Ecological Momentary Assessments Breast Cancer Survivor

Ashley M Henneghan ^1* Emily W. Paolillo ² Kathleen Van Dyk ³ Oscar Franco-Rocha ¹ Mansi Patel ¹ Soyeong Bang ⁴ Raeanne Moore ⁵

• ¹ The University of Texas at Austin, Austin, United States
• ² Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California, United States
• ³ Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States
• ⁴ School of Nursing, Columbia University, New York City, New York, United States
• ⁵ UC San Diego Health, University of California, San Diego, San Diego, California, United States

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|).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.