Face-to-face versus remote administration of the Montgomery-Asberg Depression Rating Scale using videoconference and telephone

Abstract

Although the use of telemedicine in psychiatry has a long history in providing clinical care to patients, its use in clinical trials research has not yet been commonly employed. Telemedicine allows for the remote assessment of study patients, which could be done by a centralized, highly calibrated, and impartial cohort of raters independent of the study site. This study examined the comparability of remote administration of the Montgomery-Asberg Depression Rating Scale (MADRS) by videoconference and by telephone to traditional face-to-face administration. Two parallel studies were conducted: one compared face-to-face with videoconference administration (N=35), and the other compared face-to-face with telephone administration (N=35). In each study, depressed patients were interviewed independently twice: once in the traditional face-to-face manner, and the second time by either videoconference or teleconference. A counterbalanced order was used. The mean MADRS score for interviews conducted remotely by videoconference was not significantly different from the mean MADRS scores conducted by face-to-face administration (mean difference=0.51 points), P=.388, intraclass correlation (ICC)=.94, P<0001. Similarly, the mean MADRS score for interviews conducted by telephone was not significantly different from the mean MADRS score conducted by face-to-face administration (mean difference=0.74 points), P=.270, ICC=.93, P<0001. Results of the study support the comparability of remote administration of the MADRS, by both telephone and videoconference, to face-to-face administration. Comparability of the administration mode allows for remote assessment of patients in both research and clinical applications.

Review of key telepsychiatry outcomes

“…On the other hand, Yoshino et al [75] observed statistically significantly lower ICC scores in the narrow bandwidth condition compared to the broad bandwidth in for BPRS scores. In a rigorous comparison of inter-rater reliability that reduced artificial inflation of reliability estimates by requiring interviewers to generate their own clarifying questions and probes, Kobak et al [66][67][68] observed very high reliability estimates between four psychiatrists at three different locations using the HAMD via telepsychiatry or FTF [67] . And although diagnostic assessments via telepsychiatry appear to be reliable even when using interpreters [60] , there are mixed results of the reliability of telepsychiatry assessments when visual information is required.…”

“…Two studies compared the accuracy of diagnoses made using the SCID [59,60] , two studies evaluated reliability of child assessments [42,61] , four studies evaluated reliability of neuropsychological assessments [62][63][64][65] , and three studies evaluated reliability of measures of depressive symptom severity [66][67][68] . The remaining studies evaluated a range of targets such as alcohol use severity [69] , diagnostic accuracy [70][71][72] , competency to stand trial [73] , psychosis [26] , and adult autism [21] .…”

Telepsychiatry in South Africa – present and future

“…Comparing video-conferencing, telephone consultations and conventional face-to-face methods, satisfactory assessment was possible with all three modes for depression, using the Montgomery-Asberg Depression Rating Scale. 3 Telepsychiatry has also been successful in child psychiatry, depression, dementia, schizophrenia, suicide prevention, post-traumatic stress, panic disorders, substance abuse, eating disorders and smoking prevention. 4 …”

A Web-Based Tutorial for Parents of Young Children with Autism: Results from a Pilot Study

“…The USQ has been used to evaluate how well subjects like the clinical content of computerized or Web-based applications. [22][23][24][25][26][27][28] It contains 15 statements, each of which is rated on a 4-point scale (strongly agree, agree, disagree, strongly disagree), and covers several dimensions of the user experience ( Table 1). Good internal consistency has been reported (Cronbach's alpha = 0.92).…”