Validation of a videoconference‐based neuropsychological assessment: The e‐COG study

Abstract

AbstractBackgroundThe videoconference‐based neuropsychological assessment, also called teleneuropsychology, is a promising tool for the diagnosis and follow‐up of individuals living in underserved areas, care facilities or other institutions, and even emigrants. This kind of consultation has proved particularly useful during the COVID‐19 pandemic, suggesting how it could be used more systematically. This study is the first to explore the reliability of neuropsychological teleassessment in France.MethodIn the e‐COG study, we included 150 older memory‐complainers, with an MMSE>20, seeking medical advice at a memory clinic (Pitié‐Salpêtrière Hospital) or at the Aloïs Memory Network, both based in Paris, France. At baseline, all participants underwent a comprehensive face‐to‐face neuropsychological assessment. After 4 months, the participants were randomized, so that half of them performed another face‐to‐face assessment, and the other half a teleassessment. For the teleassessment, the examiner used a MacBook Pro system with internet connection, microphone and speaker. The patient was with an assistant with no training in neuropsychology, who intervened during certain tests requiring material handling or physical contact. Two cameras were installed, one to film the entire room, and the other to film what the participant wrote or drew. We compared (i) face‐to‐face versus teleassessment scores using t‐tests and Chi2 tests (or Fisher Exact test when relevant); (ii) scores at assessment 1 versus 2, according to the administration method, using Paired t‐tests and MacNemar tests (or Bowker test when relevant).ResultDemographic characteristics of the sample are shown in Table 1. The two assessments 4 months apart yielded overall stable scores, regardless of the method of administration (Face‐to‐Face or Video). Very few tests showed significant differences between the two assessments, but the effect size was very weak (all Cohen's d ≤ 0.35). The STAI‐Y‐A score, measuring the level of anxiety felt at the moment, was slightly but non‐significantly higher in the Face‐to‐Face (versus Video) condition (p=0.07), and therefore it seems that the remote assessment does not induce greater anxiety in the patient.ConclusionNeuropsychological teleassessment is a valid and promising tool that could be incorporated into the diagnostic and follow‐up processes of patients with suspected or full‐blown cognitive impairment.