Authors :
Jodie Chapman, PhD – The Florey
Christoph Helmstaedter, PhD – University Clinic of Bonn
David Abbott, PhD – The Florey
Heath Pardoe, PhD – The Florey
David Vaughan, MD, PhD – The Florey
Graeme Jackson, MD, MBBS – Austin Health
Presenting Author: Chris Tailby, PhD – The Florey
The Australian Epilepsy Project, PhD – The Florey
Rationale:
Processing speed and attention are neuropsychological domains commonly impacted by epilepsy and other neurological and psychological disorders. The written Symbol Digit Modalities Task (SDMT) and Trail Making Test (TMT) are widely used evidence-based measures that assess these domains, but these tasks are difficult to administer remotely.
Remote videoconference neuropsychological assessments offer opportunities that remain under-exploited.
We aimed to evaluate teleneuropsychology-suitable oral and digital alternatives to these tasks by comparing them to their written counterparts.
Methods:
Three-hundred and thirty-seven Australian Epilepsy Project (AEP) adult participants with seizure disorders completed the written SDMT and TMT in-person. One-hundred and fifty-five of these participants also completed the oral SDMT and TMT during a remote videoconference-based neuropsychological assessment while 182 completed novel, clinician-administered digital SDMT and TMT remotely via custom videoconference-based software.
Results:
Remotely administered oral and digital SDMT were strongly correlated with in-person written SDMT (r (133) = .77, p < .001 and r (125) = .75, p < .001, respectively). Oral TMT-B was only moderately associated (r (126) = .52, p < .001) with written TMT-B, and less strongly related to measures of sustained attention and spatial working memory than its written counterpart. Digital TMT-B better reproduced the written test’s properties with significantly improved association with written TMT-B (r (157) = .69, p < .001 ).
Conclusions: Oral and digital SDMT are valid teleneuropsychology counterparts to in-person written SDMT. The digital TMT better captures the cognitive demands and performance characteristics of the in-person written form than does oral TMT. Videoconference-integrated digital tasks also offer increased standardisation and automation in administration and scoring, and the potential for rich metadata, making them an attractive area for further development.
This study highlights the benefits of capitalising on the teleneuropsychology modality, not only in terms of increasing the reach and accessibility of neuropsychology, but also by enhancing task administration and scoring.
Funding:
The Australian Epilepsy Project received funding from the Australian Government under the Medical Research Future Fund (Frontier Health and Medical Research Program - Grant Numbers MRFF75908 and RFRHPSI000008) and the Victoria State Government (Victorian-led Frontier Health and Medical Research Program).