DYNSEO-Hospital Broca Collaboration: Revolution of Digital Cognitive Tests

1. Presentation of Our Revolutionary Partnership

The alliance between DYNSEO and Broca Hospital represents much more than a simple technical collaboration. It is the union of two complementary expertise serving medical innovation. On one side, DYNSEO brings its technological mastery and forward-thinking vision of cognitive stimulation solutions. On the other side, Broca Hospital, a reference university hospital center, offers its unmatched clinical expertise and in-depth knowledge of field needs.

This unique synergy has made it possible to design tools that address the current challenges of modern neuropsychology. The main objective of our collaboration is to create a complete battery of cognitive tests on touchscreen tablets, intended for healthcare professionals to optimize the assessment and monitoring of elderly people with loss of autonomy. This innovative approach radically transforms traditional clinical practice.

The e-Tests project presents a major strategic interest by facilitating the current practice of neuropsychological assessment. The benefits are numerous: automation of scoring, creation of individualized sheets, adaptation to all practice contexts, and optimal security of patient data. This digital revolution fits perfectly into the challenges of telemedicine and applied research of tomorrow.

2. Broca Hospital: A Partner of Excellence

Broca Hospital occupies a unique position in the French hospital landscape. Part of the University Hospitals Paris Centre of AP-HP, this geriatric establishment stands out for its recognized expertise in neuropsychology and its innovative approach to care for elderly people. With nearly 2000 admissions of less than 24 hours per year, the day hospital serves as an ideal testing ground for our innovations.

The multidisciplinary team at Broca Hospital brings together highly qualified professionals: geriatricians, neuropsychologists, specialized nurses, and researchers. This human richness ensures a holistic approach to cognitive disorders and a rigorous validation of our digital tools. The memory consultation center, in particular, provides an optimal clinical environment to test and validate our technological innovations.

The international reputation of Broca Hospital in clinical research is a major asset for the credibility of our developments. The professionals at the day hospital actively participate as end-users and experts in cognitive assessment, bringing their irreplaceable expertise to every stage of the creation process. This direct involvement ensures the clinical relevance and optimal usability of our solutions.

3. LUSAGE Living Lab: Collaborative Innovation Laboratory

The LUSAGE Living Lab is the scientific heart of our collaboration, bringing a fundamental research dimension to our technological developments. Integrated into the research unit EA 4468 "Alzheimer's disease: Risk factors, care, and support for patients and families" at the University of Paris Descartes, LUSAGE benefits from international recognition with its ENoLL certification obtained in 2012.

This unique structure specializes in the uses and co-creation of technological solutions dedicated to elderly people suffering from cognitive disorders. LUSAGE's methodological approach combines technological expertise and in-depth knowledge of neurodegenerative pathologies, ensuring innovations perfectly suited to clinical realities. This dual competence represents a major asset for the development of our digital tools.

The research team led by Professor Anne-Sophie Rigaud brings undeniable scientific legitimacy to our work. Ya Huei Wu, neuropsychologist and doctor in neuropsychology, contributes to the excellence of our developments through her research in gerontechnology. Her thesis on co-design and validation of digital tests directly feeds into our collaborative innovation process.

4. CEN STIMCO : National Validation and Expertise

The National Expertise Center in Cognitive Stimulation (CEN STIMCO) plays a crucial role in the evaluation and validation of our collaboration. Established at the initiative of the CNSA, this independent organization supports innovation in the field of cognitive stimulation and compensation. Its mission is to foster connections between users, professionals, companies, associations, and researchers to advance the sector.

The intervention of CEN STIMCO brings an objective and rigorous evaluation dimension to our work. The organization also contributes to the normalization and standardization of cognitive stimulation solutions, ensuring that our developments meet the highest quality standards. This external validation enhances the scientific and clinical credibility of our technological innovations.

The neutrality and transparency of CEN STIMCO make it an ideal evaluation partner to measure the real impact of our solutions. The organization facilitates exchanges among all stakeholders in the ecosystem, creating a collaborative dynamic conducive to innovation. This multidisciplinary approach ensures that our tools meet the expectations of all end users.

5. Our Achievements: Three Revolutionary Test Batteries

The result of our intensive two-and-a-half-year collaboration is the development of three innovative cognitive test batteries, each tailored to specific users. This segmented approach ensures maximum relevance for each usage context, from healthcare professionals to self-assessing patients. Each battery has been designed according to a rigorous co-creation methodology directly involving end users.

The first battery, intended for doctors, addresses the crucial need for rapid screening of cognitive disorders. Composed of four essential tests, it allows for a comprehensive evaluation in just ten minutes, facilitating referral to more in-depth diagnostic assessments. This time efficiency constitutes a major advantage in the context of often overloaded medical consultations.

