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Tsiakiri A, Koutzmpi V, Megagianni S, Toumaian M, Geronikola N, Despoti A, Kanellopoulou S, Arampatzi X, Margioti E, Davila A, Zoi P, Kalligerou F, Liozidou A, Tsapanou A, Sakka P. Remote neuropsychological evaluation of older adults. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:796-803. [PMID: 35595233 DOI: 10.1080/23279095.2022.2074850] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of technological means in the process of neuropsychological assessment has been proposed as a technique with promising results in the field of detection of neurocognitive disorders for community-dwelling older adults. Especially during the pandemic period due to COVID-19, telemedicine assumed to be vital in the field of early diagnosis of cognitive disorders and highlighted the clinical utility of remote methods of neuropsychological assessmentby video-conference. This descriptive study presents the development of a remote neuropsychological assessment protocol by selecting appropriate validated tests as part of a more comprehensive evaluation for older adults dwelling in the community. We recruited participants from the Athens Alzheimer's Association center in collaboration with the Hellenic Neuropsychological Society, in Athens, Greece, regarding the period between April 2020 and October 2021. 90 individuals, tested for the first time, were categorized into three groups according to their diagnosis which included: (a) Mild Cognitive Impairment (MCI), (b) Alzheimer's disease, (c) cognitively healthy older adults. The presented protocol outlines the main considerations of a framework about remote neuropsychological assessment, which can maximize the effectiveness of interventions and continuity regarding the care of older adults. The recommendations outlined in the presented protocol highlight strengths and limitations that should be taken into account in remote control procedures. Although the protocol was created in response to pandemic restrictions, tele-neuropsychology shows promise as a way to improve access opportunity to neurodiagnostic services for rural aging and underserved populations, which lack specialized healthcare services. Further application to different populations will add validity to the presented descriptive protocol.
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Affiliation(s)
- A Tsiakiri
- Department of Neurology, Medical School, Democritus University of Thrace, Alexandroupoli, Greece
- Hellenic Neuropsychological Society, Athens, Greece
| | - V Koutzmpi
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - S Megagianni
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - M Toumaian
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Sensorimotor Control, University Mental Health, Neurosciences and Precision Medicine Research Institute "Costas Stefanis," Athens, Greece
| | - N Geronikola
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Despoti
- Hellenic Neuropsychological Society, Athens, Greece
- Clinical Ergospirometry, Exercise and Rehabilitation Laboratory, 1st Critical Care Department, Evangelismos Hospital, School of Medicine, National & Kapodistrian University of Athens, Athens, Greece
| | | | - X Arampatzi
- Athens Alzheimer's Association, Athens, Greece
| | - E Margioti
- Athens Alzheimer's Association, Athens, Greece
| | - A Davila
- Athens Alzheimer's Association, Athens, Greece
| | - P Zoi
- Athens Alzheimer's Association, Athens, Greece
| | - F Kalligerou
- Athens Alzheimer's Association, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - A Liozidou
- Hellenic Neuropsychological Society, Athens, Greece
- Laboratory of Cognitive Neuroscience and Clinical Neuropsychology, The Scientific College of Greece. Department of Medicine, School of Health Sciences, National and Kapodistrian University of Athens
| | - A Tsapanou
- Hellenic Neuropsychological Society, Athens, Greece
- Athens Alzheimer's Association, Athens, Greece
- Cognitive Neuroscience Division, Columbia University Irving Medical Center, New York, NY, USA
| | - P Sakka
- Athens Alzheimer's Association, Athens, Greece
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Junco B, Samano Martin Del Campo D, Karakeshishyan V, Bass D, Sobczak E, Swafford E, Bolanos A, Rooks J, Baumel BS, Ramos AR, Rundek T, Alkhachroum A. Long-term brain fog and cognitive impairment in previously hospitalized COVID-19 patients. PLoS One 2024; 19:e0309102. [PMID: 39208280 PMCID: PMC11361661 DOI: 10.1371/journal.pone.0309102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVES Limited research exists on COVID-19 associated brain fog, and on the long-term cognitive and psychiatric sequelae in racially and ethnically diverse patients. We characterize the neuropsychological sequelae of post-acute COVID-19 in a diverse cohort and investigate whether COVID-19 clinical severity remains associated with brain fog and cognitive deficits approximately 2 years post infection. METHODS A cross-sectional study of patients with a history of COVID-19 hospitalization (March-September 2020). COVID-19 clinical severity was indexed using the National Early Warning Score 2 and a comprehensive neuropsychological tele-battery was administered 2 years post discharge. Pearson's r correlations assessed association, while independent sample t-tests examined group differences. Significant outcomes were further analyzed using multiple regression and ANCOVAs, adjusting for key covariates. RESULTS In 41 adult patients (19 female, 30 Hispanic, 13 Black, mean age of 65 (SD = 15), COVID-19 level of severity was associated with greater number of endorsed brain fog symptoms (Pearson's r = .34, 95% CI [.04, .59]), worse overall cognitive functioning (global cognition: r = -.36, 95% CI [-.61, -.05]) and reduced performance on an attention and working memory task (digit span backwards: r = -.41, 95% CI [-.66, -.09]) at 2-year follow-up. Brain fog symptoms most associated with COVID-19 severity included difficulty focusing (r = .46, 95% CI [.18, .67]), detached (r = .41, 95% CI [.12, .64]) and feeling sleepy (r = .40, 95% CI [.11, .63]). Patients' cognitive performance was generally below average (global cognition z-score: M = -.96, SD = .66), with group differences based on sex and ethnicity evidenced on individual cognitive tests. DISCUSSION This study emphasizes the importance of continued research on the long-term effects of COVID-19 infection on neuropsychological outcomes, particularly among underrepresented, health-disparate groups. Greater understanding of these associations could improve detection and treatment of those at increased risk of cognitive decline or impairment.
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Affiliation(s)
- Barbara Junco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Daniel Samano Martin Del Campo
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
- Department of Neurosurgery, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Vela Karakeshishyan
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Danielle Bass
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Evie Sobczak
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Emily Swafford
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Ana Bolanos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Joshua Rooks
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Bernard S. Baumel
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Alberto R. Ramos
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Ayham Alkhachroum
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, United States of America
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Tsiaras Y, Koutsonida M, Varthi MA, Galliou I, Zoubouli C, Aretouli E. Development of a self-administered online battery for remote assessment of executive functions and verbal memory: equivalence with face-to-face administration, preliminary norms, and acceptance. J Clin Exp Neuropsychol 2024:1-15. [PMID: 38984860 DOI: 10.1080/13803395.2024.2376839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024]
Abstract
OBJECTIVES Interest in teleneuropsychology services increased considerably after the COVID-19 pandemic. However, the utility of unsupervised administration of computerized tests remains largely unexplored. In the present study, we developed a brief computerized battery that assesses self-reported cognitive abilities and performances on executive functioning and verbal memory. We investigated the equivalence of the self-administration online (SAO) procedure and the face-to-face (FTF) administration. Preliminary normative data were developed and the acceptance of the SAO procedure was explored. METHODS A community sample of 169 Greek adults [94 women; mean age: 41.95 (SD = 13.40) years, mean years of education: 15.10 (SD = 2.65)] completed the SAO assessment. A subgroup of 40 participants was tested in a counterbalanced way both with SAO and FTF. Participants' performances were compared with paired sample t-tests and the agreement between the two methods was estimated with intraclass correlation coefficients (ICCs). Multiple linear regression analyses were applied to investigate the effect of demographic characteristics on SAO measures. RESULTS No difference between SAO and FTF scores was observed. ICCs indicated moderate to good agreement (.418-.848) for most measures. Age was positively associated with self-reported cognitive state and negatively with neuropsychological performances and the level of acceptance of the SAO procedure. Approximately 80% of participants reported satisfaction from the SAO assessment, 69% good compliance with the instructions, but less than 30% belief that the FTF assessment could be adequately replaced. CONCLUSION SAO testing is feasible and well accepted among Greek adults yielding equivalent results with FTF testing. Despite the wide satisfaction, though, notable reluctance was noted for the substitution of FTF with SAO procedures.
