To validate and assess the feasibility of using the Creyos virtual cognitive assessment platform to measure neuropsychological performance among cardiac surgery patients before and after their operation.

Neuropsychological complications may occur in approximately half of patients after cardiac surgery, including deficits in memory, executive function and processing speed. However, existing approaches to assessing cognition among cardiac surgery patients have carried methodological limitations, which has led to inconsistent findings, making it difficult to compare results across studies.

We conducted a pilot feasibility observational study at two tertiary care hospitals. Patients ≥18 years old who were scheduled to undergo open heart surgery were approached for recruitment.  Consenting patients completed baseline neuropsychological assessment within 1-month before surgery, followed by a repeat assessment 1-month after surgery. Remote cognitive assessment was conducted via the Creyos Research battery, consisting of 12 tasks that collectively assess multiple domains of cognition including reasoning ability, verbal processing, and memory. We assessed the feasibility of remote assessment by evaluating outcomes related to virtual test administration, as well as the feasibility of the study itself by quantifying completion rates.

Thirty-two  patients participated before surgery and 15 participated 1-month after their operation. Relative to healthy age- and sex-matched norms, cardiac patients demonstrated impaired performance (≥1.0 SD) on at least one Creyos test, both before (96%) and after surgery (100%). Domain-specific analyses revealed that impairment was most pronounced specifically on tasks that relied on verbal processing skills. Remote administration of cognitive testing was feasible, and patients were largely amenable to virtual assessment although participant attrition was a limitation of the study.

A web-based patient-administered cognitive testing battery, Creyos, can identify domain-specific impairment in a clinical patient cohort. We suggest that the use of this tool be expanded to large-scale interventional trials to more accurately identify cognitive impairment and to longitudinally monitor cognitive recovery.