| Publication Abstract Display | | Type: Poster | | Title: Evidence of the feasibility of video-based neuropsychological evaluations among persons With and Without HIV. | | Authors: Kohli M, Fisher A, Sun-Suslow N, Heaton A, Dawson M, Franklin DR, Iudicello JE, Heaton RK, Moore DJ | | Date: 02-03-2021 | | Abstract:Objective: The use of telehealth to provide remote health care services is rapidly growing especially during the COVID-19 pandemic. Available evidence suggests that video-based neuropsychological assessments (VBA) are feasible compared to traditional in-person assessments (IPA); however, we are unaware of any study that has examined the reliability of VBA among persons with HIV (PWH). Considering PWH can be immunosuppressed and may be at-risk for contracting COVID-19, the aim of the current investigation is to determine the reliability and feasibility of remotely-administered VBA compared to IPA among PWH.
Participants and Methods: In our first 40 participants assessed with VBA during the COVID-19 pandemic (March-June 2020), 30 of whom were PWH (Mage=59.7, SDage=10.7) and 10 (Mage=69.7, SDage=14.2) were HIV- adults. Participants completed two comprehensive neuropsychological IPA at the HIV Neurobehavioral Research Program at the University of California, San Diego (time between IPA1 and IPA2: Mdn = 375, IQR = [229-526]) prior to one VBA (time between IPA2 and VBA: Mdn = 361, IQR = [214-421]) during the COVID-19 pandemic. Neuropsychological assessments included in analyses were: Hopkins Verbal Learning Test-Revised (HVLT-R), Controlled Oral Word Fluency Test (COWAT) FAS, Wechsler Adult Intelligence Scale 3rd Edition (WAIS-III) Symbol Search and Letter Number Sequencing, Stroop Color and Word Test, Paced Auditory Serial Addition Test (Channel 1), and Boston Naming Test. Total raw scores and sub-scores for each assessment were used in analyses. Spearman’s rho correlations and paired t-tests were used to assess test-retest reliability and performance-level differences between 1) the two consecutive IPA (i.e., IPA1 and IPA2), and 2) IPA2 and remote VBA.
Results: Results indicate moderate to strong test-retest correlations between the IPA1 and IPA2 evaluations (σ = 0.66-0.93, ps < .05), and between IPA2 and remote VBA (σ = 0.72-0.95, ps < .05). Furthermore, performance levels on 12 of the 14 neuropsychological tests and sub-tests were comparable across test visits regardless of administration format. There were significant mean differences in raw scores between the two IPA on the Stroop Color Test (IPA1 = 61.9 seconds, IPA2 = 59.0 seconds; t(39) = -2.8, p = .007), such that participants had higher scores on IPA1 compared to IPA2. Results show significant mean differences in raw scores between the IPA2 and remote VBA only on the HVLT-R Total Recall (IPA2 visit = 22.2 words, VBA visit = 20.6 words, t(39) = -2.2, p = .036) such that participants had lower scores on the HVLT-R VBA.
Conclusions: Among our sample of persons with and without HIV, we provided evidence of test-retest reliability and performance-level comparability of our IPA and those administered in the VBA format. Considering the current COVID-19 pandemic, there is an immediate need for reliable neuropsychological assessments that can be administered remotely especially for PWH. Video-based neuropsychological evaluation shows promise as a way to improve access to neuropsychological services in vulnerable populations and amidst the COVID-19 pandemic, and to maintain consistent neuropsychological test batteries in ongoing research studies. |
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