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Affiliation(s)
- Yiannis Tsiaras
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
- Psychiatric Department, 424 General Military Hospital, Thessaloniki, Greece
| | - Myrto Koutsonida
- Department of Hygiene and Epidemiology, University of Ioannina, School of Medicine, Ioannina, Greece
| | - Maria-Ameriso Varthi
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Iliana Galliou
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Christina Zoubouli
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
| | - Eleni Aretouli
- Department of Psychology, School of the Social Sciences, University of Ioannina, Ioannina, Greece
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Yıldırım E, Büyükişcan ES, Kalem ŞA, Gürvit İH. Remote Neuropscyhological Assessment: Teleneuropsychology. Noro Psikiyatr Ars 2024; 61:167-174. [PMID: 38868842 PMCID: PMC11165610 DOI: 10.29399/npa.28535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/18/2023] [Indexed: 06/14/2024] Open
Abstract
Introduction Teleneuropsychology, which includes the remote application of neuropsychological tests to patients via telephone or videoconferencing, can expand access to health services for patients who reside in distant areas or have mobility restrictions. With the emergence of the COVID-19 pandemic, there has been a significant increase in the use of teleneuropsychology in cognitive assessment. In this review, the aim was to critically review the results of studies conducted in the field of teleneuropsychology and the fundamental principles related to tele-neuropsychological assessment. Additionally, the "guideline for home-based teleneuropsychology" developed for Türkiye's practices is outlined in this review. Method A literature search was conducted using the Web of Science and PubMed databases to include all types of articles related to the subject. Results The results of studies on in-clinic and home-based teleneuropsychological assessment indicate that tests that assess cognitive functions such as attention, memory, executive functions, and language, particularly those based on verbal administration, can be reliably applied through teleneuropsychological assessment. However, there are factors to consider when referring patients for teleneuropsychological assessment, selecting tests for assessment, and making ethical considerations. Additionally, it is important to follow recommended steps for both the clinician and the patient and/or their caregiver before and during the interview in order for the assessment to be carried out effectively. Conclusion Although direct contact with the patient is an essential element in clinical neuropsychology practice, when necessary, teleneuropsychological assessment performed by trained experts following appropriate application procedures can be a good alternative to face-to-face evaluations.
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Affiliation(s)
- Elif Yıldırım
- Işık University, Department of Psychology, Istanbul, Turkey
| | | | - Şükriye Akça Kalem
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
| | - İ. Hakan Gürvit
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Istanbul, Turkey
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Del Bene VA, Walker KA. From Practice to Public Health: Broadening Neuropsychology's Reach & Value-An Introduction to the National Academy of Neuropsychology's 2022 Annual Conference Special Issue. Arch Clin Neuropsychol 2024; 39:273-275. [PMID: 38520366 DOI: 10.1093/arclin/acae012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/25/2024] Open
Abstract
This special issue is centered around presentations from the National Academy of Neuropsychology 2022 Annual Conference. The theme of the conference, "From Practice to Public Health: Broadening Neuropsychology's Reach & Value" is pivotal for the field's future. With an ever-shifting technological landscape and recent changes in clinical practice post-COVID, we are left wondering how neuropsychology will develop. How will we use biomedical and technological advances, such as blood-based Alzheimer's disease biomarkers or passive digital recordings, to improve clinical care and further expand our understanding of disease mechanisms? As neuropsychologists, how can we use our expertise to empirically inform public health policy? The diagnosis and treatment of post-acute sequelae of COVID-19, the identification and characterization of post-pandemic educational setbacks, and the adaptation of new technological and diagnostic advances into clinical practice workflows represent a vital set of new challenges and opportunities poised to disrupt traditional modes of practice. The articles in this special issue convey the role of neuropsychology in addressing these emerging issues and illustrate how and why neuropsychology is well positioned to be at the forefront of clinical practice and scientific advancements.
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Affiliation(s)
- Victor A Del Bene
- Department of Neurology, The University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, AL, USA
| | - Keenan A Walker
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA
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Varela JL, Sperling SA, Block C, O’Leary K, Hart ES, Kiselica AM. A survey of neuropsychological assessment feedback practices among neuropsychologists. Clin Neuropsychol 2024; 38:529-556. [PMID: 37438247 PMCID: PMC10784416 DOI: 10.1080/13854046.2023.2233738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/30/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVE Feedback on neuropsychological assessment is a critical part of clinical practice, but there are few empirical papers on neuropsychological feedback practices. We sought to fill this gap in the literature by surveying practicing neuropsychologists in the United States. Questions addressed how they provide verbal and written feedback to patients and referral sources. Survey questions also addressed billing practices and training in the provision of feedback. METHODS A survey was developed using Qualtrics XM to survey currently licensed, independently practicing clinical neuropsychologists in the United States about their feedback practices. The survey was completed by 184 individuals. RESULTS Nearly all respondents reported that they provide verbal feedback to patients, most often in-person, within three weeks following testing. Typically, verbal feedback sessions with patients last 45 min. Verbal feedback was provided to referrals by about half of our sample, typically via a brief phone call. Most participants also reported providing written feedback to both the patient and referring provider, most commonly via the written report within three weeks after testing. Regarding billing, most respondents use neuropsychological testing evaluation codes. The COVID-19 pandemic appeared to have had a limited impact on the perceived effectiveness and quality of verbal feedback sessions. Finally, respondents reported that across major stages of professional development, training in the provision of feedback gradually increased but was considered inadequate by many participants. CONCLUSIONS Results provide an empirical summary of the "state of current practice" for providing neuropsychological assessment feedback. Further experimental research is needed to develop an evidence-base for effective feedback practices.
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Affiliation(s)
- Jacob L. Varela
- University of Missouri, Columbia, MO, 65211, USA
- Regent University, Virginia Beach, VA, 23464, USA
| | | | - Cady Block
- Emory University, Atlanta, GA, 30322, USA
| | | | - Eric S. Hart
- University of Missouri, Columbia, MO, 65211, USA
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Sperling SA, Acheson SK, Fox-Fuller J, Colvin MK, Harder L, Cullum CM, Randolph JJ, Carter KR, Espe-Pfeifer P, Lacritz LH, Arnett PA, Gillaspy SR. Tele-Neuropsychology: From Science to Policy to Practice. Arch Clin Neuropsychol 2024; 39:227-248. [PMID: 37715508 DOI: 10.1093/arclin/acad066] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/17/2023] Open
Abstract
OBJECTIVE The primary aim of this paper is to accelerate the number of randomized experimental studies of the reliability and validity in-home tele-neuropsychological testing (tele-np-t). METHOD We conducted a critical review of the tele-neuropsychology literature. We discuss this research in the context of the United States' public and private healthcare payer systems, including the Centers for Medicare & Medicaid Services (CMS) and Current Procedural Terminology (CPT) coding system's telehealth lists, and existing disparities in healthcare access. RESULTS The number of tele-np publications has been stagnant since the onset of the COVID-19 pandemic. There are less published experimental studies of tele-neuropsychology (tele-np), and particularly in-home tele-np-t, than other tele-np publications. There is strong foundational evidence of the acceptability, feasibility, and reliability of tele-np-t, but relatively few studies of the reliability and validity of in-home tele-np-t using randomization methodology. CONCLUSIONS More studies of the reliability and validity of in-home tele-np-t using randomization methodology are necessary to support inclusion of tele-np-t codes on the CMS and CPT telehealth lists, and subsequently, the integration and delivery of in-home tele-np-t services across providers and institutions. These actions are needed to maintain equitable reimbursement of in-home tele-np-t services and address the widespread disparities in healthcare access.
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Affiliation(s)
- Scott A Sperling
- Department of Neurology, Center for Neurological Restoration, Cleveland Clinic, Cleveland, OH, USA
| | | | - Joshua Fox-Fuller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychological and Brain Sciences, Boston University, Boston, MA, USA
| | - Mary K Colvin
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Lana Harder
- Children's Health, Children's Medical Center, Dallas, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - C Munro Cullum
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - John J Randolph
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
- Randolph Neuropsychology Associates, PLLC, Lebanon, NH, USA
| | | | - Patricia Espe-Pfeifer
- Department of Psychiatry and Pediatrics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Laura H Lacritz
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Peter A Arnett
- Department of Psychology, The Pennsylvania State University, State College, PA, USA
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Gierzynski TF, Gregoire A, Reader JM, Pantis R, Campbell S, Bhaumik A, Rahman-Filipiak A, Heidebrink J, Giordani B, Paulson H, Hampstead BM. Evaluation of the Uniform Data Set version 3 teleneuropsychological measures. J Int Neuropsychol Soc 2024; 30:183-193. [PMID: 37366070 PMCID: PMC10751395 DOI: 10.1017/s1355617723000383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
OBJECTIVE Few studies have evaluated in-home teleneuropsychological (teleNP) assessment and none, to our knowledge, has evaluated the National Alzheimer's Coordinating Center's (NACC) Uniform Data Set version 3 tele-adapted test battery (UDS v3.0 t-cog). The current study evaluates the reliability of the in-home UDS v3.0 t-cog with a prior in-person UDS v3.0 evaluation. METHOD One hundred and eighty-one cognitively unimpaired or cognitively impaired participants from a longitudinal study of memory and aging completed an in-person UDS v3.0 and a subsequent UDS v3.0 t-cog evaluation (∼16 months apart) administered either via video conference (n = 122) or telephone (n = 59). RESULTS We calculated intraclass correlation coefficients (ICCs) between each time point for the entire sample. ICCs ranged widely (0.01-0.79) but were generally indicative of "moderate" (i.e., ICCs ranging from 0.5-0.75) to "good" (i.e., ICCs ranging from 0.75-0.90) agreement. Comparable ICCs were evident when looking only at those with stable diagnoses. However, relatively stronger ICCs (Range: 0.35-0.87) were found between similarly timed in-person UDS v3.0 evaluations. CONCLUSIONS Our findings suggest that most tests on the UDS v3.0 t-cog battery may serve as a viable alternative to its in-person counterpart, though reliability may be attenuated relative to the traditional in-person format. More tightly controlled studies are needed to better establish the reliability of these measures.
