Telemedicine and the Evaluation of Cognitive Impairment: The Additive Value of Neuropsychological Assessment

Harrell, Kathryn M.; Wilkins, Stacy Schantz; Connor, Megan K.; Chodosh, Joshua

doi:10.1016/j.jamda.2014.04.015

Cited by 77 publications

(64 citation statements)

References 32 publications

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“…Good agreement was found across most tests examined, with intraclass correlations ranging from .58 to .88. Together with other encouraging findings from the literature using various brief assessments in small groups (Harrell, Wilkins, Connor, & Chodosh, 2014; Jacobsen, Sprenger, Andersson, & Krogstad, 2003; Kirkwood, Peck, & Bennie, 2000; Turner, Horner, VanKirk, Myrick, & Tuerk, 2012; Vestal et al, 2006), these results suggested that VTC-based neuropsychological assessment in older individuals with and without cognitive impairment was feasible and had promising reliability despite that no large-scale studies more definitively establishing reliability had been conducted. Consumer acceptability of VTC-based neuropsychological assessment has also been explored in a recent investigation, with results suggesting good acceptance of VTC-based testing among healthy and cognitively impaired older individuals (Parikh et al, 2013).…”

Section: Introductionmentioning

confidence: 75%

Teleneuropsychology: Evidence for Video Teleconference-Based Neuropsychological Assessment

Cullum

Hynan²,

Grosch

et al. 2014

J Int Neuropsychol Soc

214

136

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The use of videoconference technology to deliver health care diagnostics and treatment continues to grow at a rapid pace. Telepsychiatry and telepsychology applications are well-accepted by patients and providers, and both diagnostic and treatment outcomes have generally been similar to traditional face-to-face interactions. Preliminary applications of videoconference-based neuropsychological assessment (teleneuropsychology) have yielded promising results in the feasibility and reliability of several standard tests, although large-scale studies are lacking. This investigation was conducted to determine the reliability of video teleconference (VTC) - based neuropsychological assessment using a brief battery of standard neuropsychological tests commonly used in the evaluation of known or suspected dementia. Tests included the Mini-Mental State Examination (MMSE), Hopkins Verbal Learning Test-Revised, Digit Span forward and backward, short form Boston Naming Test, Letter and Category Fluency, and Clock Drawing. Tests were administered via VTC and in-person to subjects, counterbalanced using alternate test forms and standard instructions. Two hundred two adult subjects were tested in both rural and urban settings, including 83 with cognitive impairment and 119 healthy controls. We found highly similar results across VTC and in-person conditions, with significant intraclass correlations (mean = .74; range: 0.55–0.91) between test scores. Findings remained consistent in subjects with or without cognitive impairment and in persons with MMSE scores as low as 15. VTC-based neuropsychological testing is a valid and reliable alternative to traditional face-to-face assessment using selected measures. More VTC-based studies using additional tests in different populations are needed to fully explore the utility of this new testing medium.

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Section: Introductionmentioning

confidence: 75%

Teleneuropsychology: Evidence for Video Teleconference-Based Neuropsychological Assessment

Cullum

Hynan²,

Grosch

et al. 2014

J Int Neuropsychol Soc

214

136

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“…Devices should be adjusted to each individual, achieving better tailored interventions, and assistive technologies should be embedded in a person-centred model [55]. A good example of this is the provision of feedback sessions to ensure that the person with dementia and carer understand the assistive technologies, to answer questions, and to collaboratively discuss recommendations for improvement [56]. A recent review (not limited to dementia) on mHealth applications suggested the adoption of automated evaluation mechanisms to improve the empirical methods to assess usability [57].…”

Section: Resultsmentioning

confidence: 99%

Technologies to Support Community-Dwelling Persons With Dementia: A Position Paper on Issues Regarding Development, Usability, Effectiveness and Cost-Effectiveness, Deployment, and Ethics

