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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 2024; 31:1247-1255. [PMID: 36041462 DOI: 10.1080/23279095.2022.2115911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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Butterbrod E, van den Heuvel DMJ, Zevenhoven P, Waterink L, van Leeuwenstijn M, Jutten RJ, van der Flier WM, Sikkes SAM. Tele-neuropsychology in memory clinic settings: Reliability and usability of videoconference-based neuropsychological testing. J Int Neuropsychol Soc 2024:1-12. [PMID: 39431593 DOI: 10.1017/s1355617724000432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2024]
Abstract
OBJECTIVE Neuropsychological assessment through VideoTeleConferencing (VTC) can help improve access to diagnostic and follow-up care in memory clinics. This study investigated the stability of performance on VTC assessment in relation to in-person assessment using a test-retest design and explored user experiences of VTC assessment. MATERIALS AND METHODS Thirty-one patients (62 ± 6.7 years, 45% female, 58% Subjective Cognitive Decline, 42% Mild Cognitive Impairment/dementia diagnosis) were included from the Amsterdam Dementia Cohort between August 2020 and February 2021. Patients underwent a face-to-face neuropsychological assessment followed by a VTC assessment using the same test protocol within 4 months. Reliability coefficients were calculated using intraclass correlation coefficients (ICC). For each test, the proportion of clinically relevant differences in performances between assessment modalities was calculated. User experiences of patients and neuropsychologists were assessed with questionnaires (User Satisfaction and Ease of use [USE] questionnaire and System Usability Scale [SUS]). Neuropsychologists also participated in a focus group. RESULTS ICC values were moderate to excellent (0.63-0.93) for all test measures in the total sample. On all tests, most patients did not show clinically relevant performance differences between modalities. Patients and neuropsychologists reported overall positive VTC system usability, although neuropsychologists indicated in the focus group that patients without cognitive impairment required less training for the system and were more independent. CONCLUSION VTC assessment showed adequate to excellent test-retest reliability for a broad range of neuropsychological tests commonly used in practice. Assessment through VTC may be a user friendly method in the memory clinic, especially to monitor individuals at risk for future cognitive decline.
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Affiliation(s)
- Elke Butterbrod
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Movement and Behavioral Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Dominique M J van den Heuvel
- Department of Neurology, Basalt Rehabilitation Center, Leiden, The Netherlands
- Department of Health, Medical and Neuropsychology, Faculty of Social and Behavioral Sciences, Leiden University, Leiden, The Netherlands
| | - Pia Zevenhoven
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Lisa Waterink
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Mardou van Leeuwenstijn
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Roos J Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
- Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, the Netherlands
| | - Sietske A M Sikkes
- Department of Clinical, Neuro- and Developmental Psychology, Faculty of Movement and Behavioral Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam University Medical Center, Amsterdam, the Netherlands
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Ter Huurne D, Ramakers I, Possemis N, König A, Linz N, Tröger J, Langel K, Verhey F, de Vugt M. User Experience of a (Semi-) Automated Cognitive Phone-Based Assessment Within a Memory Clinic Population. Arch Clin Neuropsychol 2024:acae063. [PMID: 39221892 DOI: 10.1093/arclin/acae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 06/13/2024] [Accepted: 07/15/2024] [Indexed: 09/04/2024] Open
Abstract
OBJECTIVE We examined the user experience in different modalities (face-to-face, semi-automated phone-based, and fully automated phone-based) of cognitive testing in people with subjective cognitive decline and mild cognitive impairment. METHOD A total of 67 participants from the memory clinic of the Maastricht University Medical Center+ participated in the study. The study consisted of cognitive tests in different modalities, namely, face-to-face, semi-automated phone-based guided by a researcher, and fully automated phone-based without the involvement of a researcher. After each assessment, a user experience questionnaire was administered, including questions about, for example, satisfaction, simplicity, and missing personal contact, on a seven-point Likert scale. Non-parametric tests were used to compare user experiences across different modalities. RESULTS In all modalities, user experiences were rated above average. The face-to-face ratings were comparable to the ratings of the semi-automated phone-based assessment, except for the satisfaction and recommendation items, which were rated higher for the face-to-face assessment. The face-to-face assessment was preferred above the fully automated phone-based assessment on all items. In general, the semi- and fully automated phone-based assessments were comparable (simplicity, conceivability, quality of sound, visiting the hospital, and missing personal contact), while on all the other items, the semi-automated phone-based assessment was preferred. CONCLUSIONS User experience was rated high within all modalities. Simplicity, conceivability, comfortability, and participation scores were comparable in the semi-automated phone-based and face-to-face assessment. Based on these findings and earlier research on validation of the semi-automated phone-based assessment, the semi-automated assessment could be useful for screening for clinical trials, and after more research, in clinical practice.
