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Sue Palsbo, PhD National Rehabilitation Hospital/George Mason University Robert Mullen, MPH

Equivalence of Face-to-face and Videoconference Administration of Functional Communication Measures for Post-Stroke Patients. Sue Palsbo, PhD National Rehabilitation Hospital/George Mason University Robert Mullen, MPH Tobi Frymark, MA, CCC-SLP American Speech-Language Hearing Association

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Sue Palsbo, PhD National Rehabilitation Hospital/George Mason University Robert Mullen, MPH

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  1. Equivalence of Face-to-face and Videoconference Administration of Functional Communication Measures for Post-Stroke Patients Sue Palsbo, PhD National Rehabilitation Hospital/George Mason University Robert Mullen, MPH Tobi Frymark, MA, CCC-SLP American Speech-Language Hearing Association Pamela G. Forducey, PhD, ABPP INTEGRIS Neuroscience Institute and Telehealth

  2. RERC on Telerehabilitation Funding • Robert Wood Johnson Foundation, Methodologies Grant, #49143 • US Department of Education, National Institute on Disability and Rehabilitation Research (NIDRR), Rehabilitation Engineering and Research Center (RERC) on Telerehabilitation #H133E990007-00C

  3. Study Partners • Professional Association • American Speech-Hearing Language Association (ASHA) • Rehabilitation Hospitals • INTEGRIS/Jim Thorpe (Oklahoma) • National Rehabilitation Hospital (Washington DC)

  4. Goal • Determine if a post-stroke functional communication assessment tendered by a remote therapist is equivalent to a face-to-face assessment.

  5. Criteria for Selecting Measures (1) Be appropriate and relevant to people with stroke. (2) Have known psychometric properties (validity and reliability) published in peer-reviewed literature. (3) Wide use in research and clinical practice. (4) Be visually based (that is, the therapist can measure using televideo without touching the patient). (5) All measures can be completed within 30 minutes.

  6. Design Issues for Measuring Equivalence • Serial correlation bias • Measure simultaneously, not serially • Inter-rater reliability • Use measurement tools with published reliability values • Training • Bias in administration • Switch off the therapist conducting the assessment

  7. Randomization Total: 24 paired observations

  8. Functional Communication Measures • Motor speech • Speech comprehension • Speech expression

  9. The Data

  10. ICC for Speech Assessment

  11. Raw Agreement Index

  12. Conclusions and Improvements • Not clear why the percentage exact agreement was low, and the agreement within 1 score was high • Additional randomizing of SLPs would have allowed us to control for one person who appeared to consistently score lower • Scoring might have been more consistent if we had selected activities that are a better fit with the FCMs we selected

  13. Future Research • Televideo assessments are worth pursuing • Need to look at POTS videophones • Need to develop clinical protocols (positioning camera; patient safety; appropriate candidates) • Need to identify more continuous measurement scales and demonstrate equivalence • Maintain movement toward RCTs of teletherapy

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