Reliability and validity of in-home tele-neuropsychological testing in patients with Parkinson’s disease: A randomized trial

To assess the reliability and diagnostic validity of in-home tele-neuropsychological testing (in-home tele-npt) in individuals with Parkinson’s disease (PD). We randomized 79 individuals with PD to in-person npt or in-home tele-npt at Baseline, and again to the same or crossover group for Week 4 testing. We assessed group differences in mean test scores using ANOVAs with Dunnett’s t-tests. Test-retest reliability was assessed using intraclass correlation coefficients and Pearson correlations and compared across groups using 95% confidence intervals and z-tests with Fisher’s z transformations. We compared the percentage of participants exceeding each test’s standardized regression-based index across groups. We examined diagnostic validity by comparing group differences in cognitive classifications using Pearson’s Chi-square test and Fisher’s Exact test. For most tests, the mean scores between in-home tele-npt and in-person npt were not significantly different. In-home tele-npt had weaker Baseline processing speed scores. The test-retest reliability was similar between the repeated tele-npt and repeated in-person npt groups in most tests. The crossover groups had weaker test-retest reliability in processing speed, verbal fluency, and memory tests. The percentage of significant change scores varied between groups and across tests. The percentage of participants classified as cognitively impaired, and the agreement of cognitive classification between testing sessions, were not significantly different between groups. With few exceptions, in-home tele-npt and in-person tele-npt yield similar scores. Test-retest reliability is better when the testing paradigm is held constant. There are no significant differences in cognitive diagnostic classification rates between testing paradigms in individuals with PD.