The second battery, developed for neuropsychologists, integrates more sophisticated tests such as e-CT, visual spans, and Anita Violon's Hive test. These digital tools revolutionize neuropsychological practice by automating scoring and facilitating longitudinal patient monitoring. The accuracy and speed of these tests radically transform the clinical experience.

6. Medical Battery: Optimized Screening

The battery designed for doctors represents a revolution in the screening of cognitive disorders. Designed for use in standard consultations, it allows for a complete assessment of essential cognitive functions in just ten minutes. This remarkable efficiency perfectly meets the time constraints of modern medical consultations while maintaining optimal assessment quality.

The four selected tests - orientation in time, MIS and MIS-D for episodic memory, shape-number alternation for executive functions, and calculation task for concentration - cover the entire cognitive spectrum. This comprehensive approach ensures early detection of disorders that may evolve into neurodegenerative pathologies, allowing for optimal preventive management.

The automation of scoring and instant calculation of scores are major advantages for doctors. No more need to spend precious time on manual calculations: results are displayed immediately, allowing for direct interpretation and quick guidance if necessary. This ease of use transforms the medical experience and improves the quality of care.

7. Neuropsychological Battery: Expert Precision

The neuropsychological battery pushes innovation to its peak with three revolutionary tests that redefine specialized cognitive assessment. The e-CT test, a true technological feat, evaluates executive functions through a digital number barrage exercise of unparalleled precision. Patients compare stimuli between two blocks, developing mental flexibility and coordination in an intuitive digital environment.

The visual span test, a digital adaptation of the Corsi blocks, revolutionizes the assessment of short-term and working memory in the visuo-spatial modality. Reproducing sequences of lighting circles, in direct or reverse order, allows for precise determination of the visuo-spatial span. This objective measurement serves as a crucial indicator for diagnosing emerging cognitive disorders.

The Anita Violin Hive test, digitized with the permission of its creator, assesses visuo-spatial episodic memory through the memorization of grids with varied patterns. This respectful digitization of the original tool brings all the advantages of digital: increased precision, automation of scoring, and ease of use. Together, these three tests form a diagnostic arsenal of remarkable effectiveness.

8. Self-Assessment Battery: Patient Autonomy

The self-assessment battery represents the boldest innovation of our collaboration, paving the way for a new era of participatory medicine. This revolutionary approach allows patients to conduct an initial cognitive assessment independently, under light supervision from a healthcare professional. The impact on the organization of care is considerable, optimizing medical time while involving patients more in their care journey.

Composed of the same tests as the medical battery - orientation, MIS & MIS-D, shape-number alternation, and calculation - this self-administered version requires particularly careful ergonomics. Each interface has been designed to intuitively guide the user, with clear instructions and simplified navigation. This attention to detail ensures a smooth use even for patients who are not familiar with digital tools.

The results of our tests show that about 20% of patients consulting for a memory complaint but in perfect cognitive health can perform the tests completely independently. For the remaining 80%, supervision by a nurse is sufficient, freeing up valuable medical time for complex cases. This reorganization of care fits perfectly into the logic of "delegation under control" promoted by modern health policies.

9. Methodology and Innovative Co-Design

Our methodological approach is based on the proven principles of user-centered co-design, involving 32 professionals in the development process. This approach goes far beyond the recommendations of the LLSA forum and Nielsen standards, ensuring optimal user validation. The direct involvement of doctors, neuropsychologists, and patients in the design ensures a perfect match between developed tools and real field needs.

The selection of cognitive tests is based on a rigorous analysis of current clinical practices at Broca Hospital. For the medical battery, we have retained the four most discriminating tests regularly used in memory consultations. This pragmatic approach guarantees maximum clinical relevance and easier adoption by professionals already familiar with these tools in their paper version.

The validation process spans several distinct phases: initial design with experts, iterative development based on user feedback, real-world testing, and final adjustments. This rigorous methodology, inspired by the best practices of medical innovation, ensures that our tools meet the highest standards in terms of clinical effectiveness and usability.

10. Scientific Validation and Publications

The scientific credibility of our collaboration is manifested through publications in leading international journals. The article "A Tablet-PC-Based Cancellation Test Assessing Executive Functions in Older Adults" published in PLOS ONE demonstrates the scientific validity of our digital approach. This recognition by the international scientific community validates our methodology and encourages the continuation of our innovations.

The second publication "Can a tablet-based cancellation test identify cognitive impairment in older adults?" published in The American Journal of Geriatric Psychiatry confirms the diagnostic effectiveness of our tools. These research efforts, led by the team of Ya-Huei Wu, Jean-Sebastien Vidal, and their collaborators, establish solid scientific foundations for the clinical deployment of our digital solutions.

This academic recognition goes beyond the simple scientific aspect to influence clinical practices. Healthcare professionals now have a robust scientific literature to justify the adoption of our digital tools. This scientific legitimacy accelerates the digital transformation of neuropsychological practices and encourages innovation in the sector.