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Affiliation(s)
| | - Allyson Gregoire
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | - Rebecca Pantis
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Stephen Campbell
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Arijit Bhaumik
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Bruno Giordani
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Henry Paulson
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin M. Hampstead
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System, Mental Health Service, Ann Arbor, MI, USA
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Emedoli D, Houdayer E, Della Rosa PA, Zito A, Brugliera L, Cimino P, Padul JD, Tettamanti A, Iannaccone S, Alemanno F. Continuity of care for patients with dementia during COVID-19 pandemic: flexibility and integration between in-person and remote visits. Front Public Health 2024; 11:1301949. [PMID: 38259745 PMCID: PMC10800651 DOI: 10.3389/fpubh.2023.1301949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/22/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction During the pandemic, the Cognitive Disorders Unit of San Raffaele Hospital (Milan, Italy) offered patients the opportunity to undergo neuropsychological evaluations and cognitive training through telemedicine. Method We conducted an investigation to assess how patients responded to this option and to determine if telemedicine could ensure continuity of care. Results Between October 2019 and May 2022, a total of 5,768 telemedicine appointments and 8,190 in-person outpatient appointments were conducted, resulting in an increase in the rate of telemedicine activity from 16.81% in January 2020 to 23.21% in May 2022. Peaks in telemedicine activity reached 85.64% in May 2020 and 83.65% in February 2021, both representing a significant portion of the total activity. Interestingly, there was a notable positive correlation between telemedicine activity and the worsening of the Italian pandemic (r = 0.433, p = 0.027). Discussion During the peaks of contagion, the total number of visits remained stable, highlighting that telemedicine effectively served as a valuable and efficient tool to ensure continuity of care for vulnerable patients. This was evident from the integration of remote visits with in-person appointments.
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Affiliation(s)
- Daniele Emedoli
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Elise Houdayer
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | | | - Alice Zito
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Luigia Brugliera
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Paolo Cimino
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jeffrey David Padul
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Andrea Tettamanti
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sandro Iannaccone
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Federica Alemanno
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Milan, Italy
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Brown T, Zakzanis KK. A review of the reliability of remote neuropsychological assessment. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 38000083 DOI: 10.1080/23279095.2023.2279208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
The provision of clinical neuropsychological services has predominately been undertaken by way of standardized administration in a face-to-face setting. Interpretation of psychometric findings in this context is dependent on the use of normative comparison. When the standardization in which such psychometric measures are employed deviates from how they were employed in the context of the development of its associated norms, one is left to question the reliability and hence, validity of any such findings and in turn, diagnostic decision making. In light of the current COVID-19 pandemic and resultant social distancing direction, face-to-face neuropsychological assessment has been challenging to undertake. As such, remote (i.e., virtual) neuropsychological assessment has become an obvious solution. Here, and before the results from remote neuropsychological assessment can be said to stand on firm scientific grounds, it is paramount to ensure that results garnered remotely are reliable and valid. To this end, we undertook a review of the literature and present an overview of the landscape. To date, the literature shows evidence for the reliability of remote administration and the clinical implications are paramount. When and where needed, neuropsychologists, psychometric technicians and examinees may no longer need to be in the same physical space to undergo an assessment. These findings are most relevant given the physical distancing practices because of COVID-19. And whilst remote assessment should never supplant face-to-face neuropsychological assessments, it does serve as a valid alternative when necessary.
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Affiliation(s)
- Tyler Brown
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
| | - Konstantine K Zakzanis
- Graduate Department of Psychological Clinical Science, University of Toronto, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Scarborough, ON, Canada
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Walker EJ, Kirkham FJ, Stotesbury H, Dimitriou D, Hood AM. Tele-neuropsychological Assessment of Children and Young People: A Systematic Review. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2023; 9:1-14. [PMID: 37359106 PMCID: PMC10231293 DOI: 10.1007/s40817-023-00144-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
The coronavirus pandemic identified a clinical need for pediatric tele-neuropsychology (TeleNP) assessment. However, due to limited research, clinicians have had little information to develop, adapt, or select reliable pediatric assessments for TeleNP. This preliminary systematic review aimed to examine the feasibility of pediatric TeleNP assessment alongside (1) patient/family acceptability, (2) reliability, and (3) the quality of the literature. Between May 2021 and November 2022, manual searches of PubMed, PsycINFO, and Google Scholar were conducted using terms related to "pediatric" and "tele-neuropsychology." After extracting relevant papers with samples aged 0-22 years, predefined exclusion criteria were applied. Quality assessment was completed using the AXIS appraisal tool (91% rater-agreement). Twenty-one studies were included in the review, with reported qualitative and quantitative data on the feasibility, reliability, and acceptability extracted. Across included studies, TeleNP was completed via telephone/video conference with participants either at home, in a local setting accompanied by an assistant, or in a different room but in the same building as the assessor. Pediatric TeleNP was generally reported to be feasible (e.g., minimal behavioral differences) and acceptable (e.g., positive feedback). Nineteen studies conducted some statistical analyses to assess reliability. Most observed no significant difference between in-person and TeleNP for most cognitive domains (i.e., IQ), with a minority finding variable reliability for some tests (e.g., attention, speech, visuo-spatial). Limited reporting of sex-assigned birth, racialized identity, and ethnicity reduced the quality and generalizability of the literature. To aid clinical interpretations, studies should assess underexamined cognitive domains (e.g., processing speed) with larger, more inclusive samples. Supplementary Information The online version contains supplementary material available at 10.1007/s40817-023-00144-6.
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Affiliation(s)
- Elise J. Walker
- Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, England
| | - Fenella J. Kirkham
- Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, England
- Clinical and Experimental Sciences, University of Southampton, Southampton, England
| | - Hanne Stotesbury
- Developmental Neurosciences Unit and Biomedical Research Centre, UCL Great Ormond Street Institute of Child Health, London, England
| | - Dagmara Dimitriou
- Sleep Education and Research Laboratory, Department of Psychology and Human Development, UCL Institute of Education, London, England
| | - Anna M. Hood
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, University of Manchester, Coupland 1 Building, Manchester, M15 6FH Manchester, England
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12
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Seubert-Ravelo AN, Serrano-Juárez CA, Cabañas-Tinajero JÁ, González-Gutiérrez FA, Moreno-Villagómez J, Prieto-Corona B, Reyes-Méndez C, Téllez-Rodríguez M, Yáñez-Téllez MG. Teleneuropsychology during the COVID-19 pandemic in Mexico: the perspective from a middle-income country. J Clin Exp Neuropsychol 2023; 45:12-30. [PMID: 36912340 DOI: 10.1080/13803395.2023.2189229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2023]
Abstract
INTRODUCTION The use of teleneuropsychology (TeleNP) increased as a result of the COVID-19 pandemic; however, there have been no studies of the benefits and difficulties with this modality in middle-income countries. This study aimed to assess the current use of TeleNP in Mexico. METHOD Mexican neuropsychologists were invited to participate in an online survey regarding the use of TeleNP during the COVID-19 pandemic. The survey was based on issues from a literature review and consisted of 36 questions requiring yes/no, multiple choice, or ordinal answers. The survey was created using Google Forms and asked respondents to provide informed consent. A total of 107 clinical neuropsychologists completed the survey. RESULTS 82% of participants currently use TeleNP, and most reported learning about TeleNP through personal experience, literature research, and colleagues. Brief evaluations, delivery of results, and intervention were the principal services provided, most frequently on a home-to-home basis. Almost 30% of clinicians reported not requiring informed consent for use of the modality. Consultations included children, adolescents, and adults in similar numbers; older adults were less frequent. Technological limitations were the most frequent reason for ruling out the modality with particular patients. Perceived benefits included the ability to continue consultations despite social distancing measures, lesser risk of COVID-19 infection, and the possibility of seeing patients with limited access to neuropsychological services. Reasons for not using TeleNP included a lack of standardized instruments, not feeling comfortable with the modality, and lack of technological resources and skills. CONCLUSIONS Despite the socioeconomic differences between Mexico and high-income countries, most of our findings were similar to reports from those countries. However, technological limitations were common, and smartphones were commonly used, contrary to recommendations in the literature. The future use of TeleNP in Mexico should include formal training and ethical guidelines.
