Remote Assessment Research Articles

Real Time Collaborative Code Editor

Abstract: The main goal of our project is to provide an online platform especially for group coding interviews. This platform provides a comprehensive environment for seamless communication between interviewers and candidates, with the goal of addressing the challenges faced during remote technical assessments. The creation ofa feature-rich web platform is the goal of our project. Thisincludes an adaptable rich text editor that enables coding in real time, a mechanism for instantaneous code evaluation via execution and compilation, integrated video conferencing for efficient communication, and the abilityto set up interview rooms to hold several interviews at once. We're designing a user intuitive interface using technology and strong programming frameworks. The main objectives of the platform are to ensure real time code execution and a seamless interview process. This is achieved by incorporating code compilation engines implementing editing tools and utilizing WebRTC for video conferencing. By creating a user-friendly and productive environment that benefits both interviewers and candidates, our platform seeks to expedite the remote technical interview process. This means reducing logistical obstacles, making thorough coding evaluations possible, and creating a positive interview environment.

Feasibility of Using Standardized Outcome Measures in the Remote Assessment of Patients with Chronic Stroke: A Case Series

Introduction: With the increase of telerehabilitation utilization worldwide after the COVID-19 pandemic, a review of the current literature shows a concurrent increase in telerehabilitation studies focusing on interventions and delivery models. There is a gap in research on valid and reliable tests and measures that can be used in the physical therapy examination of people with stroke via telerehabilitation. Current reports on psychometric properties of most standardized outcome measures are only applicable in an in-person setting and may not be directly applicable in a remote setting where various challenges contribute to the reliability of results. This report describes the feasibility of administering selected standardized outcome measures in the remote assessment of three patients with chronic stroke with different contexts. Methods: Three patients with chronic stroke underwent physical therapy examination and intervention sessions via telerehabilitation with varying contexts. Results: Various factors affected the results of the assessment including patient and caregiver’s (if present) ability to follow instructions, availability of material and spatial resources, and stability of internet connection. Strategies to improve reliability of assessment results can also be employed such as performing repeat trials, reviewing recordings for accuracy and confirmation, using highly visible markers, and confirming measurement accuracy on video. Discussion: Physical therapy outcome measures that can feasibly be administered remotely are the Timed Up and Go Test, the 10-Meter Walk Test, the 6-Minute Walk Test, the 5-Times Sit to Stand Test, and the Stroke Impact Scale. The Mini Balance Evaluation Systems Test could not be administered remotely as close to standard protocol as possible due to the difficulty of administering the reactive postural component with patient anxiety and safety considerations and materials required.

Adaptation and development of the instruction manual for a videoconference-based Motor Assessment Scale: validity, reliability and measurement error of Tele-MAS

Purpose To develop an instruction manual to administer the Motor Assessment Scale (MAS) via videoconferencing (Tele-MAS), investigate its validity, reliability and measurement error. Materials and methods In-person assessment, conducted at the participant’s home, was compared to remote assessment conducted by rater A. Then, within two days, the rater B, repeat the remote assessment (n = 41). Part of the sample (n = 10) was assessed again within seven days by rater A to determine test-retest reliability. Concurrent validity, agreement of alternate forms (in-person x remote) for total score and reliability of individual items were analyzed using respectively the Pearson correlation coefficient, Bland-Altman plots and weighted Kappa (Kw). Interrater and test-retest reliability were analyzed by Intraclass Correlation Coefficient (ICC). Standard Error of Measurement (SEM) and Minimal detectable changes (MDC) were computed. Results The Tele-MAS instruction manual was developed. In-person MAS and Tele-MAS present a high positive correlation (r = 0.97). Bland-Altman plots showed adequate agreement (MD=-0.0 point). Most Individual items showed excellent reliability (Kw > 0.70). Tele-MAS showed excellent interrater (ICC(2,1)=0.92) and test-retest (ICC(3,1)=0.98) reliability. Tele-MAS presents a SEM = 3% and MDC = 8%. Conclusion The Tele-MAS is a valid and reliable global motor assessment scale to be applied in individuals after stroke.