11. CEN STIMCO Evaluation and Results

The independent evaluation conducted by CEN STIMCO confirms the excellence of our collaboration and strongly recommends the continuation of the project. The organization particularly highlights the quality of the work done on the e-CT test, tested on nearly 300 patients, and the innovation of the self-assessment battery validated with 26 users. These testing volumes, significantly exceeding initial requirements, ensure exceptional statistical robustness.

The usability results, measured by the SUS (System Usability Scale), reveal remarkable scores for all of our batteries. The SUS scale, an international benchmark for ergonomic evaluation, confirms the potential attractiveness of our applications for healthcare professionals. This objective validation is accompanied by enthusiastic qualitative feedback from the testing users.

The CEN STIMCO evaluator identifies a major economic potential for the public sector, estimating that our solution could generate significant savings in the medium and long term. This economic perspective, combined with demonstrated clinical benefits, strengthens the case for a large-scale deployment of our technological innovations.

12. Impact and Transformation of Practices

The impact of our collaboration goes far beyond the technological framework to profoundly transform clinical practices. The time savings of 5 minutes per administration for the e-CT test may seem modest, but multiplied by thousands of annual assessments, it represents hundreds of hours freed up for other clinical activities. This optimization directly contributes to improving the quality of care and reducing waiting times.

The portability of our solutions also transforms the spatial organization of care. Gone are the constraints of large, unusable A3 sheets at the patient's bedside: our tablets allow for quality cognitive assessment in all environments. This flexibility opens new horizons for telemedicine and home care, democratizing access to specialized cognitive assessment.

Beyond practical aspects, our innovation contributes to modernizing the image of neuropsychology. Patients appreciate the modern technological aspect of the assessment, enhancing their engagement in the diagnostic process. This positive psychological dimension favorably influences the patient experience and may improve compliance with subsequent therapeutic recommendations.

13. Future Perspectives and Developments

The recommendations from CEN STIMCO outline an ambitious roadmap for the future of our collaboration. Continuing data collection using a "Lean" approach will gradually demonstrate the validity of our tools with increasing certainty. This continuous improvement strategy is part of a logic of ongoing enhancement of our technological solutions.

The development of a data entry and transfer infrastructure constitutes the next major step in our innovation. Interoperability with existing hospital IT systems represents a crucial challenge to facilitate the adoption of our tools. This technical integration will enhance the attractiveness of our solutions and accelerate their deployment throughout the healthcare system.

The in-depth clinical validation of our cognitive tests on tablets opens exciting research perspectives. The data collected will feed into future scientific publications and contribute to the establishment of new calibration standards. This research dimension ensures that our innovation remains at the forefront of international scientific excellence.

14. Revolution of Cognitive Telemedicine

Our pioneering collaboration with Broca Hospital catalyzes the revolution of cognitive telemedicine, opening unprecedented perspectives for access to specialized care. The solutions we develop transcend traditional geographical barriers, allowing rural or isolated populations to benefit from hospital-quality cognitive assessments. This democratization of neuropsychological expertise represents a major public health issue.

The technical architecture of our tools facilitates deployment in teleconsultation mode, allowing specialists to remotely supervise assessments conducted by local professionals. This hybrid approach optimizes the use of rare expertise while maintaining essential local human contact. The patient thus benefits from the best of both worlds: cutting-edge expertise and reassuring proximity.

The data collected through our digital platforms feed into a national knowledge base that continuously enriches the assessment algorithms. This collective intelligence gradually improves diagnostic accuracy and allows for the adaptation of alert thresholds to the specificities of the French population. Our innovation is thus part of a continuous improvement approach supported by the entire medical community.

15. DYNSEO Ecosystem and COCO Synergy

Our collaboration with Broca Hospital fits perfectly into the overall DYNSEO ecosystem, creating an exceptional synergy with our COCO THINKS and COCO MOVES solutions. This integration offers a complete continuum of care, from diagnostic assessment to personalized cognitive stimulation. Professionals thus have a coherent software suite to support their patients throughout their therapeutic journey.

COCO THINKS, our cognitive stimulation application, directly benefits from the assessment data collected through our test batteries. This synergy allows for the provision of training programs perfectly tailored to the cognitive profiles identified during assessments. The evolution of performance in COCO THINKS can also enrich the longitudinal follow-up of patients, creating a virtuous loop of continuous improvement in care.

The physical dimension brought by COCO MOVES complements the cognitive approach for a holistic management of brain health. This global vision, combining rigorous assessment, targeted cognitive stimulation, and adapted physical activity, positions DYNSEO as the reference player in digital cognitive health. Our partnership with Broca Hospital strengthens this scientific and clinical legitimacy.