4.2 Article

Validity of In-Home Teleneuropsychological Testing in the Wake of COVID-19

Journal

ARCHIVES OF CLINICAL NEUROPSYCHOLOGY
Volume 36, Issue 6, Pages 887-896

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/arclin/acab002

Keywords

Neuropsychological assessment; Health care; Telehealth; Validity; Technology

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The study aims to explore the validity and clinical utility of in-home TNP testing in the wake of COVID-19, showing that in-home TNP testing is comparable to in-person neuropsychological testing, especially with large effect sizes in memory and semantic fluency tests.
Objective :Teleneuropsychology (TNP) has been shown to be a valid assessment method compared with in-person neuropsychological evaluations. Interest in delivering TNP directly to patients' homes has arisen in response to the coronavirus disease 2019 (COVID-19) pandemic. However, prior research has typically involved patients tested in clinical settings, and the validity of in-home TNP testing has not yet been established. The present study aims to explore the validity and clinical utility of in-home TNP testing in a mixed clinical sample in the wake of COVID-19. Methods: Test profiles for 111 in-home TNP patients were retrospectively compared with 120 patients who completed in-person evaluations. The TNP test battery consisted of tests measuring attention/processing speed, verbal memory, naming, verbal fluency, and visuoconstruction. TNP scores of cognitively normal (CN) patients were compared with patients with neurocognitive disorders (NCD), and score profiles were examined among suspected diagnostic groups of Alzheimer's disease (AD), Parkinson's disease (PD), and vascular disease (VaD). Results: TNP test scores did not significantly differ from in-person testing across all tests except the Hopkins Verbal Learning Test-Revised Discrimination Index. Within the TNP group, significant differences between the CN and NCD groups were found for all tests, and the memory and semantic fluency tests yielded large effect sizes (d >= 0.8). Score profiles among the AD, PD, and VaD groups were explored. Conclusions: These findings support the validity of in-home TNP testing compared with in-person neuropsychological testing. Practice considerations, limitations, and future directions are discussed.

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