Paradigm Shift in Sports Science: The IOT-Enhanced Agility-Pad for Athletic Performance Evaluation

This paper explores the development and implementation of an agility monitoring system, aiming to provide real-time assessment of an athlete's agility. The need for such technology to facilitate instant and remote agility assessment has become increasingly apparent in the field of sports science. Unfortunately, progress in this area has been relatively slow until the emergence of IoT (Internet of Things) technology, which presents a promising avenue for athlete agility monitoring through telemetering. The core of this innovative system consists of an agility pad and a real-time monitoring module, with communication facilitated by LabVIEW software. Our approach involves rigorous testing, including unit testing of the agility pad, which serves as an MQTT publisher, the server, which functions as an MQTT broker, and the monitoring module, acting as an MQTT subscriber. In addition to these technical aspects, this article showcases various outcomes of our research. These include the designs of two activity diagrams, a comprehensive conceptual framework for agility monitoring, the database structure, communication designs for the agility pad, a wiring schematic, a 3D model of the agility pad, and the corresponding wiring configuration. We have successfully constructed two sets of agility pads, each integrated with an MCU system (ESP8266) and a dedicated database architecture designed for agile monitoring. One significant achievement of our work is the identification of the optimal delay interval required on the agility pad to prevent data loss on the MQTT broker. Furthermore, we have effectively developed a mechanism for detecting and addressing abnormal data during each testing phase, which contributes to the robustness and reliability of the system. This paper not only highlights the innovative technology behind the IOT-Infused Agility-Pad but also underscores its potential to revolutionize the assessment of athletic performance, offering coaches and athletes real-time insights into agility progress.

Randomised controlled decentralised feasibility trial of a fixed low-dose combination antihypertensive drug strategy to attenuate cognitive decline in high-risk adults

ObjectivesThe Action To promote brain HEalth iN Adults study aimed to determine the feasibility and applicability of recruitment using home blood pressure (BP) monitoring, routine blood biochemistry and videoconference measures...

Use of a remote assessment pathway for diagnosis of carpal tunnel syndrome.

We undertook a retrospective cohort study of a remote carpal tunnel syndrome assessment pathway created in response to limitations caused by the COVID-19 pandemic. Between July 2020 and September 2021, 702 patients referred from primary care (general practice) were assessed in a nurse-led telephone clinic using the carpal tunnel questionnaire of Kamath and Stothard (2003). Depending on their questionnaire score, patients were referred either for nerve conduction studies or a consultant hand surgeon review for diagnosis and treatment planning. Questionnaire scores of 3 and above accurately predicted a likely diagnosis of carpal tunnel syndrome in 83% of patients, and a diagnosis was unlikely in 90% of those with a score below 3. The pathway resulted in an estimated cost savings of £24,436 (€28,862, US$30,945) in comparison with the pre-pandemic service. However, some limitations in the pathway may have impacted effective patient management and we suggest possible improvements.Level of evidence: III.

Biomimetic FeNi-MOF assisted intelligent theranostic hydrogels for pH identification and treatment of wounds

Wound healing poses a significant challenge because of prolonged treatment and compromised tissue regeneration caused by bacterial infections. Timely and efficient wound monitoring strategies are urgently needed to assess wound progression and healing in real time. To address this, we present an intelligent theranostic hydrogel system based on dual-site biomimetic FeNi metal–organic frameworks (MOFs) that enables intelligent wound pH monitoring and effective prevention of infection. Notably, the quasi-MOFs among the pristine bimetallic FeNi-MOFs and their derivatives demonstrate remarkable performance in mimicking superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) activities, along with exceptional stability. The synthesized MOF hydrogels act as wound dressings for monitoring wound status and promoting healing. By incorporating the quasi-MOF and a pH indicator (phenol red) into the hydrogel, the hybrid system allows accurate pH detection, reflecting dynamic wound conditions. Furthermore, visual changes captured by smartphones provide real-time signals for remote assessment of wound pH, facilitating precise antimicrobial therapy and on-demand pH monitoring. This multifunctional theranostic hydrogel represents a significant advancement in the development and optimization of MOF hydrogels, offering a platform for efficient wound healing and comprehensive wound assessment.

