RESULTS: Results of the Digit Addition test did not differ significantly for different testing systems. In contrast, results of the Simple Reaction Time test, Choice Reaction Time test, Symbol-Digit Substitution test, and Finger Tapping test were lower for the tablet PC (Systems 3 and 4) compared to the desktop computer (Systems 1 and 2). Systems 1 and 2 did not show significantly different results. Performance on System 3 was inferior to that on System 4, only for the Choice Reaction Time test and Finger Tapping Speed test. There were also significant differences in performance by computer familiarity when adjusted for age and education; however, the performance of each group on the test systems showed similar patterns. CONCLUSIONS: It is not recommended to use a tablet PC to administer the KCNT to evaluate neurobehavioral performance for the Simple Reaction Time test and Choice Reaction Time test; however, tablet PCs with an on-screen keyboard may be used to perform the Digit Addition test, and the Symbol-Digit Substitution test and Finger Tapping Speed test to a limited degree.

Performance of Neurobehavioral Tests Among Welders Exposed to Manganese / 대한산업의학회지

To study neurobehavioral effects for manganese fume exposure of welders, we administrated questionnaire about subjective symptom, related with manganese exposure. Neurobehavioral Core Test Battery of World Health Qrganization(NCTB) and finger tapping for 98 welders and 29 non-welding workers. We adopted welding duration as a criterion for exposure assessment, because of the lack of the longitudinal valid data and differences in airborne concentrations of manganese in welding types, such as shielded metal arc and CO2 arc welding. Neurologic, musculoskeletal and concentration symptoms were significantly increased by increase of welding duration. Performance of finger tapping preferred hand, Santa Ana dexterity test preferred hand and correct number of pursuit aiming were significantly decreased by increase of welding duration. These results comparable with previous studies that suggest neurobehavioral test, especially motor test, to be an appropriate tool to detect early neurobehavioral abnormalities related with manganeses exposure.

Development of Korean Neurobehavioral Test Battery - Assessment of the Validity of Traditional and Computerized Neurobehavioral Tests / 예방의학회지

Aim. A neurobehavioral test for workers exposed to organic solvents in the workplace can be affected by many factors : age, education, motivation, ethnicity, etc. To apply more suitable neurobehavioral test for Korean workers, we evaluated the validity of several items of computerized and traditional neurobehavioral tests. Methods. We have applied eleven tests : four items of computerized neurobehavioral test(Swedish Performance Evaluation System) including Addition, Symbol-Digit, Digit Span, and Finger tapping speed, and seven items of traditional neurobehavioral test consisting of Addition, Digit-Symbol , Digit Span, Benton visual retention test, Pursuit aiming, Pegboard, and Tapping. These tests were performed on 96 workers exposed to solvents, and 100 reference workers. The concurrent and construct validities were evaluated by group difference, correlation with age, educational level, hippuric acid level, neurotoxic symptom, current exposure level, multitrait-multimethod matrix, factor analysis, and discriminant analysis. Results. Statistically significant differences were observed between the workers exposed to solvents and referents in computerized Symbol-Digit, Finger tapping speed, traditional Digit-Symbol and Pegboard. The computerized Symbol-Digit, traditional Digit-Symbol, Addition, Benton visual retention test, and Pegboard were found to be related to the age. The performance of computerized Symbol-Digit, Addition, and traditional Digit-Symbol were found to be related to the educational level significantly. The computerized Symbol-Digit, Finger tapping speed, and traditional Digit-Symbol were found to be related to hippuric acid, and neurotoxic symptom. The discriminability of Finger tapping speed, and Pegboard was better than the other tests. In discriminant analysis, the model with two variables, the computerized Symbol-Digit and Pegboard, classified almost 70 percent of the workers correctly. Conclusions. These results suggest that the computerized Symbol-Digit, Finger tapping speed, and Pegboard are more satisfactory for our purpose, and the Addition, Tapping, Benton visual retention test, and Pursuit aiming are less valid than other items. These may allow the reasonable selection of core neurobehavioral tests for workers exposed to solvents in Korea.

