Feasibility of Videophone-Assisted Neuropsychological Testing For Intensive Care Unit Survivors

Abstract

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.

Figure 1.

The setup of the videophone-assisted neuropsychological testing on the subject’s side. A high definition (1920×1080) web camera is mounted on a tripod and is pointed towards the table. The web camera is connected to a laptop computer with external speakers. The neuropsychological rater is communicating with the subject using videoconferencing software such as Skype.

Figure 2.

The web camera on the subject’s end should be pointed and adjusted so that the case report form can be fully visualized by the neuropsychological rater.