Are we ready to cure post-stroke cognitive impairment? Many key prerequisites can be achieved quickly and easily.

Post-stroke (PS) cognitive impairment (CI) is frequent and its devastating functional and vital consequences are well known. Despite recent guidelines, they are still largely neglected. A large number of recent studies have re-examined the epidemiology, diagnosis, imaging determinants and management of PSCI. The aim of this update is to determine whether these new data answer the questions that are essential to reducing PSCI, the unmet needs, and steps still to be taken. Literature review of stroke unit-era studies examining key steps in the management of PSCI: epidemiology and risk factors, diagnosis (cognitive profile and assessments), imaging determinants (quantitative measures, voxelwise localization, the disconnectome and associated Alzheimer's disease [AD]) and treatment (secondary prevention, symptomatic drugs, rehabilitation and noninvasive brain stimulation) of PSCI. (1) the prevalence of PSCI of approximately 50% is probably underestimated; (2) the sensitivity of screening tests should be improved to detect mild PSCI; (3) comprehensive assessment is now well-defined and should include apathy; (4) easily available factors can identify patients at high risk of PSCI; (5) key imaging determinants are the location and volume of the lesion and the resulting disconnection, associated AD and brain atrophy; WMH, ePVS, microhemorrhages, hemosiderosis, and cortical microinfarcts may contribute to cognitive impairment but are more likely to be markers of brain vulnerability or associated AD that reduce PS recovery; (6) remote and online assessment is a promising approach for selected patients; (7) secondary stroke prevention has not been proven to prevent PSCI; (8) symptomatic drugs are ineffective in treating PSCI and apathy; (9) in addition to cognitive rehabilitation, the benefits of training platforms and computerized training are yet to be documented; (10) the results and the magnitude of improvement of noninvasive brain stimulation, while very promising, need to be substantiated by large, high-quality, sham-controlled RCTs. These major advances pave the way for the reduction of PSCI. They include (1) the development of more sensitive screening tests applicable to all patients and (2) online remote assessment; crossvalidation of (3) clinical and (4) imaging factors to (5) identify patients at risk, as well as (6) factors that prompt a search for associated AD; (7) the inclusion of cognitive outcome as a secondary endpoint in acute and secondary stroke prevention trials; and (8) the validation of the benefit of noninvasive brain stimulation through high-quality, randomized, sham-controlled trials. Many of these objectives can be rapidly and easily attained.

Introducing a Simple Tool of Patient Self-Assessment of Wrist Range of Motion.

Hand disorders can reduce wrist range of motion (ROM). The SARS-CoV-2 pandemic highlighted challenges in routine follow-up exams, making telemedicine a viable solution. This study evaluates the feasibility and accuracy of patient self-measured wrist ROM using a self-designed goniometer template. The template was designed to measure flexion/extension and radial/ulnar abduction movements. A cohort of 50 adults (25 males/25 females) participated in this prospective study. The exclusion criteria included wrist immobilization and ages outside of 18-65 years. Participants self-assessed their wrist ROM with the goniometer template. Measurements were independently performed by a student and a specialist using standard goniometry, as well as a resident using the self-designed goniometer. The results were blinded for unbiased analysis. Mean differences in ROM varied across movement directions, with minimal differences for ulnar abduction and more substantial deviations for radial abduction, extension and flexion. The patient-specialist comparison showed deviations below 5 degrees for flexion and ulnar abduction in 50% of cases. Telemedicine, expanded by the COVID-19 pandemic, offers significant potential for hand rehabilitation. Current methods of ROM assessment lack cost-effectiveness and simplicity. Our method, demonstrating comparable accuracy for most movements, provides a cost-effective, reliable alternative for remote ROM assessment, enhancing telemedicine practices in hand rehabilitation.

