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Use of Tablet-Based Neurocognitive Assessment Software for the Detection of Alcohol Impairment

By Sanjeev Janarthanan, Huy Phi, Benjamin Flores, Yael Katz, David M Eagleman, Bin Huang, Reza Hosseini Ghomi

Posted 18 May 2020
medRxiv DOI: 10.1101/2020.05.12.20086868

Background: Acute ingestion of alcohol impairs cognitive function and poses significant threat to public health and safety with impaired operation of motor vehicles. However, there is a lack of access to tools to assess one's cognitive impairment due to alcohol. The purpose of this study was to explore the use of a neuropsychological assessment software, BrainCheck, to assess levels of alcohol impairment based on performance on the neuropsychological assessments. Methods: We administered the BrainCheck battery to 91 volunteer participants. Participants were required to take a baseline battery prior to any alcohol ingestion, and another testing battery after a voluntary drinking period. Blood alcohol concentration (BAC) for the participant was obtained using a breathalyzer. We performed statistical analysis comparing alcohol vs. non-alcohol performance on the BrainCheck battery, and used significant metrics of these assessments to generate predictive models. Results: Statistical analyses were performed comparing participants performance on the BrainCheck battery before and after alcohol consumption. Comparison was also done comparing performance between an intoxicated group with a BAC > 0.05, and a sober group with a BAC [≤] 0.05. Two assessment metrics were found to be significant among comparison groups after P-value correction, and four test metrics were observed to moderately correlate (|r| > 0.40) with BAC levels. Three linear regression models (least-squares, ridge and LASSO) were built to predict participant BAC levels, with the best performing model being the least-squares model with a RMSE of 0.027. We also built a predictive logistic regression model to detect whether the participant is intoxicated or not, with 80.6% accuracy, 73.3% sensitivity, and 75.0% specificity. Discussion: The BrainCheck battery has potential to predict alcohol impairment, including participant BAC levels and if the participant is intoxicated or not. BrainCheck provides another option to assess an individual's cognitive impairment due to alcohol, with the utility of being portable and available on one's smartphone.

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