Hamner Taralee, Salorio Cynthia F, Kalb Luther, Jacobson Lisa A
Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, MD, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
J Int Neuropsychol Soc. 2022 Sep;28(8):835-844. doi: 10.1017/S1355617721001053. Epub 2021 Sep 27.
Teletesting has the potential to reduce numerous barriers to patient care which have only become exacerbated during the COVID-19 pandemic. Although telehealth is commonly utilized throughout medicine and mental health practices, teletesting has remained limited within cognitive and academic evaluations. This may be largely due to concern for the validity of test administration via remote assessment. This cross-sectional study examined the equivalency of cognitive [Wechsler Intelligence Scales for Children - Fifth Edition (WISC-V)] and academic [Kaufman Test of Educational Achievement - Third Edition (KTEA-3)] subtests administered via either teletesting or traditional in-person testing within clinically referred youth.
Chart review using a retrospective, cross-sectional design included a total of 893 children and adolescents, ranging from 4 to 17 years (Mean age = 10.2 years, = 2.9 years) who were administered at least one subtest from the aforementioned cognitive or academic assessments. Of these, 285 received teletesting, with the remaining ( = 608) receiving in-person assessment. A total of seven subtests (five from the WISC-V and two from the KTEA-3) were examined. A series of inverse probability of exposure weighted (IPEW) linear regression models examined differences between groups for each of the seven subtests after adjustment for numerous demographic, diagnostic, and parent-reported symptom variables.
Only two significant differences were found, such that WISC-V Visual Puzzles ( < .01) and KTEA-3 Math Concepts ( = .03) scores were slightly higher in the teletesting versus in-person groups. However, these differences were quite small in magnitude (WISC-V Visual Puzzles, = .33, KTEA-3 Math Concepts, = .18).
Findings indicate equivalency across methods of service delivery without clinically meaningful differences in scores among referred pediatric patients.
远程测试有潜力减少患者护理中的诸多障碍，而这些障碍在新冠疫情期间愈发严重。虽然远程医疗在整个医学和心理健康实践中普遍使用，但远程测试在认知和学术评估中仍很有限。这可能主要是因为担心通过远程评估进行测试管理的有效性。这项横断面研究检验了在临床转诊的青少年中，通过远程测试或传统面对面测试进行的认知[韦氏儿童智力量表第五版（WISC-V）]和学术[考夫曼教育成就测验第三版（KTEA-3）]子测验的等效性。
采用回顾性横断面设计进行图表审查，共纳入893名儿童和青少年，年龄在4至17岁之间（平均年龄 = 10.2岁，标准差 = 2.9岁），他们接受了上述认知或学术评估中的至少一项子测验。其中，285人接受了远程测试，其余（n = 608）接受了面对面评估。共检查了七个子测验（五个来自WISC-V，两个来自KTEA-3）。一系列暴露加权逆概率（IPEW）线性回归模型在对众多人口统计学、诊断和家长报告的症状变量进行调整后，检验了七个子测验中每组之间的差异。
仅发现两个显著差异，即远程测试组的WISC-V视觉拼图（p < .01）和KTEA-3数学概念（p = .03）得分略高于面对面测试组。然而，这些差异的幅度相当小（WISC-V视觉拼图，效应量 = .33，KTEA-3数学概念，效应量 = .18）。
研究结果表明，在转诊的儿科患者中，不同服务提供方式之间具有等效性，且分数在临床上无显著差异。