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Affiliation(s)
- Ana Natalia Seubert-Ravelo
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Carlos Alberto Serrano-Juárez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - José-Ángel Cabañas-Tinajero
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Fátima Aideé González-Gutiérrez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Julieta Moreno-Villagómez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Belén Prieto-Corona
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Carolina Reyes-Méndez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Marybeth Téllez-Rodríguez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
| | - Ma Guillermina Yáñez-Téllez
- Clinical Neuropsychology Residency Program, Research and Postgraduate Division, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, México
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13
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Vaccaro R, Aglieri V, Rossi M, Pettinato L, Ceretti A, Colombo M, Guaita A, Rolandi E. Remote testing in Abbiategrasso (RTA): results from a counterbalanced cross-over study on direct-to-home neuropsychology with older adults. Aging Clin Exp Res 2023; 35:699-710. [PMID: 36710319 PMCID: PMC9884598 DOI: 10.1007/s40520-023-02343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/10/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND The SARS-CoV-2 pandemic forced to rethink teleneuropsychology, since neuropsychological assessments started to be performed by phone or videoconference, with personal devices and without direct assistance from the clinician, a practice called "Direct-To-Home NeuroPsychology" (DTH-NP). AIMS The present study, employing a counterbalanced cross-over design, was aimed at evaluating (1) the feasibility and (2) the acceptability of DTH-NP in Italian older adults without previously diagnosed neurocognitive disorder, (3) the comparability between remote and face-to-face administration of selected neuropsychological tests. METHODS Fifty-eight community-dwelling older adults (65-85 years) were randomly assigned to one of two groups performing a complete neuropsychological assessment remotely (via phone call and videoconference) and face-to-face, in a counterbalance order, 8 weeks apart. The study recruitment rate was calculated, and the number of uncompleted tests and acceptability questionnaire responses were compared between the two administration modalities. Comparability was defined as good reliability of DTH-NP (intraclass correlation coefficient) and agreement between remote and face-to-face scores (Bland-Altman plots). RESULTS Recruitment rate was 81%, with a preference for telephonic contact (79%). The acceptability analysis did not reveal any issues related to the DTH-NP assessment, even if most participants would rather repeat it face-to-face. Tests assessing short-term memory, language, and reasoning showed good comparability. DISCUSSION AND CONCLUSION Our results point out to a good recruitment rate in a DTH-NP study in an Italian population of older adults (mean age = 80), satisfying acceptability of DTH-NP and remote-face-to-face comparability of certain verbally mediated tests. Further studies including larger samples in videoconference modality, and outpatients, could better clarify its strengths and limits.
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Affiliation(s)
- Roberta Vaccaro
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Virginia Aglieri
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy.
| | - Michele Rossi
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Laura Pettinato
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
- Camillo Golgi Geriatric Institute, Abbiategrasso, Milan, Italy
| | - Arcangelo Ceretti
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Mauro Colombo
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Antonio Guaita
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
| | - Elena Rolandi
- Golgi Cenci Foundation, Corso San Martino, 10 20081, Abbiategrasso, Milan, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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Koay JM, Spat-Lemus J, Cornwell MA, Sacks-Zimmerman A, Mandelbaum S, Kohn A, McLean E, Meli G, Bender HA. The Evolving Need for Neuropsychology in Neurosurgical Settings: Challenges Facing Transformative Care. World Neurosurg 2023; 170:277-285. [PMID: 36782426 DOI: 10.1016/j.wneu.2022.09.099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/10/2023]
Abstract
Clinical neuropsychology has been a valuable asset to neurologic surgery, contributing to lateralization and localization of pathologic brain tissue, identification of eloquent cortex, and evaluation of postoperative neuropsychological functioning. Moreover, neuropsychologists provide empirically driven interventions aimed at supporting preparation and/or recovery of neurosurgery patients. Nonetheless, several challenges may limit the reliability, validity, and generalizability of the assessment data obtained and reduce the usefulness of other neuropsychological services provided. Specifically, linguistic, cultural, educational, and other biases associated with demographic characteristics can lead to a narrowed view of an individual's life experiences, which must be confronted to fulfill the mission of ensuring that all patients have access to care that is appropriate to their needs. Instead of perceiving these challenges as insurmountable barriers, such issues can be viewed as opportunities to catalyze change and foster innovation for the future of neuropsychological care in neurosurgical settings. In addition to reviewing the possible mechanisms of these obstacles, the current article offers tangible solutions at both a macro level (e.g., discipline-wide transformations) and micro level (e.g., individualized patient-centric approaches). Outlined are practical techniques to potentially improve consensus and standardization of methods, advance and globalize research, expand representativeness of measures and practices to serve diverse individuals, and increase treatment adherence through engagement of patients and their families.
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Affiliation(s)
- Jun Min Koay
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Erin McLean
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychology, Hofstra University, Hempstead, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
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15
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McLean E, Cornwell MA, Bender HA, Sacks-Zimmerman A, Mandelbaum S, Koay JM, Raja N, Kohn A, Meli G, Spat-Lemus J. Innovations in Neuropsychology: Future Applications in Neurosurgical Patient Care. World Neurosurg 2023; 170:286-295. [PMID: 36782427 DOI: 10.1016/j.wneu.2022.09.103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 02/11/2023]
Abstract
Over the last century, collaboration between clinical neuropsychologists and neurosurgeons has advanced the state of the science in both disciplines. These advances have provided the field of neuropsychology with many opportunities for innovation in the care of patients prior to, during, and following neurosurgical intervention. Beyond giving a general overview of how present-day advances in technology are being applied in the practice of neuropsychology within a neurological surgery department, this article outlines new developments that are currently unfolding. Improvements in remote platform, computer interface, "real-time" analytics, mobile devices, and immersive virtual reality have the capacity to increase the customization, precision, and accessibility of neuropsychological services. In doing so, such innovations have the potential to improve outcomes and ameliorate health care disparities.
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Affiliation(s)
- Erin McLean
- Department of Psychology, Hofstra University, Hempstead, New York, USA; Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Melinda A Cornwell
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
| | - H Allison Bender
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA.
| | | | - Sarah Mandelbaum
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Jun Min Koay
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, Florida, USA
| | - Noreen Raja
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey, USA
| | - Aviva Kohn
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Clinical Psychology with Health Emphasis, Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA
| | - Gabrielle Meli
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA; Department of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Jessica Spat-Lemus
- Department of Neurological Surgery, Weill Cornell Medicine, New York, New York, USA
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16
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Gonzalez JA, Clark US, Byrd D, Clarke Y, Greenwood K, Tell E, Carrion-Park C, Pizzirusso M, Burgess R, Morgello S. Preliminary Findings from a Telephone-Based Cognitive Screening of an Adult HIV Research Cohort during the COVID-19 Pandemic. Arch Clin Neuropsychol 2022; 37:1710-1719. [PMID: 35780306 PMCID: PMC9278200 DOI: 10.1093/arclin/acac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES Few publications have documented the utility of in-home telephone-based cognitive screeners during COVID-19. This manuscript describes the adaptation of select face-to-face (FTF) neuropsychological tests to telephonic administration in a longitudinal cohort of people with HIV (PWH). Using the cohort's pre-pandemic neuropsychological data, we explore the utility of telephonic administration in this population. METHODS Of a longitudinal cohort of 170 adult PWH, 59 completed telephonic medical and cognitive screenings with comparable pre-pandemic FTF data. Telephone screeners and FTF evaluations were compared using repeated measures ANCOVAs to examine whether test performance differed between administration types and levels of pre-pandemic cognitive performance. Individuals with pre-pandemic test scores more than a standard deviation below the demographically-corrected mean were categorized as "below average" cognitive performance (n = 23), and the remainder as "average" (n = 36). RESULTS Over 90% of participants gave positive feedback about the telephone encounter. The average cognitive performance group scored higher than the below average group on all measures across both administration types. Telephone and FTF test scores did not differ significantly for measures of category fluency, letter fluency, and verbal learning. However, the below average group scored higher on a verbal memory measure administered via telephone compared with FTF. CONCLUSIONS Support for telephonic adaptation of select FTF measures in longitudinal research is mixed, with verbal fluency tasks showing the strongest equivalency. When employed carefully with a clear understanding of their limitations, telephone adaptations can provide an opportunity to continue study objectives, promote equity, and monitor participant well-being during times of duress.
