Abstract
BACKGROUND
Since COVID-19 there has been an increase in consultations with patients in neuro-oncological practice via video teleconferencing (VTC). While VTC can increase access to care, the degree to which cognitive screening can be reliably conducted via VTC in brain tumor patients is unclear. The aim of this study is to investigate reliability of a predominantly computerized cognitive screening conducted via VTC (Teams) vs in-person in a Dutch hospital.
MATERIAL AND METHODS
Glioma and meningioma patients underwent an in-person neuropsychological screening as part of standard care before surgery. Between May 2020 and October 2022, patients underwent their 3-month follow-up as part of their standard care via VTC due to COVID. Before May 2020, patients underwent this follow-up in-person. The screening consisted of a computerized battery (CNS vital signs) and paper and pencil tasks (Fluency, Digit span forward and backward). We compared the stability of raw scores over time of patients undergoing VTC vs. in-person administration with intraclass correlation coefficients (ICCs, continuous scores) and absolute agreement (non-continuous scores). We also statistically compared percentages of patients showing reliable change between groups (α=0.05).
RESULTS
Compared to the in-person group (n=112), the VTC (n=112) group was younger (51±14 vs 58±14 years), contained more male patients (56% vs 34%) and more patients with higher education (49% vs 29%). The groups did not differ on other sociodemographic, tumor or treatment characteristics. The majority of test measures for both the VTC (13 out of 15) and in-person group (10 out of 15) had acceptable to excellent ICC values (range 0.50-0.91 vs 0.61-0.87). ICCs of reaction time scores on simpler tests, the Stroop test part 1 (0.45 vs 0.47), and a Continuous Performance test (0.37 vs 0.46), and of a Visual Recognition test (0.33 vs 0.44) were low for both groups. ICCs of a Verbal Recognition test (0.44 vs 0.65) and Digit Span test backward (0.44 vs 0.65) were low only for the VTC group. The degree of agreement on non-continuous measures was similar for both groups, except for Continuous Performance test accuracy. Significantly more patients in the VTC group showed reliable improvement on the Continuous Performance test (15% vs 11%).
CONCLUSION
Neuropsychological screening via video consultation is a promising method, as it can provide opportunities for more patients to receive care from home. Reliability was comparable for VTC and in-person administration for most measures. Performances over time assessed via VTC appeared less stable for Digit span backward, a paper and pencil test, and for Verbal Recognition accuracy, a computerized test. Future research into patient characteristics of the VTC group, and consequences for performances, is warranted.
Since COVID-19 there has been an increase in consultations with patients in neuro-oncological practice via video teleconferencing (VTC). While VTC can increase access to care, the degree to which cognitive screening can be reliably conducted via VTC in brain tumor patients is unclear. The aim of this study is to investigate reliability of a predominantly computerized cognitive screening conducted via VTC (Teams) vs in-person in a Dutch hospital.
MATERIAL AND METHODS
Glioma and meningioma patients underwent an in-person neuropsychological screening as part of standard care before surgery. Between May 2020 and October 2022, patients underwent their 3-month follow-up as part of their standard care via VTC due to COVID. Before May 2020, patients underwent this follow-up in-person. The screening consisted of a computerized battery (CNS vital signs) and paper and pencil tasks (Fluency, Digit span forward and backward). We compared the stability of raw scores over time of patients undergoing VTC vs. in-person administration with intraclass correlation coefficients (ICCs, continuous scores) and absolute agreement (non-continuous scores). We also statistically compared percentages of patients showing reliable change between groups (α=0.05).
RESULTS
Compared to the in-person group (n=112), the VTC (n=112) group was younger (51±14 vs 58±14 years), contained more male patients (56% vs 34%) and more patients with higher education (49% vs 29%). The groups did not differ on other sociodemographic, tumor or treatment characteristics. The majority of test measures for both the VTC (13 out of 15) and in-person group (10 out of 15) had acceptable to excellent ICC values (range 0.50-0.91 vs 0.61-0.87). ICCs of reaction time scores on simpler tests, the Stroop test part 1 (0.45 vs 0.47), and a Continuous Performance test (0.37 vs 0.46), and of a Visual Recognition test (0.33 vs 0.44) were low for both groups. ICCs of a Verbal Recognition test (0.44 vs 0.65) and Digit Span test backward (0.44 vs 0.65) were low only for the VTC group. The degree of agreement on non-continuous measures was similar for both groups, except for Continuous Performance test accuracy. Significantly more patients in the VTC group showed reliable improvement on the Continuous Performance test (15% vs 11%).
CONCLUSION
Neuropsychological screening via video consultation is a promising method, as it can provide opportunities for more patients to receive care from home. Reliability was comparable for VTC and in-person administration for most measures. Performances over time assessed via VTC appeared less stable for Digit span backward, a paper and pencil test, and for Verbal Recognition accuracy, a computerized test. Future research into patient characteristics of the VTC group, and consequences for performances, is warranted.
| Original language | English |
|---|---|
| Pages (from-to) | V63-V64 |
| Number of pages | 2 |
| Journal | Neuro-Oncology |
| Volume | 26 |
| DOIs | |
| Publication status | Published - 2024 |
| Event | 19th Meeting of the European-Association-of-Neuro-Oncology (EANO) - Glasgow Duration: 17 Oct 2024 → 20 Oct 2024 |