AROMHA Brain Health Test: A Remote Olfactory Assessment as a Screen for Cognitive Impairment.

Cost-effective, noninvasive screening methods for preclinical Alzheimer's disease (AD) and other neurocognitive disorders remain an unmet need. The olfactory neural circuits develop AD pathological changes prior to symptom onset. To probe these vulnerable circuits, we developed the digital remote AROMHA Brain Health Test (ABHT), an at-home odor identification, discrimination, memory, and intensity assessment. The ABHT was self-administered among cognitively normal (CN) English and Spanish speakers (n=127), participants with subjective cognitive complaints (SCC; n=34), and mild cognitive impairment (MCI; n=19). Self-administered tests took place remotely at home under unobserved (among interested CN participants) and observed modalities (CN, SCC, and MCI), as well as in-person with a research assistant present (CN, SCC, and MCI). Olfactory performance was similar across observed and unobserved remote self-administration and between English and Spanish speakers. Odor memory, identification, and discrimination scores decreased with age, and olfactory identification and discrimination were lower in the MCI group compared to CN and SCC groups, independent of age, sex, and education. The ABHT revealed age-related olfactory decline, and discriminated CN older adults from those with cognitive impairment. Replication of our results in other populations would support the use of the ABHT to identify and monitor individuals at risk for developing dementia.

Remote Neuropsychological Assessment: Forensics, Research, and Ethics

Remote Neuropsychological Assessment: Forensics, Research, and Ethics

Assessing Habitat Suitability: The Case of Black Rhino in the Ngorongoro Conservation Area

Efforts to identify suitable habitat for wildlife conservation are crucial for safeguarding biodiversity, facilitating management, and promoting sustainable coexistence between wildlife and communities. Our study focuses on identifying potential black rhino (Diceros bicornis) habitat within the Ngorongoro Conservation Area (NCA), Tanzania, across wet and dry seasons. To achieve this, we used remote sensing data with and without field data. We employed a comprehensive approach integrating Sentinel-2 and PlanetScope images, vegetation indices, and human activity data. We employed machine learning recursive feature elimination (RFE) and random forest (RF) algorithms to identify the most relevant features that contribute to habitat suitability prediction. Approximately 36% of the NCA is suitable for black rhinos throughout the year; however, there are seasonal shifts in habitat suitability. Anthropogenic factors increase land degradation and limit habitat suitability, but this depends on the season. This study found a higher influence of human-related factors during the wet season, with suitable habitat covering 53.6% of the NCA. In the dry season, browse availability decreases and rhinos are forced to become less selective of the areas where they move to fulfil their nutritional requirements, with anthropogenic pressures becoming less important. Furthermore, our study identified specific areas within the NCA that consistently offer suitable habitat across wet and dry seasons. These areas, situated between Olmoti and the Crater, exhibit minimal disturbance from human activities, presenting favourable conditions for rhinos. Although the Oldupai Gorge only has small suitable patches, it used to sustain a large population of rhinos in the 1960s. Land cover changes seem to have decreased the suitability of the Gorge. This study highlights the importance of combining field data with remotely sensed data. Remote sensing-based assessments rely on the importance of vegetation covers as a proxy for habitat and often overlook crucial field variables such as shelter or breeding locations. Overall, our study sheds light on the imperative of identifying suitable habitat for black rhinos within the NCA and underscores the urgency of intensified conservation efforts. Our findings underscore the need for adaptive conservation strategies to reverse land degradation and safeguard black rhino populations in this dynamic multiple land-use landscape as environmental and anthropogenic pressures evolve.

A Remote Oral Self-Care Behaviors Assessment System in Vulnerable Populations: Usability and Feasibility Study.

