Feasibility, reliability and validity of smartphone administered cognitive ecological momentary assessments in breast cancer survivors

Ashley M Henneghan; Emily W Paolillo; Kathleen M Van Dyk; Oscar Y Franco-Rocha; Mansi Patel; So Hyeon Bang; Raeanne C Moore

doi:10.3389/fdgth.2025.1543846

Feasibility, reliability and validity of smartphone administered cognitive ecological momentary assessments in breast cancer survivors

Front Digit Health. 2025 Apr 22:7:1543846. doi: 10.3389/fdgth.2025.1543846. eCollection 2025.

Authors

Ashley M Henneghan^#^{1

2}, Emily W Paolillo^#³, Kathleen M Van Dyk^{4

5}, Oscar Y Franco-Rocha¹, Mansi Patel⁶, So Hyeon Bang⁷, Raeanne C Moore⁸

Affiliations

¹ School of Nursing, University of Texas at Austin, Austin, TX, United States.
² Dell Medical School, Department of Oncology, University of Texas at Austin, Austin, TX, United States.
³ Department of Neurology, Memory and Aging Center, University of California, San Francisco, Weill Institute for Neurosciences, San Francisco, CA, United States.
⁴ Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States.
⁵ Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, CA, United States.
⁶ Department of Neuroscience, College of Natural Sciences, University of Texas at Austin, Austin, TX, United States.
⁷ School of Nursing, Columbia University, New York, NY, United States.
⁸ UC San Diego Health Sciences, University of California San Diego, San Diego, CA, United States.

^# Contributed equally.

Abstract

Objective: Breast cancer and its treatment are associated with cancer-related cognitive impairments (CRCI). Cognitive ecological momentary assessments (EMA) allow for the assessment of individual subjective and objective cognitive functioning in real world environments and can be easily administered via smartphones. The objective of this study was to establish the feasibility, reliability, and validity of a cognitive EMA platform, NeuroUX, for assessing CRCI in breast cancer survivors.

Methods: Using a prospective design, clinical cognitive assessments (neuropsychological testing; patient reported outcomes) were collected at baseline, followed by an 8-week EMA smartphone protocol assessing self-reported cognitive concerns and objective cognitive performance via mobile cognitive tests once per day, every other day. Satisfaction and feedback questions were included in follow-up data collection. Feasibility data were analyzed using descriptive methods. Test-retest reliability was examined using intraclass correlation coefficients for each cognitive EMA (tests and self-report questions), and Pearson's correlation was used to evaluate convergent validity between cognitive EMAs and baseline clinical cognitive variables.

Results: 105 breast cancer survivors completed the EMA protocol with high adherence (87.3%) and high satisfaction (mean 87%). Intraclass correlation coefficients for all cognitive EMAs were strong (>0.73) and correlational findings indicated moderately strong convergent validity (|0.23| < r < |0.61|).

Conclusion: Fully remote, self-administered cognitive testing for 8-weeks on smartphones was feasible in breast cancer survivors who completed adjuvant treatment and the specific cognitive EMAs (cognitive EMA tests and self-report questions) administered demonstrate strong reliability and validity for CRCI.

Keywords: breast cancer survivors; cancer-related cognitive impairment; ecological momentary assessments; feasibility; mobile cognitive testing; reliability; validity.

Abstract

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