97 Looking in the Webcam Reflection: A Scoping Review of Videoconferencing-Based Teleneuropsychological Assessment Since the Start of the COVID-19 Pandemic
Authors: Fox-Fuller Joshua T , Sunderaraman Preeti , Munro Cullum C. , Quiroz Yakeel T. 
Published: December 2023

Objective:

Following the start of the SARS-COV-2 (COVID-19) pandemic there was a rapid uptake in teleneuropsychology (TeleNP). Many clinicians and researchers used videoconferencing technologies (e.g., Zoom®) to conduct remote neuropsychological assessments. Prior reviews (e.g., Marra et al., 2020) have indicated promise for the use of videoconference-based approaches to cognitive assessment under certain circumstances, though arguably nobody foresaw the widespread use of teleNP during the pandemic. Given the rapid expansion in the teleNP literature in the past couple of years, in this scoping review we specifically discuss research updates made during the COVID-19 pandemic pertaining to teleNP assessment of adults conducted via videoconferencing and their potential clinical applications.

Participants and Methods:

GoogleScholar and PubMed were used to search for peer-reviewed original research articles published between January 1, 2020 (i.e., the approximate beginning of the COVID-19 pandemic) and August 1, 2022. Broad search terms were used pertaining to teleNP, remote cognitive assessment, videoconferencing, and neuropsychological assessment, resulting in 16 articles.

Results:

Though most of the included studies were based in the United States (n=5), there was international representation across studies (Chile=1; United Kingdom=1; Australia=2; New Zealand=1; France=2; Greece=1; Japan=2, Singapore=1). All of the identified articles examined TeleNP-related research questions using cognitive tests administered via videoconferencing that have been previously studied in-person to varying degrees. Several of the studies focused on psychometric characterization (i.e., reliability and validity) of the examined tests when delivered via videoconferencing, whereas others focused on demonstrating the relative equivalence of neuropsychological scores obtained via videoconferencing versus in-person evaluations.

Conclusions:

Formal psychometric studies of traditional in-person neuropsychological tests delivered via videoconferencing since the start of the COVID-19 pandemic suggest that this remote modality of assessment is generally reliable and valid. Moreover, multiple recent studies have demonstrated relative equivalence of neuropsychological scores obtained via videoconferencing versus neuropsychological test scores obtained in-person. When considered alongside teleNP research conducted prior to the COVID-19 pandemic (e.g. Cullum et al., 2014), recent studies on videoconference-based neuropsychological assessment indicate that videoconferencing may not necessarily be a complete substitute for an in-person comprehensive evaluation given the inherent limitations of the procedure. However, teleNP via videoconferencing may be a promising tool in the neuropsychologist’s toolbox because it can help reduce common barriers to in-person neuropsychological assessment (e.g., travel time to clinics). Additional research on videoconferencing-based cognitive assessment is needed, especially in low-and-middle income countries (LMIC) and diverse populations where there may be more economic barriers to remote neuropsychological assessment relative to more economically-developed countries. Notably it is possible that research from LMIC may have been missed through the screening processes used in this review (e.g., inclusion of articles written in English).