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Cognitive Impairment Assessment Via Telehealth Found Reliable
Studies support the reliability of telemedicine for the assessment of mild-to-moderate cognitive impairments, according to a systematic literature review published in the Journal of Personalized Medicine.
“Telemedicine, by reducing the global costs of the assessment and the cognitive follow up of older adults, could represent an opportunity for making evaluation and care of adult-onset cognitive dysfunctions more affordable for public health systems and families of patients suffering from these problems,” wrote researchers from the University of Camerino in Italy.
The review looked at studies published over the past 2 decades to assess the reliability of neuropsychological tests used to assess cognitive status via telemedicine compared with traditional face-to-face encounters.
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According to the review, results on the Mini-Mental State Examination (MMSE) did not differ when the test was administered remotely, although negligible minor differences in scoring were present.
“MMSE via videoconference is as accurate as face-to-face examination,” researchers wrote, “and can be used alternatively to it.”
Other tests used in the diagnosis of cognitive impairments, such as Token Test, the Comprehension of Words and Phrases, and the Controlled Oral Word Association Test, also showed high reliability when administered remotely compared with face to face, researchers reported. In addition, the review found mostly high patient acceptance, satisfaction, and confidence in remote assessment.
The review did point out potential challenges in costs and maintaining connectivity, as well as the need for a back-up plan if video or audio cuts out mid-assessment. Researchers also suggested standardized scoring practices specific to video-based assessment.
“In summary, standard neuropsychological tests can be used by videoconference provided that some modifications in the instructions and in evaluating scores are considered,” reviewers advised. “To ensure reliable results in this, field tests must be administered by raters who are properly trained and with specified competencies.”