A validation study for remote testing of cognitive function in multiple sclerosis

Barcellos, Lisa F.; Horton, Mary; Shao, Xiaorong; Bellesis, Kalliope H; Chinn, Terrence; Waubant, Emmanuelle; Bakshi, Nandini; Marcus, Jackie; Benedict, Ralph H. B.; Schaefer, Catherine

doi:10.1177/1352458520937385

Cited by 32 publications

(22 citation statements)

References 10 publications

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“…In conclusion, the present study shows that in-home TNP testing is a valid and clinically useful approach for obtaining a limited neuropsychological profile, and that the findings extend the limited data that have been reported by other groups to date ( Barcellos et al., 2020 ). These findings show that a cognitive test battery including tests of attention, processing speed, language, visuospatial processing, and memory can be administered using in-home TNP testing.…”

Section: Discussionsupporting

confidence: 87%

“…Although these results are promising, it is notable that the TNP testing in all studies included in the meta-analysis involved patients or participants undergoing TNP testing in either a controlled clinic or laboratory setting. A recent study from Barcellos and colleagues (2020 ) involved in-home TNP testing with patients with multiple sclerosis. The authors’ analyses showed that tests of verbal memory and processing speed could be administered remotely to patients in their homes.…”

Section: Introductionmentioning

confidence: 99%

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Validity of In-Home Teleneuropsychological Testing in the Wake of COVID-19

Parks

Davis

Spresser

et al. 2021

Archives of Clinical Neuropsychology

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Objective Teleneuropsychology (TNP) has been shown to be a valid assessment method compared with in-person neuropsychological evaluations. Interest in delivering TNP directly to patients’ homes has arisen in response to the coronavirus disease 2019 (COVID-19) pandemic. However, prior research has typically involved patients tested in clinical settings, and the validity of in-home TNP testing has not yet been established. The present study aims to explore the validity and clinical utility of in-home TNP testing in a mixed clinical sample in the wake of COVID-19. Methods Test profiles for 111 in-home TNP patients were retrospectively compared with 120 patients who completed in-person evaluations. The TNP test battery consisted of tests measuring attention/processing speed, verbal memory, naming, verbal fluency, and visuoconstruction. TNP scores of cognitively normal (CN) patients were compared with patients with neurocognitive disorders (NCD), and score profiles were examined among suspected diagnostic groups of Alzheimer’s disease (AD), Parkinson’s disease (PD), and vascular disease (VaD). Results TNP test scores did not significantly differ from in-person testing across all tests except the Hopkins Verbal Learning Test-Revised Discrimination Index. Within the TNP group, significant differences between the CN and NCD groups were found for all tests, and the memory and semantic fluency tests yielded large effect sizes (d ≥ 0.8). Score profiles among the AD, PD, and VaD groups were explored. Conclusions These findings support the validity of in-home TNP testing compared with in-person neuropsychological testing. Practice considerations, limitations, and future directions are discussed.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Validity of In-Home Teleneuropsychological Testing in the Wake of COVID-19

Parks

Davis

Spresser

et al. 2021

Archives of Clinical Neuropsychology

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“…Retrospective observation of the tasks administered remotely during fully or partially remote assessments begun during the lockdown reveals that many were verbal in nature, in accordance with previous literature [ 17 , 24 , 30 ]. These included, for example, the Rey Auditory Verbal Learning Test (RAVLT, [ 37 ]), story recall [ 38 ], verbal fluency, reading, sentence completion, and several verbal intelligence subtests from the Wechsler Adult Intelligence Scale (WAIS [ 39 ];).…”

Section: Case Illustration: Response Of An Israeli Assessment and Rehabilitation Organizationsupporting

confidence: 85%

“…They found that verbally administered tests, including list learning, digit span, and verbal fluency tasks, were generally not affected by administration method, while remote versions of visual and motor tests like picture naming and clock drawing received less support. More recently, Barcellos et al [ 30 ] reported further evidence that tests of verbal memory and processing speed could be effectively administered remotely.…”

Section: Remote Testing During Covid-19: Recommendations and Considerationsmentioning

confidence: 99%

How, when, and for whom: decisions regarding remote neuropsychological assessment during the 2020 COVID-19 pandemic

