Reliability of the MMSE Administered In-Person and by Telehealth

Abstract

Background:Recent advances in telehealth have improved access to health care for those in rural areas. It is important that examinations conducted via telehealth are comparable to in-person testing. A rural and remote memory clinic in Saskatoon provided an opportunity to compare scores on the Mini-Mental State Examination (MMSE) administered in-person and via telehealth.Methods:After an initial one day assessment in Saskatoon, patients were seen in follow-up at 6 and 12 weeks. Individual patients were randomly assigned to either in-person follow-up assessment in Saskatoon or telehealth assessment in their home community. Patients who initially received in-person assessments were seen by telehealth for their next follow-up visit and vice-versa. The same neurologist administered MMSEs at all visits. The first 71 patients with both 6 and 12 week follow-up assessments were included in this study. The scores of in-person and telehealth MMSE administrations were compared using the methods of Bland and Altman as well as a paired t-test.Results:MMSE scores did not differ significantly between telehealth (22.34 +/- 6.35) and in-person (22.70 +/- 6.51) assessments.Conclusion:Telehealth provides an acceptable means of assessing mental status of patients in remote areas.

A narrative review of the evidence regarding the use of telemedicine to deliver video‐interpreting during dementia assessments for older people

“…Agreement is a measure of how similar results are between repeated measures, while reliability is defined as how well individual patients are distinguishable from each despite measurement errors (de Vet, Terwee, Knol, & Bouter, ). Eleven papers were found that measured agreement and reliability of neurocognitive assessments administered by TM compared with either FTF or telephone methods (Castanho et al, ; Cullum et al, ; Cullum et al, ; Galusha‐Glasscock et al, ; Grosch et al, ; Loh et al, ; Loh, Donaldson, Flicker, Maher, & Goldswain, ; Martin‐Khan et al, ; McEachern, Kirk, Morgan, Crossley, & Henry, ; Wadsworth et al, ; Wong, Martin‐Khan, Rowland, Varghese, & Gray, ). The most common neurocognitive assessments administered in these studies include MMSE (Castanho et al, ; Cullum et al, ; Cullum et al, ; Galusha‐Glasscock et al, ; Grosch et al, ; Loh et al, ; Loh et al, ; Martin‐Khan et al, ; McEachern et al, ; Wadsworth et al, ), Geriatric Depression Scale (GDS) (Loh et al, ; Loh et al, ), and RUDAS (Martin‐Khan et al, ; Wong et al, ).…”

The Telehealth Satisfaction Scale: Reliability, Validity, and Satisfaction with Telehealth in a Rural Memory Clinic Population

“…One objective of the research was to determine the acceptability of telehealth for pre-clinic assessment and follow-up appointments. We have previously reported on provider and patient-caregiver satisfaction with the use of telehealth in the clinic, 19 the reliability of cognitive assessments administered in-person and by telehealth, 20 and the development and evaluation of a telehealth videoconferenced support group for spouses of RRMC patients diagnosed with atypical early-onset dementias. 21 Details about the RRMC development and evaluation 22 and interdisciplinary approach 23 are reported elsewhere.…”

Diagnosis of cognitive decline and dementia in rural areas — A scoping review

“…In a Canadian study, participants were tested in the context of a rural and remote memory clinic . After an initial visit in the clinic, individual patients were randomly assigned to either an initial 6‐week follow‐up in person or to a telehealth assessment.…”