Abstract- Poster

Abstract

Background –There are no studies conducted till now for assessing reliability of physical examination done virtually in the context of telepsychiatry, with only 2 studies examining the reliability of visual observations in telepsychiatry and showing contrasting results. Hence need to validate physical examination done virtually.Aims -To compare the reliability of tele-psychiatric assessments in picking up and assessing the severity of Extra Pyramidal Side Effects(EPSE) of antipsychotic medications in comparison with that of In-person physical examination (gold standard).Methods -An observational cross-sectional study where a total of 121 patients with primary psychiatric disorders on antipsychotic medications were recruited from clinical services of NIMHANS in a convenient fashion. A sequential procedure was carried out where an in-person physical examination looking for EPSE along with application of relevant scales was done by an independent examiner. This was immediately followed by a Virtual Physical Examination(ViPE) carried out by another blinded researcher using a 17 question scale created specifically for the ViPE. The scales used to assess severity of antipsychotic side effects were Abnormal Involuntary Movements Scale(AIMS) and Barnes Akathisia Rating Scale(BARS).Results –A total of 54 patients were found to have EPSE in in-person physical examination as opposed to 52 patients in VIPE. The measure of agreement in picking up EPSE between in-person physical examination and VipE was statistically significant (kappa coefficient – 0.832,significance<0.001).The agreement in severity of EPSE as compared on the Global outcome of severity AIMS scale 8(kappa coefficient – 0.777,significance<0.001) and Global assessment of severity of akathisia in BARS (kappa coefficient – 0.920,significance<0.001) were also statistically significant.Conclusion –ViPE is a reliable method to pick up and assess the severity of EPSEs.