title: A pilot study of virtual visits in Huntington disease.
abstract: BACKGROUND
  Virtual visits through web-based video conferencing can increase access to specialty care for individuals with Huntington disease (HD) and facilitate research participation.
  
  
  OBJECTIVE
  To determine the feasibility of conducting virtual visits directly into the homes of individuals with HD, to assess the reliability of conducting remote versus in-person motor assessments, and to determine the test-retest reliability of conducting motor assessments remotely.
  
  
  METHODS
  Individuals with mild to moderate HD underwent baseline in-person clinic assessments and completed a HD care survey. Participants were randomized to receive three virtual visits from one of two physicians over four months that included a modified Unified Huntington's Disease Rating Scale motor examination (excluding rigidity and balance assessments) via web-based video conferencing. Intraclass coefficients (ICC) were calculated to determine the level of agreement between remote and in-person assessments. Participants also completed a survey on their interest in telemedicine.
  
  
  RESULTS
  Thirteen individuals underwent baseline assessments, eleven (85%) participants completed at least one virtual visit, and 27 (82%) of 33 total virtual visits were completed. Remote motor scores demonstrated good reliability (ICC = 0.78; n = 11) compared to in-person motor scores. Test-retest reliability of motor scores conducted remotely was excellent (ICC = 0.90; n = 11). Participants expressed moderate future interest in using virtual visits to participate in research and to receive care.
  
  
  CONCLUSIONS
  In this pilot study, virtual visits into the home were feasible and reliable for conducting motor assessments in HD. Larger scale studies need to confirm and generalize these findings to a broader population of participants.
authors: Department of Neurology, University of Rochester, Rochester, NY, USA.
authors: Michael T
authors: MT
authors: Bull
authors: Johns Hopkins University School of Medicine, University of Rochester, Rochester, NY, USA.
authors: Kristin
authors: K
authors: Darwin
authors: Duke University School of Medicine University of Rochester, Rochester, NY, USA.
authors: Vinayak
authors: V
authors: Venkataraman
authors: Department of Neurology, University of Rochester, Rochester, NY, USA.
authors: Joseph
authors: J
authors: Wagner
authors: Department of Biostatistics and Computational Biology, University of Rochester, Rochester, NY, USA.
authors: Christopher A
authors: CA
authors: Beck
authors: Department of Neurology, University of Rochester, Rochester, NY, USA.
authors: E Ray
authors: ER
authors: Dorsey
authors: Department of Neurology, University of Rochester, Rochester, NY, USA.
authors: Kevin M
authors: KM
authors: Biglan
mesh_terms: D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006816:Huntington Disease / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D010865:Pilot Projects; D015203:Reproducibility of Results; D017216:Telemedicine / Q000379:methods* / Q000592:standards*; D014481:United States; D049269:Videoconferencing
keywords: Huntington disease; Telehealth; feasibility; reliability; remote assessment