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Affiliation(s)
- Jairo A Gonzalez
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Uraina S Clark
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Desiree Byrd
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Psychology, Queens College & The Graduate Center, The City University of New York, New York City, NY, USA
| | - Yusuf Clarke
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Kaitlyn Greenwood
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Elizabeth Tell
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Cira Carrion-Park
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Maria Pizzirusso
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Rhonda Burgess
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Susan Morgello
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Neuroscience, The Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
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17
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Fox-Fuller JT, Ngo J, Pluim CF, Kaplan RI, Kim DH, Anzai JAU, Yucebas D, Briggs SM, Aduen PA, Cronin-Golomb A, Quiroz YT. Initial investigation of test-retest reliability of home-to-home teleneuropsychological assessment in healthy, English-speaking adults. Clin Neuropsychol 2022; 36:2153-2167. [PMID: 34311660 PMCID: PMC8789947 DOI: 10.1080/13854046.2021.1954244] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Prior teleneuropsychological research has assessed the reliability between in-person and remote administration of cognitive assessments. Few, if any, studies have examined the test-retest reliability of cognitive assessments conducted in sequential clinic-to-home or home-to-home teleneuropsychological evaluations - a critical issue given the state of clinical practice during the COVID-19 pandemic. This study examined this key psychometric question for several cognitive tests administered over repeated videoconferencing visits 4-6 months apart in a sample of healthy English-speaking adults. A total of 44 participants (ages 18-75) completed baseline and follow-up cognitive testing 4-6 months apart. Testing was conducted in a home-to-home setting over HIPAA-compliant videoconferencing meetings on participants' audio-visual enabled laptop or desktop computers. The following measures were repeated at both virtual visits: the Controlled Oral Word Association Test (FAS), Category Fluency (Animals), and Digit Span Forward and Backward from the Wechsler Adult Intelligence Scale, Fourth Edition. Intraclass correlation coefficients (ICC), Pearson correlations, root mean square difference (RMSD), and concordance correlation coefficients (CCC) were calculated as test-retest reliability metrics, and practice effects were assessed using paired-samples t-tests. Some tests exhibited small practice effects, and test-retest reliability was marginal or worse for all measures except FAS, which had adequate reliability (based on ICC and r). Reliability estimates with RMSD suggested that change within +/- 1 SD on these measures may reflect typical test-retest variability. The included cognitive measures exhibited questionable reliability over repeated home-to-home videoconferencing evaluations. Future teleneuropsychology test-retest reliability research is needed with larger, more diverse samples and in clinical populations.
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Affiliation(s)
- Joshua T. Fox-Fuller
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Julie Ngo
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Celina F. Pluim
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Rini I. Kaplan
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Dong-Ho Kim
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Juliana A. U. Anzai
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Defne Yucebas
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Soibifaa M. Briggs
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Paula A. Aduen
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alice Cronin-Golomb
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA
| | - Yakeel T. Quiroz
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Messler A, Hargrave D, Sordahl J. VA psychologists' professional practices and attitudes toward tele-neuropsychology among a tele-neuropsychology interest group within the Veterans Health Administration. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 36041462 DOI: 10.1080/23279095.2022.2115911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To provide understanding of practices and attitudes toward tele-neuropsychology (teleNP) among Veterans Health Administration (VA) psychologists who have joined a related community of practice. METHODS Several VA psychologists (the authors) developed this survey to better understand dissemination of teleNP and attitudes toward teleNP among those involved in a VA teleNP community of practice. We contacted VA psychologists within this group to complete the survey. The survey was open from July to August 2021, during which time a total of 62 VA psychologists participated. RESULTS Response rate was estimated to be 41% of those receiving the survey (62 respondents). Approximately two thirds of those completing the survey reported current practice of teleNP (68%; n = 42). In contrast, only 25% of the entire sample (n = 15) conducted any teleNP pre-pandemic. Job satisfaction related to being able to perform teleNP is high. Support for continued and increased use of teleNP is high, with most respondents (84%) indicating they will be at least somewhat likely to practice teleNP post-pandemic. CONCLUSIONS The survey provides increased support for the use of teleNP by VA psychologists who responded to the survey, with significantly increased adoption since the Covid-19 pandemic, and greater likelihood of intention to use teleNP post pandemic.
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Affiliation(s)
- Ana Messler
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
| | - David Hargrave
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
| | - Jeffrey Sordahl
- Boise VA Medical Center, Clinical Resource Hub 20, Boise, ID, USA
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19
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Ceslis A, Mackenzie L, Robinson GA. Implementation of a Hybrid Teleneuropsychology Method to Assess Middle Aged and Older Adults During the COVID-19 Pandemic. Arch Clin Neuropsychol 2022; 37:1644-1652. [PMID: 35670292 PMCID: PMC9384241 DOI: 10.1093/arclin/acac037] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Hybrid teleneuropsychology has emerged as a useful assessment method to manage physical distancing requirements during the COVID-19 pandemic. We describe the development of a hybrid teleneuropsychology clinic and compare results of six neuropsychological tasks across testing modalities, as well as a participant experience survey. Method Healthy middle-aged and older adults completed a face-to-face assessment two years previously. Participants either completed reassessment face-to-face or via the hybrid setup. Results were compared across time points and delivery modality. Results There were no significant differences in scores at reassessment between face-to-face and a hybrid setup on nonverbal fluid intelligence, verbal memory, visual memory, language, working memory or verbal initiation. Retest reliability was moderate to excellent for verbal and visual memory, attention and naming. Results of an anonymous survey indicated that participants felt comfortable and established good rapport with the examiner. Conclusions This hybrid method of teleneuropsychology can be used to obtain high quality and reliable results including on tasks yet to be evaluated for teleneuropsychology, including the Graded Naming Test and the Topographical Recognition Memory Test.
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Affiliation(s)
- Amelia Ceslis
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, Brisbane, Australia
| | - Lisa Mackenzie
- Queensland Brain Institute, The University of Queensland, Brisbane, Australia
| | - Gail A Robinson
- Neuropsychology Research Unit, School of Psychology, The University of Queensland, Brisbane, Australia.,Queensland Brain Institute, The University of Queensland, Brisbane, Australia
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Sarno M, Buré-Reyes A, Harcourt S, Haq I, Luca C, Jagid J, Levin B. Success of home-to-home tele-neuropsychology (TeleNP) in deep brain stimulation (DBS) candidacy assessments: COVID-19 and beyond. Parkinsonism Relat Disord 2022; 98:56-61. [PMID: 35487126 PMCID: PMC9363774 DOI: 10.1016/j.parkreldis.2022.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/07/2022] [Accepted: 04/17/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Marina Sarno
- University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida, 33136, USA.
| | - Annelly Buré-Reyes
- University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida, 33136, USA
| | - Scott Harcourt
- University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida, 33136, USA
| | - Ihtsham Haq
- University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida, 33136, USA
| | - Corneliu Luca
- University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida, 33136, USA
| | - Jonathan Jagid
- University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida, 33136, USA
| | - Bonnie Levin
- University of Miami, Department of Neurology, 1150 NW 14th Street Miami, Florida, 33136, USA
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21
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Zeghari R, Guerchouche R, Tran-Duc M, Bremond F, Langel K, Ramakers I, Amiel N, Lemoine MP, Bultingaire V, Manera V, Robert P, König A. Feasibility Study of an Internet-Based Platform for Tele-Neuropsychological Assessment of Elderly in Remote Areas. Diagnostics (Basel) 2022; 12:diagnostics12040925. [PMID: 35453973 PMCID: PMC9031122 DOI: 10.3390/diagnostics12040925] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 12/03/2022] Open
Abstract
Today, in rural isolated areas or so-called ‘medical deserts’, access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, telemedicine platforms are gradually more employed for remote medical assessment. Only a few are tailored to comprehensive teleneuropsychological assessment of older adults. Hence, our study focuses on evaluating the feasibility of performing a remote neuropsychological assessment of older adults suffering from a cognitive complaint. 50 participants (aged 55 and older) were recruited at the local hospital of Digne-les-Bains, France. A brief neuropsychological assessment including a short clinical interview and several validated neuropsychological tests was administered in two conditions, once by Teleneuropsychology (TNP) and once by Face-to-Face (FTF) in a crossover design. Acceptability and user experience was assessed through questionnaires. Results show high agreement in most tests between the FTF and TNP conditions. The TNP was overall well accepted by the participants. However, differences in test performances were observed, which urges the need to validate TNP tests with broader samples with normative data.