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Affiliation(s)
- Daphne Ter Huurne
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Dr. Tanslaan 12, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Inez Ramakers
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Dr. Tanslaan 12, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Nina Possemis
- Department of Psychiatry and Neuropsychology, Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Dr. Tanslaan 12, Maastricht University, 6200 MD Maastricht, the Netherlands
| | - Alexandra König
- National Institute for Research in Computer Science and Automation (INRIA), Stars team, route des Lucioles 06902 Sophia Antipolis, France
| | - Nicklas Linz
- ki elements, Bleichstrasse 27, 66121 Saarbrücken, Germany
| | | | - Kai Langel
- Janssen Clinical Innovation, Turnhoutseweg 30, B-2340 Beerse, Belgium
| | - Frans Verhey
- Department of Psychiatry and psychology, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and psychology, Maastricht University Medical Center+ (MUMC+), P. Debyelaan 25, 6202 AZ Maastricht, the Netherlands
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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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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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Shura RD, Sapp A, Ingram PB, Brearly TW. Evaluation of telehealth administration of MMPI symptom validity scales. J Clin Exp Neuropsychol 2024; 46:86-94. [PMID: 38375629 DOI: 10.1080/13803395.2024.2314734] [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: 10/06/2023] [Accepted: 01/11/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION Telehealth assessment (TA) is a quickly emerging practice, offered with increasing frequency across many different clinical contexts. TA is also well-received by most patients, and there are numerous guidelines and training opportunities which can support effective telehealth practice. Although there are extensive recommended practices, these guidelines have rarely been evaluated empirically, particularly on personality measures. While existing research is limited, it does generally support the idea that TA and in-person assessment (IA) produce fairly equitable test scores. The MMPI-3, a recently released and highly popular personality and psychopathology measure has been the subject of several of those experimental or student (non-client) based studies; however, no study to date has evaluated these trends within a clinical sample. This study empirically tests for differences in TA and IA test scores on the MMPI-3 validity scores when following recommended administration procedures. METHOD Data were from a retrospective chart review. Veterans (n = 550) who underwent psychological assessment in a Veterans Affairs Medical Center ADHD evaluation clinic were contrasted between in person and telehealth assessment modalities on the MMPI-2-RF and MMPI-3. Groups were compared using t tests, chi square, and base rates. RESULTS Results suggest that there were minimal differences in elevation rates or mean scores across modality, supporting the use of TA. CONCLUSIONS This study's findings support the use of the MMPI via TA with ADHD evaluations, Veterans, and in neuro/psychological evaluation settings more generally. Observed elevation rates and mean scores of this study were notably different from those seen in other VA service clinics sampled nationally, which is an area of future investigation.