Preventative self-care can reduce dental disease that disproportionately burdens vulnerable populations. Personalized digital oral self-care behavioral interventions offer a promising solution. However, the success of these digital interventions depends on toothbrushing data collection e-platforms attuned to the needs and preferences of vulnerable communities. The aim of this study is to assess the usability and feasibility of the Remote Oral Behaviors Assessment System (ROBAS), which has been adapted to address the unique requirements of socioeconomically disadvantaged minority individuals. A cohort of 53 community-clinic participants, including 31 (58%) Latino and 22 (42%) Black individuals with no prior experience using electric toothbrushes, were recruited to use ROBAS, with planned assessments at baseline, 2 months, and 4 months. Beyond evaluating ROBAS's technical performance, extensive feedback was gathered to gauge users' experiences, viewpoints, and overall contentment. The System Usability Scale (SUS) served as a primary metric for assessing user satisfaction and acceptability. ROBAS exhibited largely reliable and consistent data-gathering capabilities. SUS scores (mean 75.6, SD 14.5) reflected participant contentment within a range of values for other commonly used digital devices and technologies. Among participants who answered questions about willingness to pay for ROBAS, 97% (30/31) indicated that they were willing to pay for ROBAS either as a one-time payment or as a subscription-based service. Additionally, 87.5% of participants expressed that they would endorse it to acquaintances. Most participants expressed no reservations about privacy; among those who expressed privacy concerns (n=20, 50%), the concerns included exposure of information (n=18, 45%), monitoring of brushing habits (n=12, 30%), and collection of information (n=14, 35%), although these concerns did not significantly correlate with specific participant traits. In qualitative terms, users valued ROBAS's ability to monitor brushing habits but called for refinements, especially in Wi-Fi and application connectivity. Recommendations for system improvements encompassed enhanced app functionality, individualized coaching, more comprehensive brushing data, and the addition of flossing activity tracking. The research highlights ROBAS's promise as a digital platform for unobtrusively tracking daily oral self-care activities in marginalized communities. The system proved to be both feasible, as evidenced by its stable and accurate data capture of brushing behaviors, and user-friendly, as reflected by strong SUS scores and positive user feedback. Influential factors for its uptake included ease of learning and operation, and the feedback provided.

Remote pulmonary pathology diagnosis using a handheld device for acquiring lung sounds at the mouth: a proof of concept study

IntroductionObtaining relevant information about respiratory conditions is a unique challenge in the rapidly growing field of telehealth. While auscultation using a stethoscope remains the first-line method in primary care, it is not a practical solution in a home setting, as it requires the presence of both a skilled caregiver and experienced interpreter online. We conducted a proofofconcept study of a simple selfcheck thermometer-like device (OmnySense®), which acquires auscultatory data through a microphone in the head of the device.ObjectivesTo have a concept of proof that home handled simplified device can asure a remote opion in telemedicine enhancing prompt and ease way to diagnose lung pathologies.MethodsWe assessed the agreement between subjective evaluations of lung sounds using the device and those using a digital stethoscope for the presence of crackles and/or wheezes. A total of 385 recordings from 13 patients admitted to the internal department were blindly, individually, and randomly assessed by three experienced physicians. The intra-modality agreement for crackles between evaluators was moderate for both the device and the stethoscope, with kappa statistics of 0.44 and 0.6 for the device and stethoscope, respectively, for the detection of wheezing and 0.46 and 0.4, respectively, for the crackles. The intermodality agreement was moderate for wheezes, with a kappa of 0.53, and was substantial for crackles, with a kappa of 0.71. Comparing the ability of crackles to diagnose pulmonary findings by imaging showed comparable sensitivity and specificity for both modalities.ConclusionsOur findings suggest that the diagnostic performance of OmnySense’s selfoperating device is similar to that of physician interpretation of digital stethoscope recordings; thus, OmnySense has the potential to become a useful tool in the remote assessment of respiratory conditions and pathologies.

Measuring Cognitive Impairments Associated With Schizophrenia in Clinical Practice: Overview of Current Challenges and Future Opportunities.

