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Feasibility of Videophone-Assisted Neuropsychological Testing For Intensive Care Unit Survivors
Jin H Han1, Erin M Collar2, Caroline Lassen-Greene3
1Jin H. Han is a faculty member of the Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center and an associate professor in the Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, Tennessee; and a faculty member at the Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Tennessee Valley Health Care Center, Nashville, Tennessee.
Background:
Most hospitals lack neuropsychologists, and this lack has hampered the conduct of large-scale, multicenter clinical trials to evaluate the effect of interventions on long-term cognition in patients in intensive care units (ICUs).
Objective:
To evaluate the feasibility of videophone-assisted neuropsychological testing administered by using an inexpensive high-definition web camera and a laptop.
Methods:
This prospective, single-center observational study, conducted at a tertiary care academic hospital, included ICU survivors aged 18 years or older. Participants were seated in a quiet room with a proctor who provided neuropsychological testing forms and addressed technical difficulties. The neuropsychological rater was in a room 100 yd (90 m) from the participant. Skype was used for videoconferencing via a wireless connection. After the testing session was completed, participants completed surveys.
Results:
In April 2017, 10 ICU survivors (median age, 63 years; range, 51-73 years) were enrolled. All indicated that "Videophone-assisted neuropsychological testing is reasonable to use in research studies." When asked "What made the videophone-assisted cognitive testing difficult?" 1 participant (10%) reported occasionally becoming frustrated with the testing because the wireless internet speed was slower than usual and reduced the resolution of visual stimuli. Three participants (30%) reported difficulty with the line orientation task because the lines were "shaky" and the images were "hard to see."
Conclusion:
Videophone-assisted neuropsychological testing is feasible for evaluating cognition in multicenter studies of ICU patients. Feedback provided will be used to refine this telemedicine approach to neuropsychological testing.