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Affiliation(s)
- Radia Zeghari
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Correspondence:
| | - Rachid Guerchouche
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
| | - Minh Tran-Duc
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
| | - François Bremond
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
| | - Kai Langel
- Janssen Clinical Innovation (JCI), Janssen Research & Development, Division of Janssen Pharmaceutica NV, 2340 Beerse, Belgium;
| | - Inez Ramakers
- MHeNs School for Mental Health and Neuroscience, Maastricht University, 6211 LK Maastricht, The Netherlands;
| | - Nathalie Amiel
- Consultation Mémoire, Centre Hospitalier Digne-les-Bains, 04000 Digne-les-Bains, France; (N.A.); (M.P.L.); (V.B.)
| | - Maria Pascale Lemoine
- Consultation Mémoire, Centre Hospitalier Digne-les-Bains, 04000 Digne-les-Bains, France; (N.A.); (M.P.L.); (V.B.)
| | - Vincent Bultingaire
- Consultation Mémoire, Centre Hospitalier Digne-les-Bains, 04000 Digne-les-Bains, France; (N.A.); (M.P.L.); (V.B.)
| | - Valeria Manera
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
| | - Philippe Robert
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
| | - Alexandra König
- Cognition Behavior Technology (CoBTeK) Lab, FRIS-Université Côte d’Azur, 06000 Nice, France; (R.G.); (F.B.); (V.M.); (P.R.); (A.K.)
- Institut National de Recherche en Informatique et en Automatique (INRIA), 06902 Valbonne, France;
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22
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Womble MN, Reynolds E, Kissinger-Knox A, Collins MW, Kontos AP, West RV, Eagle S, Elbin RJ. The Emerging Role of Telehealth for Concussion Clinical Care During the Coronavirus (COVID-19) Pandemic. J Head Trauma Rehabil 2022; 37:E49-E54. [PMID: 34320559 DOI: 10.1097/htr.0000000000000713] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has substantially altered the delivery of healthcare for providers and their patients. Patients have been reticent to seek care for many diseases and injuries including concussion due to fears of potential exposure to COVID-19. Moreover, because of social distancing recommendations and stay-at-home orders, patient screening, evaluation, and delivery of care have become less efficient or impossible to perform via in-person clinic visits. Consequently, there was a sudden need to shift healthcare delivery from primarily in-person visits to telehealth. This sudden shift in healthcare delivery brings with it both challenges and opportunities for clinical concussion care. This article is designed to discuss these challenges and opportunities and provide an experiential-based framework for providing concussion care via telehealth. We first provide an overview of a clinical concussion model utilized at concussion specialty clinics from 3 geographically disparate healthcare systems for in-person service delivery prior to COVID-19. We then discuss the creation of new clinical workflows to facilitate the continued provision of concussion specialty care using telehealth. Finally, we examine lessons learned during this healthcare delivery shift including limitations and potential barriers for telehealth for concussion care, as well as opportunities for expansion of concussion care in rural and underserved areas. We also discuss the need to empirically evaluate the comparative efficacy of telehealth and in-person concussion care moving forward.
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Affiliation(s)
- Melissa N Womble
- Inova Sports Medicine Concussion Program, Fairfax, Virginia (Dr Womble); Baylor Scott & White Sports Concussion Program, Frisco, Texas (Dr Reynolds); Sports Medicine Concussion Program, Department of Orthopaedics, The University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (Drs Kissinger-Knox, Collins, Kontos, and Eagle); Inova Sports Medicine, Fairfax, Virginia (Dr West); and Office for Sport Concussion Research, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville (Dr Elbin)
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23
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Hewitt KC, Block C, Bellone JA, Dawson EL, Garcia P, Gerstenecker A, Grabyan JM, Howard C, Kamath V, LeMonda BC, Margolis SA, McBride WF, Salinas CM, Tam DM, Walker KA, Del Bene VA. Diverse experiences and approaches to tele neuropsychology: Commentary and reflections over the past year of COVID-19. Clin Neuropsychol 2022; 36:790-805. [DOI: 10.1080/13854046.2022.2027022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Kelsey C. Hewitt
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Cady Block
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - John A. Bellone
- Perspectives Psychological Services, Fullerton, California, USA
| | - Erica L. Dawson
- Department of Neurology, The Ohio State University, Columbus, Ohio, USA
| | - Patricia Garcia
- Department of Rehabilitation Neuropsychology, Rehabilitation Hospital of Indiana, Indianapolis, Indiana, USA
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, UAB Heersink School of Medicine, Birmingham, Alabama, USA
| | - Jonathan M. Grabyan
- Michael E. DeBakey VA Medical Center, Behavioral Health Program, Houston, Texas, USA
| | - Christopher Howard
- Psychology Department, Utah State Hospital, Provo, Utah, USA
- Department of Psychology, Brigham Young University, Provo, Utah, USA
| | - Vidyulata Kamath
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brittany C. LeMonda
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry, NYU Langone, NYU Psychiatry Associates, New York, New York, USA
| | - Seth A. Margolis
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Psychiatry & Human Behavior, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Willie F. McBride
- Perspectives Psychological Services, Fullerton, California, USA
- Department of Neurology, University of Virginia Health, Charlottesville, Virginia, USA
| | - Christine M. Salinas
- Perspectives Psychological Services, Fullerton, California, USA
- Neuropsychology Concierge®, Indialantic, Florida, USA
| | - Danny M. Tam
- VA NY Harbor Healthcare System, Division of Psychology, Mental Health Service, New York, New York, USA
| | - Keenan A. Walker
- Perspectives Psychological Services, Fullerton, California, USA
- National Institute on Aging, Laboratory of Behavioral Neuroscience, Baltimore, Maryland, USA
| | - Victor A. Del Bene
- Department of Neurology, University of Alabama at Birmingham, UAB Heersink School of Medicine, Birmingham, Alabama, USA
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24
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Vaccaro R, Aglieri V, Rolandi E, Rossi M, Pettinato L, Ceretti A, Colombo M, Guaita A. The Remote Testing in Abbiategrasso (RTA) Study Protocol: A Counter-Balanced Crossover Trial to Assess the Feasibility of Direct-to-Home-Neuropsychology with Older People. Health (London) 2022. [DOI: 10.4236/health.2022.145043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Mahon S, Webb J, Snell D, Theadom A. Feasibility of administering the WAIS-IV using a home-based telehealth videoconferencing model. Clin Neuropsychol 2021; 36:558-570. [PMID: 34647856 DOI: 10.1080/13854046.2021.1985172] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Use of telehealth to deliver neuropsychological services has proven to be a feasible approach, however, there is limited research which has examined the reliability of home-based assessment models using a comprehensive intelligence test. The aim of this study was to examine the reliability and feasibility of a home-based videoconferencing administration of the Wechsler Adult Intelligence Scales-4th Edition (WAIS-IV). Thirty healthy participants (aged 18-40 years) completed the WAIS-IV both in-person and via home-based videoconferencing utilizing a randomized counter-balanced methodology to attempt to control for an order effect. Paper record forms for Coding/Symbol Search and Blocks were sent and returned via tamper proof courier packs. Participants completed an online survey of their experiences of TNP following completion of their assessments. Group mean comparisons, intra class correlation coefficients (ICCs) and Bland-Altman measures of bias were calculated. Findings from both modalities were highly concordant across all WAIS-IV subtests and indices, with all ICCs rated as "excellent," (≥0.9). There were no significant mean group differences and no evidence of proportional bias. The majority of participants were very satisfied with the use of videoconferencing as an application for cognitive assessment and high levels of participant compliance were observed. In this non-clinical cohort home-based videoconference administration of the WAIS-IV was feasible, reliable and acceptable. TNP may offer an alternative for those consumers where there are challenges in accessing a face-to-face service delivery model, thereby improving equity, and enabling continuation of service delivery. Future research is needed with a larger and more ethnically diverse clinical population.
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Affiliation(s)
- Susan Mahon
- TBI Network, Auckland University of Technology, Auckland, New Zealand
| | - James Webb
- TBI Network, Auckland University of Technology, Auckland, New Zealand.,Webb Psychology, Auckland, New Zealand
| | - Deborah Snell
- University of Otago Christchurch, Christchurch, New Zealand
| | - Alice Theadom
- TBI Network, Auckland University of Technology, Auckland, New Zealand
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26
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Fox-Fuller JT, Rizer S, Andersen SL, Sunderaraman P. Survey Findings About the Experiences, Challenges, and Practical Advice/Solutions Regarding Teleneuropsychological Assessment in Adults. Arch Clin Neuropsychol 2021; 37:274-291. [PMID: 34564721 PMCID: PMC8513402 DOI: 10.1093/arclin/acab076] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE In the wake of the coronavirus pandemic, teleneuropsychology utilization has increased. There is a need to characterize the first-hand experiences of individuals using teleneuropsychology, identify the common teleneuropsychology challenges, and devise practical strategies for mitigating/resolving these challenges. METHOD Survey data were collected from U.S. based neuropsychologists and other individuals (e.g., graduate students and research assistants) who were engaged in remote cognitive assessment with adults (n = 87). Frequency analyses were conducted to examine: how respondents used teleneuropsychology (e.g., duration of use, types of measures and devices/technology platforms used); challenges that were encountered with different technology platforms and teleneuropsychology use; and advice for navigating these challenges. RESULTS Most respondents began using teleneuropsychology relatively recently in the context of the coronavirus pandemic, with home-to-home or clinic-to-home settings being the most frequently reported teleneuropsychology settings. Zoom®, Doxy.Me®, and MyChart® were the most frequently used platforms, largely due to workplace mandates and/or Health Insurance Portability and Accountability Act-compliant features. Common challenges with teleneuropsychology included internet connection issues and environmental distractions in examinees' homes, and examinees having limited-to-no access to technologies requisite for teleneuropsychology. Providing clear instructions to the examinee prior to the teleneuropsychology visit was the most common advice for ensuring a successful teleneuropsychology evaluation. Similar response patterns were generally noted for those who used TeleNP for clinical or research purposes. CONCLUSIONS These survey results reflect common experiences and challenges with teleneuropsychology and identify priority targets for increasing its feasibility, reliability, and validity. Findings provide context for the development of formal teleneuropsychology competencies.
