title: Remote cognitive assessments for patients with multiple sclerosis: a feasibility study.
abstract: BACKGROUND
  measuring cognitive function in patients with multiple sclerosis (MS) can be challenging given the obstacles faced when traveling to testing centers.
  
  
  OBJECTIVE
  the purpose of this study was to evaluate the feasibility of remote cognitive assessment in patients with MS using the automated neuropsychological assessment metrics (ANAM-MS) and the symbol digit modalities test (SDMT).
  
  
  METHODS
  patients meeting the McDonald criteria for MS (n = 24) were randomized to complete the live-in-office condition or a remote-in-office condition first, with all patients completing both sessions. Patients (n = 20) then completed a final remote-in-home testing session. Both remote sessions were proctored by a psychologist using a secure telehealth connection.
  
  
  RESULTS
  scores on the live SDMT differed from scores in the two remote settings F(2, 38) = 4.46, p = 0.018. However, summary scores on the ANAM-MS were similar across the three settings, F(2, 36) = 2.21, p = 0.124. Satisfaction with telehealth testing was high on the part of the examiner and patients. Each telehealth testing session saved more than $144.00 in travel costs and lost wages.
  
  
  CONCLUSIONS
  this study demonstrated that valid results can be obtained when evaluating patients remotely using ANAM-MS. Some differences were noted for the SDMT that suggest that either specific norms or a different implementation approach may be needed for telehealth.
authors.affiliation: Veterans Affairs Medical Center, Washington, DC/ Veterans Affairs Multiple Sclerosis Center of Excellence-East, USA jill.settle@va.gov.
authors.forename: Jill R
authors.initials: JR
authors.lastname: Settle
authors.affiliation: Veterans Affairs Medical Center, Washington, DC/ Veterans Affairs Multiple Sclerosis Center of Excellence-East, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Robinson
authors.affiliation: Neurology Department, Georgetown University School of Medicine, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Kane
authors.affiliation: Veterans Affairs Medical Center, Washington, DC/ Veterans Affairs Multiple Sclerosis Center of Excellence-East, USA.
authors.forename: Heidi W
authors.initials: HW
authors.lastname: Maloni
authors.affiliation: Department of Veterans Affairs MS Center of Excellence-East and Georgetown University School of Medicine.
authors.forename: Mitchell T
authors.initials: MT
authors.lastname: Wallin
mesh_terms: D000328:Adult; D003071:Cognition; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications / Q000191:economics / Q000523:psychology*; D009483:Neuropsychological Tests; D017060:Patient Satisfaction; D011584:Psychology; D011597:Psychomotor Performance; D011930:Reaction Time; D015203:Reproducibility of Results; D017216:Telemedicine / Q000191:economics / Q000379:methods*
keywords: Multiple sclerosis; assessment; cognition; telehealth