Interrelation of Neuropsychiatric Symptom and Neurobehavioral Test among Workers Exposed to Organic Solvents / 대한산업의학회지

A cross-sectional study of 118 car painters and controls of 113 workers was performed to investigate the interrelation between self-reported neuropsychiatric symptom and neurobehavioral performance using Scandinavian Questionnaire 16, Zung anxiety, depression scale and Swedish performance evaluation system (simple reaction time, symbol digit, digit span, finger tapping speed). The typical symptoms characteristic of painter's syndrome were not found and no significant association was found between solvent exposure and !total score of neuropsychiatric symptom but neurobehavioral performance of simple reaction time, symbol digit and digit span had association with solvent exposure. No significant associations were found between total score of neurotoxic symptom, anxiety scale, depression scale and the neurobehavioral performance. In factor analysis, the factor of questionnaire 16 measuring function of memory demonstrated no significant association with the factor of neurobehavioral test items measuring short term memory.

Effects of Number and Method of Visual Stimuli on Simple Reaction Time / 대한산업의학회지

In. order to evaluate the effects of number and method of visual stimuli on simple reaction time and determine the proper number of trials, simple reaction time of the computerized test of NTOS (Neurobehavioral Test for Occupational Screening) was carried out on 240 medical students. The prominent difference was found between male and female on simple reaction time. Regarding the effect of number based on the parameters of measures and the purpose of test itself, 64 trials was considered as proper number. The mean reaction time was different according to the methods of visual stimuli, such as color and size(p<0.05). The larger and more intence visual stimuli were, the faster sim-ple reaction time was. In respect to sex, that difference was similar. But, there was no difference depending upon whether the each result of each trial was showed on the monitor. The subjects, however, showed much interest when the result showed. Further studies, including the various variables on visual stimuli, are required to compare among various studies.

A Computer-Administered Neurobehavioral Evaluation of Workers Exposed to Organic Solvents / 대한산업의학회지

A cross-sectional study was performed to evaluate the effects of chronic exposure to solvent on neurobehavioral performance of solvent exposed 89 workers engaged in a video tape manufacturing fatory. A control group of 43 workers was selected fro different sections of the factory. The mean age and the mean duration of employment were 29 years and 5.4 years. Each workers completed a medical and occupational questionnaire. Adverse effects on the central nervous system were assessed by self reported Scandinavian questionnaire 16, New Anxiety-Depression Scale and seven test of Swedish Performance Evaluation System. These included simple reaction time, choice reaction time, digit classification, finger tapping speed, additions, symbol digit and digit span. Several potential confounding factors were included as indepedent variables in all analysis of neurobehavioral tests and symptoms. These included age, sex, educational level, familiarity with computer, alcohol drinking and amount of smoking. No significant associations were found between solvent exposure and total symptom score and mood score, Although the mean duration of employment was 5.4 years, comparison of mean performance scores adjusted for confounding factors showed a significantly poorer performance on choice reaction time(p<0.05), digit classification (p<0.01), additions (p<0.01) and symbol digit(p<0.01) in exposed group. Factor matrix of neurobehavioral tests produced by varimax rotation showed three distinct factors, which correspond to assessments of "memory", "coordination" and "response speed". These factors accounted for 62.6% of the total variance of the sample. Familiarity with computer was found to be associated with performance of symbol digit and amount of smoking appeared to slow finger tapping speed. Male and college graduate workers have less errors than others. There were no significant correlation between neurotoxic symptom score and performance of neurobehavioral tests.

Effect on Computerized Neurobehavioral Test Performance of the Car Painters Exposed to Organic Solvents / 예방의학회지

A cross-sectional study was performed to evaluate the effects of chronic low-dose sol-vent on neurobehavioral performance of 118 male car painters. A control group of 113 workers matched for age was selected from different sections of the factory. The mean age and the mean duration of employment were 33 years and 6.7 years in both groups. Mean years of education were 11.4 years in car painters and 11.8 years in controls. Each worker completed a medical and occupational questionnaire and four tests of Swedish performance evaluation system. These included simple reaction time, symbol digit, digit span and finger tapping speed. Although the mean duration of employment was 6.7 years, comparison of mean performance showed a significantly poorer performance on simple reaction time (P<0.05), symbol digit (p<0.01) and digit span(p<0.05) in car painters. In univariate analysis, age and educational level contributed to poorer performance on symbol digit and digit span smoking appeared to slow finger tapping speed in car painters. Performance of four tests of car painters exposed to high level of solvent was poorer than that of car painters exposed to low level. In multiple regression models, controlling for age, alcohol, smoking and shift work, solvent exposure was found to be associated with performance of simple reaction time, symbol digit and digit span and exposure to high level of solvent was related to poorer performance of symbol digit and digit span.