Bloch

Maril²,

Kavé

2021

Isr J Health Policy Res

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Neuropsychological assessment provides crucial information about cognitive, behavioral, and socioemotional functioning in medical, educational, legal, and social contexts. During the 2020 COVID-19 pandemic, the Israeli Ministry of Health initially mandated that all psychological assessments be postponed. However, as referrals to time-sensitive, high-need, and high-stakes assessments began to accumulate, it became necessary to consider remote solutions. In the current paper, we describe the considerations that affected the transition to remote activity in a prominent Israeli provider of neuropsychological assessment and rehabilitation services, referring to technological and environmental conditions, cognitive requirements, and tasks, as well as to legal, regulatory, and funding issues. After discussing how assessments should be conducted to maximize feasibility and validity while minimizing risks to clients and clinicians, we propose a preliminary model for deciding whether specific referrals warrant remote administration. The model delineates key factors in decisions regarding remote assessment, emphasizing the distinct roles of the referring clinician and the neuropsychologist who conducts the assessment, and highlighting the need for collaboration between them. The abrupt need for remote assessments during the pandemic required a quick response with little preparation. The lessons learned from this process can be applied in the future, so that the need for remote services can be met with greater certainty and uniformity.

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“…In an analysis of 8022 follow-up visits from 4199 patients in which the MSPT was integrated into visits, the tablet-based data collection resulted in more patients completing assessment and in a shorter time frame relative to analog methods, making it easier to incorporate these tests into care in spite of time constraints placed on HCPs [ 115 ]. Digitally administered tools also hold promise for use via telehealth, which has become important during the COVID-19 pandemic; early work seeking to validate remote use of the Symbol Digit Modalities Test (SDMT) and California Verbal Learning Test (CVLT-II) suggests that these tools may be effectively used remotely [ 116 ]. Such self-administered and/or remote technology-based screening tools are likely the future of invisible symptom monitoring, as they can help to streamline information collection, thus allowing more concerns to be addressed in a shorter amount of time during clinical visits.…”

Section: How Can We As a Community Address Invisible Symptoms In A Comprehensive Manner?mentioning

confidence: 99%

Comprehensive Approach to Management of Multiple Sclerosis: Addressing Invisible Symptoms—A Narrative Review

Lakin

Davis

Binns³

et al. 2021

Neurol Ther

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Graphical Plain Language Summary Multiple sclerosis (MS) is a chronic autoimmune inflammatory disease of the central nervous system, leading to neurodegeneration and manifesting as a variety of symptoms. These can include “invisible” symptoms, not externally evident to others, such as fatigue, mood disorders, cognitive impairments, pain, bladder/bowel dysfunction, sexual dysfunction, and vision changes. Invisible symptoms are highly prevalent in people living with MS, with multifactorial etiology and potential to impact the disease course. Patient experiences of these symptoms include both physical and psychosocial elements, which when unaddressed negatively influence many aspects of quality of life and perception of health. Despite the high impact on patient lives, gaps persist in awareness and management of these hidden symptoms. The healthcare provider and patient author experiences brought together here serve to raise the profile of invisible symptoms and review strategies for a team-based approach to comprehensive MS care. We summarize the current literature regarding the prevalence and etiology of invisible symptoms to convey the high likelihood that a person living with MS will contend with one or more of these concerns. We then explore how open communication between people living with MS and their care team, stigma mitigation, and shared decision-making are key to comprehensive management of invisible symptoms. We recommend validated screening tools and technological advancements that may be incorporated into MS care to regularly monitor these symptoms, offering insight into how healthcare providers can both educate and listen to patients, with the goal of improved patient quality of life. By pairing clinical knowledge with an understanding and consideration of the patient perspective, providers will be equipped to foster a patient-centered dialogue that encourages shared decision-making. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-021-00239-2.

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A validation study for remote testing of cognitive function in multiple sclerosis

Cited by 32 publications

References 10 publications

Validity of In-Home Teleneuropsychological Testing in the Wake of COVID-19

Validity of In-Home Teleneuropsychological Testing in the Wake of COVID-19

How, when, and for whom: decisions regarding remote neuropsychological assessment during the 2020 COVID-19 pandemic

Comprehensive Approach to Management of Multiple Sclerosis: Addressing Invisible Symptoms—A Narrative Review

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