Cognitive impairment associated with schizophrenia (CIAS) negatively impacts daily functioning, quality of life, and recovery, yet effective pharmacotherapies and practical assessments for clinical practice are lacking. Despite the pivotal progress made with establishment of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for clinical research, implementation of the full MCCB is too time-consuming and cost-ineffective for most clinicians in clinical practice. Here we discuss current assessments in relation to delivery format (interview-based and performance-based), validity, ease of use for clinicians and patients, reliability/reproducibility, cost-effectiveness, and suitability for clinical implementation. Key challenges and future opportunities for improving cognitive assessments are also presented. Current assessments that require 30min to complete would have value in clinical settings, but the associated staff training and time required might preclude their application in most clinical settings. Initial profiling of cognitive deficits may require about 30min to assist in the selection of evidence-based treatments; follow-up monitoring with brief assessments (10-15min in duration) to detect treatment-related effects on global cognition may complement this approach. Guidance on validated brief cognitive tests for the strategic monitoring of treatment effects on CIAS is necessary. With increased advancements in technology-based and remote assessments, development of validated formats of remote and in-person assessment, and the necessary training models and infrastructure required for implementation, are likely to be of increasing clinical relevance for future clinical practice.

Advancing ocular oncology care through teleophthalmology: a patient-centric perspective

ObjectiveAssessing patient satisfaction is an important component of understanding a program's efficacy and quality. The purpose of this study is to evaluate patient satisfaction with a teleophthalmology program tailored for ocular oncology that provides screening, remote assessment, care planning, and follow-up. Study designRetrospective survey. MethodsAn adapted version of the Telehealth Satisfaction Scale, consisting of the 8 questions plus 5 additional questions specific to the teleophthalmology program, was used to survey patients. The teleophthalmology program involves diagnostic imaging, remote physician assessments, and follow-up phone calls from health care team members to deliver results to patients. For reporting, the Consensus-Based Checklist for Reporting of Survey Studies was used. T-tests explored satisfaction differences across demographics and teleophthalmology visits. ResultsAmong the 95 patients contacted, 91 agreed to participate in the survey (96% response rate). Participants exhibited high overall satisfaction with the teleophthalmology program, reflected in a mean Telehealth Satisfaction Scale score of 28.88 (SD = 3.35 of 32). The median number of teleophthalmology visits completed was 4.0 (range of 1–8 appointments). No significant differences in satisfaction were found on the basis of age (P = 0.56), urban or rural residence (P = 0.17), or the number of telemedicine appointments (P = 0.51). ConclusionsThis analysis displays high satisfaction levels among patients within an ocular oncology clinic participating in the current telemedicine program, irrespective of age, geography, or number of teleophthalmology visits. Participants reported having their health care needs met with minimal clinical encounters due to remote consultations and telephone communications.

Voice Tone Emotion Recognition for the Depressed: A review

This study investigates the application of voice tone emotion recognition for individuals with depression, utilizing advanced machine learning techniques. The research focuses on analyzing voice tone to detect emotional states, providing a non-invasive method to monitor and potentially diagnose depression. Audio data from participants were preprocessed through noise reduction and normalization, followed by feature extraction, including pitch, tone, and frequency. The extracted features were then analyzed using a combination of traditional machine learning and deep learning models. Our model achieved an accuracy of 85% in emotion recognition, with high precision and recall for neutral and happy tones. The findings highlight the model's potential in enhancing mental health monitoring and interventions. By enabling continuous, remote assessment of emotional states, this technology can aid in early detection, personalized therapy, and timely interventions for depression. The study also addresses existing challenges, such as variability in speech patterns and ethical considerations, proposing future research directions to improve accuracy and applicability. This research underscores the transformative impact of emotion recognition technology in mental health, offering promising applications in telehealth and personalized care for individuals with depression. Keywords: Voice tone, emotion recognition, depression, mental health, machine learning.

