The agreement between face-to-face and tele-assessment of ataxia severity scales in multiple sclerosis patients with ataxia

Abstract

Background Tele-assessments are becoming increasingly important to increase access to healthcare services and facilitate patient follow-up. Whether they can provide results with similar accuracy to face-to-face assessments remains relevant. Objective The aim of this study was to compare the face-to-face and tele-assessment scores of the International Cooperative Ataxia Rating Scale (ICARS) and Assessment and Rating of Ataxia (SARA) in ataxic MS patients and to examine their suitability for tele-assessment. Methods The participants were assessed both online and face-to-face. Randomization determined which method would be used first to assess the participants. ICARS and SARA were used in the assessments. Face-to-face assessments were conducted as part of routine clinical practice by one researcher, while teleassessments were performed via real-time video by two different researchers. The video was recorded and reassessed one week later. The agreement and correlation between face-to-face and teleassessments were analyzed using intra-class correlation coefficients (ICC), Bland-Altman Plots, and Pearson's/Spearman's correlation coefficients. Results This study included 20 patients with ataxic MS with an EDSS score of 3.6 +/- 0.66. The inter-rater reliability of tele-assessments (ICCICARS = 0.97; ICCSARA = 0.97) achieved excellent reliability. Intra-rater reliability of the tele-assessment was excellent (ICCICARS = 0.99; ICCSARA = 0.99). High correlations were observed in ICARS and SARA scores between face-to-face and tele-assessment methods according to assessors (r > .80 for all). Conclusion ICARS and SARA are reliable and agreed-upon tests that can be used with tele-assessments, offering similar data to face-to-face methods.