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Affiliation(s)
- Joshua T Fox-Fuller
- Boston University, Department of Psychological and Brain Sciences, Boston, MA, USA
| | - Sandra Rizer
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA
| | - Stacy L Andersen
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Preeti Sunderaraman
- Cognitive Neuroscience Division of the Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Irving Medical Center, New York, NY, USA.,Gertrude. H. Sergievsky Center, Columbia University Irving Medical Center, New York, NY, USA.,Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
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27
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Alosco ML, Mariani ML, Adler CH, Balcer LJ, Bernick C, Au R, Banks SJ, Barr WB, Bouix S, Cantu RC, Coleman MJ, Dodick DW, Farrer LA, Geda YE, Katz DI, Koerte IK, Kowall NW, Lin AP, Marcus DS, Marek KL, McClean MD, McKee AC, Mez J, Palmisano JN, Peskind ER, Tripodis Y, Turner RW, Wethe JV, Cummings JL, Reiman EM, Shenton ME, Stern RA. Developing methods to detect and diagnose chronic traumatic encephalopathy during life: rationale, design, and methodology for the DIAGNOSE CTE Research Project. Alzheimers Res Ther 2021; 13:136. [PMID: 34384490 PMCID: PMC8357968 DOI: 10.1186/s13195-021-00872-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that has been neuropathologically diagnosed in brain donors exposed to repetitive head impacts, including boxers and American football, soccer, ice hockey, and rugby players. CTE cannot yet be diagnosed during life. In December 2015, the National Institute of Neurological Disorders and Stroke awarded a seven-year grant (U01NS093334) to fund the "Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) Research Project." The objectives of this multicenter project are to: develop in vivo fluid and neuroimaging biomarkers for CTE; characterize its clinical presentation; refine and validate clinical research diagnostic criteria (i.e., traumatic encephalopathy syndrome [TES]); examine repetitive head impact exposure, genetic, and other risk factors; and provide shared resources of anonymized data and biological samples to the research community. In this paper, we provide a detailed overview of the rationale, design, and methods for the DIAGNOSE CTE Research Project. METHODS The targeted sample and sample size was 240 male participants, ages 45-74, including 120 former professional football players, 60 former collegiate football players, and 60 asymptomatic participants without a history of head trauma or participation in organized contact sports. Participants were evaluated at one of four U.S. sites and underwent the following baseline procedures: neurological and neuropsychological examinations; tau and amyloid positron emission tomography; magnetic resonance imaging and spectroscopy; lumbar puncture; blood and saliva collection; and standardized self-report measures of neuropsychiatric, cognitive, and daily functioning. Study partners completed similar informant-report measures. Follow-up evaluations were intended to be in-person and at 3 years post-baseline. Multidisciplinary diagnostic consensus conferences are held, and the reliability and validity of TES diagnostic criteria are examined. RESULTS Participant enrollment and all baseline evaluations were completed in February 2020. Three-year follow-up evaluations began in October 2019. However, in-person evaluation ceased with the COVID-19 pandemic, and resumed as remote, 4-year follow-up evaluations (including telephone-, online-, and videoconference-based cognitive, neuropsychiatric, and neurologic examinations, as well as in-home blood draw) in February 2021. CONCLUSIONS Findings from the DIAGNOSE CTE Research Project should facilitate detection and diagnosis of CTE during life, and thereby accelerate research on risk factors, mechanisms, epidemiology, treatment, and prevention of CTE. TRIAL REGISTRATION NCT02798185.
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Affiliation(s)
- Michael L Alosco
- Boston University Alzheimer's Disease Research Center, Boston University CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Megan L Mariani
- Boston University CTE Center, Boston University School of Medicine, Boston, MA, USA
| | - Charles H Adler
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Laura J Balcer
- Departments of Neurology, Population Health and Ophthalmology, NYU Grossman School of Medicine, New York, NY, USA
| | - Charles Bernick
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA
- Department of Neurology, University of Washington, Seattle, WA, USA
| | - Rhoda Au
- Boston University Alzheimer's Disease Research Center, Boston University CTE Center, Framingham Heart Study, and Slone Epidemiology Center, Boston, MA, USA
- Departments of Anatomy & Neurobiology and Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Sarah J Banks
- Departments of Neuroscience and Psychiatry, University of California, San Diego, CA, USA
| | - William B Barr
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Sylvain Bouix
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert C Cantu
- Boston University Alzheimer's Disease Research Center, Departments of Neurology and Neurosurgery, Boston University School of Medicine, Boston, MA, USA
| | - Michael J Coleman
- Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA
| | - David W Dodick
- Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Lindsay A Farrer
- Departments of Medicine (Biomedical Genetics), Neurology, Ophthalmology, Epidemiology, and Biostatistics, BU Schools of Medicine and Public Health, Boston, MA, USA
| | - Yonas E Geda
- Alzheimer's Disease and Memory Disorders Program, Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Douglas I Katz
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Encompass Health Braintree Rehabilitation Hospital, Braintree, MA, USA
| | - Inga K Koerte
- Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, Ludwigs-Maximilians-Universität, Munich, Germany
| | - Neil W Kowall
- Boston University Alzheimer's Disease Research Center, Departments of Neurology and Neurosurgery, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Alexander P Lin
- Center for Clinical Spectroscopy, Department of Radiology, Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Daniel S Marcus
- Department of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Kenneth L Marek
- Institute for Neurodegenerative Disorders, Invicro, LLC, New Haven, CT, USA
| | - Michael D McClean
- Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| | - Ann C McKee
- Boston University Alzheimer's Disease Research Center, Boston University CTE Center, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- VA Boston Healthcare System, Boston, MA, USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Research Center, Boston University CTE Center, Framingham Heart Study, Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Joseph N Palmisano
- Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, MA, USA
| | - Elaine R Peskind
- VA Northwest Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Yorghos Tripodis
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Robert W Turner
- Department of Clinical Research & Leadership, The George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Jennifer V Wethe
- Department of Psychiatry and Psychology, Mayo Clinic School of Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - Jeffrey L Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Eric M Reiman
- Banner Alzheimer's Institute, University of Arizona, Arizona State University, Translational Genomics Research Institute, and Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Martha E Shenton
- Psychiatry Neuroimaging Laboratory, Departments of Psychiatry and Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robert A Stern
- Boston University Alzheimer's Disease Research Center, Boston University CTE Center, Departments of Neurology, Neurosurgery, and Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA.
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28
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Dupuy EG, Besnier F, Gagnon C, Vincent T, Grégoire CA, Blanchette CA, Saillant K, Bouabdallaoui N, Iglesies-Grau J, Payer M, Marin MF, Belleville S, Juneau M, Vitali P, Gayda M, Nigam A, Bherer L. COVEPIC (Cognitive and spOrt Virtual EPIC training) investigating the effects of home-based physical exercise and cognitive training on cognitive and physical functions in community-dwelling older adults: study protocol of a randomized single-blinded clinical trial. Trials 2021; 22:505. [PMID: 34325710 PMCID: PMC8319877 DOI: 10.1186/s13063-021-05476-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/21/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND In the context of the COVID-19 pandemic, lockdown and social distancing measures are applied to prevent the spread of the virus. It is well known that confinement and social isolation can have a negative impact on physical and mental health, including cognition. Physical activity and cognitive training can help enhance older adults' cognitive and physical health and prevent the negative collateral impacts of social isolation and physical inactivity. The COVEPIC study aims to document the effects of 6 months of home-based physical exercise alone versus home-based physical exercise combined with cognitive training on cognitive and physical functions in adults 50 years and older. METHODS One hundred twenty-two healthy older adults (> 50 years old) will be recruited from the community and randomized to one of the two arms for 6 months: (1) home-based physical exercises monitoring alone and (2) combined physical exercises monitoring with home-based cognitive training. The primary outcome is cognition, including general functioning (Montreal Cognitive Assessment (MoCA) score), as well as executive functions, processing speed, and episodic memory (composite Z-scores based on validated neuropsychological tests and computerized tasks). The secondary outcome is physical functions, including balance (one-leg stance test), gait and mobility performance (Timed Up and Go, 4-meter walk test), leg muscle strength (5-time sit-to-stand), and estimated cardiorespiratory fitness (Matthews' questionnaire). Exploratory outcomes include mood, anxiety, and health-related quality of life as assessed by self-reported questionnaires (i.e., Geriatric depression scale-30 items, Perceived stress scale, State-trait anxiety inventory-36 items, Perseverative thinking questionnaire, Connor-Davidson Resilience Scale 10, and 12-item Short Form Survey). DISCUSSION This trial will document the remote monitoring of home-based physical exercise alone and home-based physical combined with cognitive training to enhance cognitive and physical health of older adults during the COVID-19 pandemic period. Remote interventions represent a promising strategy to help maintain or enhance health and cognition in seniors, and potentially an opportunity to reach older adults in remote areas, where access to such interventions is limited. TRIAL REGISTRATION Clinical trial Identifier NCT04635462 . COVEPIC was retrospectively registered on November 19, 2020.