Meiland

Innes

Mountain

et al. 2017

JMIR Rehabil Assist Technol

256

241

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BackgroundWith the expected increase in the numbers of persons with dementia, providing timely, adequate, and affordable care and support is challenging. Assistive and health technologies may be a valuable contribution in dementia care, but new challenges may emerge.ObjectiveThe aim of our study was to review the state of the art of technologies for persons with dementia regarding issues on development, usability, effectiveness and cost-effectiveness, deployment, and ethics in 3 fields of application of technologies: (1) support with managing everyday life, (2) support with participating in pleasurable and meaningful activities, and (3) support with dementia health and social care provision. The study also aimed to identify gaps in the evidence and challenges for future research.MethodsReviews of literature and expert opinions were used in our study. Literature searches were conducted on usability, effectiveness and cost-effectiveness, and ethics using PubMed, Embase, CINAHL, and PsycINFO databases with no time limit. Selection criteria in our selected technology fields were reviews in English for community-dwelling persons with dementia. Regarding deployment issues, searches were done in Health Technology Assessment databases.ResultsAccording to our results, persons with dementia want to be included in the development of technologies; there is little research on the usability of assistive technologies; various benefits are reported but are mainly based on low-quality studies; barriers to deployment of technologies in dementia care were identified, and ethical issues were raised by researchers but often not studied. Many challenges remain such as including the target group more often in development, performing more high-quality studies on usability and effectiveness and cost-effectiveness, creating and having access to high-quality datasets on existing technologies to enable adequate deployment of technologies in dementia care, and ensuring that ethical issues are considered an important topic for researchers to include in their evaluation of assistive technologies.ConclusionsBased on these findings, various actions are recommended for development, usability, effectiveness and cost-effectiveness, deployment, and ethics of assistive and health technologies across Europe. These include avoiding replication of technology development that is unhelpful or ineffective and focusing on how technologies succeed in addressing individual needs of persons with dementia. Furthermore, it is suggested to include these recommendations in national and international calls for funding and assistive technology research programs. Finally, practitioners, policy makers, care insurers, and care providers should work together with technology enterprises and researchers to prepare strategies for the implementation of assistive technologies in different care settings. This may help future generations of persons with dementia to utilize available and affordable technologies and, ultimately, to benefit from them.

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“…Neuropsychological testing can provide valuable input for diagnostic and therapeutic planning for individuals with neuromuscular disorders that also impact cognition. To this end, cognitive screening and complete neuropsychological batteries have been successfully performed through telehealth at remote community facilities with the assistance of a trained telepresenter . A meta‐analysis mental health services by telephone to address adjustment and depression in the setting of physical disability has been described with improvements in coping skills, mood, community integration, and quality of life .…”

Section: Specific Telehealth Applications For Neuromuscular or Musculmentioning

confidence: 99%

Telehealth applications for outpatients with neuromuscular or musculoskeletal disorders

Howard

Kaufman

2018

Muscle and Nerve

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Telehealth describes the provision of medical services remotely through technology, and may enhance patient access to specialty care services. Although teleneurology has expanded widely since the introduction of telestroke in 1999, telehealth services for outpatients with neuromuscular or musculoskeletal disorders are less widespread. In this narrative review, we will describe the current technology, applications, outcomes, and limitations of this dynamically growing field. Evidence for telehealth applications related to neuromuscular diseases, palliative care, specialized multidisciplinary services, and musculoskeletal care are reviewed. With growing demand for specialized services and finite resources, telehealth provides a promising avenue to promote access to high-quality care, decrease the cost and burden of travel for patients, and with the expansion of software to personal computing and mobile devices, offer flexible, low-overhead practice opportunities for clinicians. Providers embarking on careers in telehealth should be aware of current legal restrictions impacting care to minimize risk and avoid liability. Muscle Nerve 58: 475-485, 2018.

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Telemedicine and the Evaluation of Cognitive Impairment: The Additive Value of Neuropsychological Assessment

Cited by 77 publications

References 32 publications

Teleneuropsychology: Evidence for Video Teleconference-Based Neuropsychological Assessment

Teleneuropsychology: Evidence for Video Teleconference-Based Neuropsychological Assessment

Technologies to Support Community-Dwelling Persons With Dementia: A Position Paper on Issues Regarding Development, Usability, Effectiveness and Cost-Effectiveness, Deployment, and Ethics

Telehealth applications for outpatients with neuromuscular or musculoskeletal disorders

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