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Affiliation(s)
- Robert D Shura
- Research & Academic Affairs Service Line, Salisbury VA Healthcare System, Salisbury, NC, USA
- Neurocognition Research Lab, VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, NC, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Alison Sapp
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
| | - Paul B Ingram
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA
- Department of Veterans Affairs Eastern Kansas Healthcare, Leavenworth VAMC, Leavenworth, KS, USA
| | - Timothy W Brearly
- Department of Neurology, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
- Penn State College of Medicine, Department of Neurology, Hershey, PA, 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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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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Dong H, Shin H, Ho E, Jin HJ, Letourneau S, Banerjee T, Masschelein G, Davidson J, Wilson C, de Ribaupierre S, Eagleson R, Symonette CJ. Next-Generation Remote Hand Assessments: Cross-Platform DIGITS Web Application. JOURNAL OF HAND SURGERY GLOBAL ONLINE 2023. [DOI: 10.1016/j.jhsg.2023.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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ter Huurne D, Possemis N, Banning L, Gruters A, König A, Linz N, Tröger J, Langel K, Verhey F, de Vugt M, Ramakers I. Validation of an Automated Speech Analysis of Cognitive Tasks within a Semiautomated Phone Assessment. Digit Biomark 2023; 7:115-123. [PMID: 37901366 PMCID: PMC10601928 DOI: 10.1159/000533188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/02/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction We studied the accuracy of the automatic speech recognition (ASR) software by comparing ASR scores with manual scores from a verbal learning test (VLT) and a semantic verbal fluency (SVF) task in a semiautomated phone assessment in a memory clinic population. Furthermore, we examined the differentiating value of these tests between participants with subjective cognitive decline (SCD) and mild cognitive impairment (MCI). We also investigated whether the automatically calculated speech and linguistic features had an additional value compared to the commonly used total scores in a semiautomated phone assessment. Methods We included 94 participants from the memory clinic of the Maastricht University Medical Center+ (SCD N = 56 and MCI N = 38). The test leader guided the participant through a semiautomated phone assessment. The VLT and SVF were audio recorded and processed via a mobile application. The recall count and speech and linguistic features were automatically extracted. The diagnostic groups were classified by training machine learning classifiers to differentiate SCD and MCI participants. Results The intraclass correlation for inter-rater reliability between the manual and the ASR total word count was 0.89 (95% CI 0.09-0.97) for the VLT immediate recall, 0.94 (95% CI 0.68-0.98) for the VLT delayed recall, and 0.93 (95% CI 0.56-0.97) for the SVF. The full model including the total word count and speech and linguistic features had an area under the curve of 0.81 and 0.77 for the VLT immediate and delayed recall, respectively, and 0.61 for the SVF. Conclusion There was a high agreement between the ASR and manual scores, keeping the broad confidence intervals in mind. The phone-based VLT was able to differentiate between SCD and MCI and can have opportunities for clinical trial screening.
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Affiliation(s)
- Daphne ter Huurne
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Nina Possemis
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Leonie Banning
- Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | | | - Alexandra König
- National Institute for Research in Computer Science and Automation (INRIA), Sophie Antipolis, France
- ki elements, Saarbrücken, Germany
| | | | | | - Kai Langel
- Janssen Clinical Innovation, Beerse, Belgium
| | - Frans Verhey
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
| | - Inez Ramakers
- Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Maastricht University Medical Center+ (MUMC+), Maastricht, The Netherlands
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11
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Srivastava A, Swaminathan A, Chockalingam M, Srinivasan MK, Surya N, Ray P, Hegde PS, Akkunje PS, Kamble S, Chitnis S, Kamalakannan S, Ganvir S, Shah U. Tele-Neurorehabilitation During the COVID-19 Pandemic: Implications for Practice in Low- and Middle-Income Countries. Front Neurol 2021; 12:667925. [PMID: 34690907 PMCID: PMC8529345 DOI: 10.3389/fneur.2021.667925] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings.
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Affiliation(s)
- Abhishek Srivastava
- Centre for Physical Medicine and Rehabilitation, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | | | | | - Murali K Srinivasan
- Faculty of Occupational Therapy, Meenakshi Academy of Higher Education and Research, Chennai, India
| | - Nirmal Surya
- Chairman Surya Neuro Centre Mumbai, President Indian Federation of Neurorehabilitation (IFNR), Mumbai, India
| | - Partha Ray
- National Health Services England, The Walton Centre Liverpool & National Professor of Neurology, Liverpool, United Kingdom
| | - Prasanna S Hegde
- Deglutology and Speech-Language Pathology, HCG Hospital, Bangalore, India
| | - Preetie Shetty Akkunje
- Department of Speech Pathology and Audiology, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sanjivani Kamble
- Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, India
| | - Sonal Chitnis
- Bharati Vidyapeeth (Deemed to be) University, School of Audiology Speech Language Pathology, Pune, India
| | - Sureshkumar Kamalakannan
- South Asia Centre for Disability Inclusive Development and Research (SACDIR), Public Health Foundation of India, The Indian Institute of Public Health Hyderabad, Hyderabad, India
| | - Suvarna Ganvir
- Department of Neuro Physiotherapy, Dr. Vitalrao Vikhe Patil Foundation's College of Physiotherapy, Ahmednagar, India
| | - Urvashi Shah
- Department of Neurology, King Edward Memorial and Global Hospitals Mumbai, Mumbai, India
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