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Affiliation(s)
- Emma Gabrielle Dupuy
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada.
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada.
| | - Florent Besnier
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Christine Gagnon
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Thomas Vincent
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Catherine-Alexandra Grégoire
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
| | - Caroll-Ann Blanchette
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Kathia Saillant
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada
| | - Nadia Bouabdallaoui
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Josep Iglesies-Grau
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Marie Payer
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, H3W 1 W5, Canada
| | - Marie-France Marin
- Department of Psychology, Université du Québec à Montréal, Montréal, Québec, H3C 3P8, Canada
- Research Center, Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, H3W 1 W5, Canada
| | - Sylvie Belleville
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada
- Department of Psychology, Université de Montréal, Montréal, Québec, H2V 2S9, Canada
| | - Martin Juneau
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Paolo Vitali
- CIUSSS Nord-de-l'Île-de-Montréal, Montréal, Québec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | - Mathieu Gayda
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Anil Nigam
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada
| | - Louis Bherer
- Research center and Centre ÉPIC, Montreal Heart Institute, Université de Montréal, Montréal, Québec, H1T 1 N6, Canada.
- Department of Medicine, Faculty of Medicine, Université de Montréal, Montréal, Québec, H3C 3 J7, Canada.
- Research Center, Institut universitaire en santé mentale de Montréal, Montréal, Québec, H1N 3 M5, Canada.
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Nguyen CM, Tan A, Nguyen A, Lee GJ, Qi WG, Thaler NS, Fujii D. Cross-cultural considerations for teleneuropsychology with Asian patients. Clin Neuropsychol 2021:1-15. [PMID: 34233583 DOI: 10.1080/13854046.2021.1948104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Recent teleneuropsychology (TeleNP) models provide some degree of guidance in the application of telecommunication technologies toward the practice of neuropsychology. However, there remains a paucity of peer-reviewed data on TeleNP practices with culturally diverse patients, including Asian patients. This manuscript describes the challenges related to TeleNP practices with Asian patients and offers practical recommendations to complement existing TeleNP guidelines. METHOD Based on extant literature on multicultural applications of neuropsychology, weprovide recommendations for TeleNP services with Asian patients that pertain to specific components of a TeleNP evaluation, such as a) pre-evaluation preparation, b) determining the appropriateness of the referral, c) determining language proficiency, d) working with interpreters, e) informed consent and confidentiality issues, f) conducting a culturally sensitive clinical interview, g) behavioral observations and communication, h) test selection, and i) interpreting data and writing reports. CONCLUSIONS Our recommendations for TeleNP services with Asian patients highlight the need for flexibility to accommodate cultural differences and commitment to the complex nature of working with patients requiring interpretation services, while also recognizing the importance of preserving the validity of neuropsychological methods. Moving forward, it is imperative that the field of neuropsychology increases the training and accessibility of neuropsychologists who are knowledgeable in providing TeleNP services to Asian patients, and promotes research on the validation of TeleNP for Asian and other ethnic minority groups.
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Affiliation(s)
- Christopher M Nguyen
- Department of Psychiatry & Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Alexander Tan
- Department of Psychology, Children's Hospital of Orange County, Orange, CA, USA
| | - Ann Nguyen
- Department of Psychology, School of Behavioral Health, Loma Linda University, Loma Linda, CA, USA
| | - Grace J Lee
- Department of Psychiatry & Behavioral Health, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Wei Gabriel Qi
- Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, China
| | - Nicholas S Thaler
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA, USA
| | - Daryl Fujii
- Veterans Affairs Pacific Island Health Care Services, Honolulu, HI, USA
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Palmese CA, Wyman-Chick KA, Racine C, Pollak LE, Lin G, Farace E, Tran B, Floden D, Bobholz J, Turner TH, York MK. Assessment of deep brain stimulation candidacy during the COVID-19 pandemic: Lessons learned and future directions for neuropsychologists. Clin Neuropsychol 2021; 36:72-84. [PMID: 34030595 DOI: 10.1080/13854046.2021.1929496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Neuropsychological assessment is integral to the pre-surgical deep brain stimulation (DBS) workup for patients with movement disorders. The COVID-19 pandemic quickly affected care access and shifted healthcare delivery, and neuropsychology has adapted successfully to provide tele-neuropsychological (teleNP) DBS evaluations during this time, thus permanently changing the landscape of neuropsychological practice. Method: In this paper, we discuss the lessons learned from the pandemic and we offer care management guidelines for teleNP and in-person evaluations of pre-DBS populations, with exploration of the feasibility of the different approaches for uninterrupted care access. Results: We summarize the strengths and weaknesses of these care models and we provide future directions for the state of clinical neuropsychological practice for DBS programs, with implications for broader patient populations. Conclusions: A better understanding of these dynamics will inform and educate the DBS team and community regarding the complexities of performing DBS neuropsychological evaluations during COVID-19 and beyond.
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Affiliation(s)
- C A Palmese
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K A Wyman-Chick
- HealthPartners Struthers Parkinson's Center, Twin Cities, MN, USA
| | - C Racine
- Dept of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA
| | | | - G Lin
- Harvard Medical School, Boston, MA, USA
| | - E Farace
- Departments of Public Health Sciences and Neurosurgery, Penn State University, Hershey, PA, USA
| | - B Tran
- Dept of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - D Floden
- Psychiatry & Psychology, Cleveland Clinic, Cleveland, OH, USA
| | - J Bobholz
- Medical College of Wisconsin, Green Bay, WI, USA
| | - T H Turner
- Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - M K York
- Baylor College of Medicine, Houston, TX, USA
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31
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Bloch A, Maril S, Kavé G. How, when, and for whom: decisions regarding remote neuropsychological assessment during the 2020 COVID-19 pandemic. Isr J Health Policy Res 2021; 10:31. [PMID: 33941268 PMCID: PMC8090922 DOI: 10.1186/s13584-021-00465-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 04/26/2021] [Indexed: 02/06/2023] Open
Abstract
Neuropsychological assessment provides crucial information about cognitive, behavioral, and socioemotional functioning in medical, educational, legal, and social contexts. During the 2020 COVID-19 pandemic, the Israeli Ministry of Health initially mandated that all psychological assessments be postponed. However, as referrals to time-sensitive, high-need, and high-stakes assessments began to accumulate, it became necessary to consider remote solutions. In the current paper, we describe the considerations that affected the transition to remote activity in a prominent Israeli provider of neuropsychological assessment and rehabilitation services, referring to technological and environmental conditions, cognitive requirements, and tasks, as well as to legal, regulatory, and funding issues. After discussing how assessments should be conducted to maximize feasibility and validity while minimizing risks to clients and clinicians, we propose a preliminary model for deciding whether specific referrals warrant remote administration. The model delineates key factors in decisions regarding remote assessment, emphasizing the distinct roles of the referring clinician and the neuropsychologist who conducts the assessment, and highlighting the need for collaboration between them. The abrupt need for remote assessments during the pandemic required a quick response with little preparation. The lessons learned from this process can be applied in the future, so that the need for remote services can be met with greater certainty and uniformity.
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Affiliation(s)
- Ayala Bloch
- Department of Psychology, Ariel University, 65 Ramat HaGolan St, Ariel, Israel.
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel.
| | - Sari Maril
- The National Institute of Neuropsychological Rehabilitation, Tel Aviv, Israel
| | - Gitit Kavé
- Department of Education and Psychology, The Open University, Ra'anana, Israel
- Center for Memory and Attention Disorders, Sourasky Medical Center, Tel Aviv, Israel
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