Detecting accelerated long-term forgetting remotely in a community sample of people with epilepsy: Evidence from the Crimes and Four Doors tests

People with epilepsy often report experiencing memory problems though these are not always detectable using standard neuropsychological measures. One form of difficulty that may be relatively prevalent in epilepsy is termed accelerated long-term forgetting (ALF), typically described as relatively greater loss of memory over days or weeks following initial encoding. The current study used remote assessment to examine memory and forgetting over one week in a broad community sample of people with epilepsy and healthy control participants, using two recently developed tests, one verbal (the Crimes test) and one visual (the Four Doors test). These were administered as part of a short battery of cognitive measures, run remotely with participants over Zoom. Across this community-derived sample, people with epilepsy reported more memory complaints and demonstrated significantly faster forgetting on both the verbal and visual tests. This difference was not attributable to level of initial learning performance and was not detectable through delayed recall on a standard existing test. Our results suggests that ALF may be more common than suspected in people with epilepsy, leading to a potentially important source of memory problems that are currently undetected by standard memory tests.

Age related changes in skin sensitivity assessed with smartphone vibration testing

The capacity to perceive tactile input at the fingertips, referred to as tactile sensitivity, is known to diminish with age due to regressive changes to mechanoreceptor density and morphology. Sensitivity is measured as perceptual responses to stimuli of varying intensity. Contrary to traditional sensitivity monitoring instruments, smartphones are uniquely suited for remote assessment and have shown to deliver highly calibrated stimuli along a broad spectrum of intensity, which may improve test reliability. The aim of this study was to evaluate a vibration-emitting smartphone application, the Vibratus App, as a mode of estimating tactile sensory thresholds in the aging adult. The peripheral nerve function of 40 neurologically healthy volunteers (ages 18–71) was measured using monofilaments, a 128-Hz tuning fork, the Vibratus App, and nerve conduction studies (NCS). Between group differences were analyzed to determine each measurement’s sensitivity to age. Spearman correlation coefficients depicted the associative strength between hand-held measurements and sensory nerve action potential (SNAP) amplitude. Inter-rater reliability of traditional instruments and the software-operated smartphone were assessed by intraclass correlation coefficient (ICC2,k). Measurements taken with Vibratus App were significantly different between age groups (p < 0.001). The inter-rater reliability of monofilament, smartphone vibration, and tuning fork testing was moderate to good (ICC2,k = 0.65, 0.69, and 0.79, respectively). The findings of this study support further investigation of smartphones as sensitivity monitoring devices for at home monitoring of skin sensitivity.

Digital remote assessment of speech acoustics in cognitively unimpaired adults: feasibility, reliability and associations with amyloid pathology

BackgroundDigital speech assessment has potential relevance in the earliest, preclinical stages of Alzheimer’s disease (AD). We evaluated the feasibility, test-retest reliability, and association with AD-related amyloid-beta (Aβ) pathology of speech acoustics measured over multiple assessments in a remote setting.MethodsFifty cognitively unimpaired adults (Age 68 ± 6.2 years, 58% female, 46% Aβ-positive) completed remote, tablet-based speech assessments (i.e., picture description, journal-prompt storytelling, verbal fluency tasks) for five days. The testing paradigm was repeated after 2–3 weeks. Acoustic speech features were automatically extracted from the voice recordings, and mean scores were calculated over the 5-day period. We assessed feasibility by adherence rates and usability ratings on the System Usability Scale (SUS) questionnaire. Test-retest reliability was examined with intraclass correlation coefficients (ICCs). We investigated the associations between acoustic features and Aβ-pathology, using linear regression models, adjusted for age, sex and education.ResultsThe speech assessment was feasible, indicated by 91.6% adherence and usability scores of 86.0 ± 9.9. High reliability (ICC ≥ 0.75) was found across averaged speech samples. Aβ-positive individuals displayed a higher pause-to-word ratio in picture description (B = -0.05, p = 0.040) and journal-prompt storytelling (B = -0.07, p = 0.032) than Aβ-negative individuals, although this effect lost significance after correction for multiple testing.ConclusionOur findings support the feasibility and reliability of multi-day remote assessment of speech acoustics in cognitively unimpaired individuals with and without Aβ-pathology, which lays the foundation for the use of speech biomarkers in the context of early AD.