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Testing the Validity and Reliability of a Standardized Virtual Examination for Concussion.

Alani I Jack1, Helena T Digney1, Carter A Bell1

  • 1Department of Neurology (AIJ, HTD, CAB, SNG, LJB, SLG, NAB), New York University Grossman School of Medicine, NY; Department of Rehabilitation Sciences (JIM, GTS), School of Public Health and Health Professions, State University of New York at Buffalo; UBMD Department of Orthopaedics and Sports Medicine (MNH, JJL) and Department of Psychiatry (BSW), Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo; Departments of Population Health (LJB) and Ophthalmology (LJB, SLG), New York University Grossman School of Medicine, NY; and Department of Neurology (DMT), Lenox Hill Hospital at Northwell Health, New York, NY.

Neurology. Clinical Practice
|June 19, 2024
PubMed
Summary
This summary is machine-generated.

The Telemedicine Buffalo Concussion Physical Examination (Tele-BCPE) provides reliable concussion assessments, whether performed in-person or virtually by one or two examiners. This tool validates remote neurological examination findings for concussion care.

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Area of Science:

  • Neurology
  • Telemedicine
  • Concussion Management

Background:

  • Concussion assessments traditionally rely on in-person examinations.
  • The COVID-19 pandemic accelerated the adoption of telemedicine in healthcare.
  • Standardized tools are needed to ensure reliable remote concussion evaluations.

Purpose of the Study:

  • To determine the inter-modality and inter-rater agreement of the Telemedicine Buffalo Concussion Physical Examination (Tele-BCPE).
  • To assess the validity and reliability of a standardized telemedicine concussion examination.
  • To evaluate the consistency of Tele-BCPE results across different examination settings and examiners.

Main Methods:

  • The Tele-BCPE was used for virtual examinations by two neurologists.
  • In-person examinations were conducted by the treating neurologist.
  • Intraclass correlation coefficients (ICC) and Cohen's kappa (κ) were used to measure agreement.

Main Results:

  • High inter-modality agreement (ICC = 0.95) and inter-rater agreement (ICC = 0.88) were found for total Tele-BCPE scores.
  • Substantial inter-modality agreement (κ ≥ 0.61) was observed for 25 of 29 examination elements.
  • Substantial inter-rater agreement was found for 8 of 29 elements.

Conclusions:

  • The Tele-BCPE is a valid and reliable tool for concussion assessment in both in-person and telemedicine settings.
  • The Tele-BCPE demonstrates consistent results regardless of the examiner or modality.
  • Telemedicine concussion assessments can provide reliable findings, supporting its integration into clinical practice.