Equivalence of in-person and videoconference administration of the Physical and Neurological Examination of Subtle Signs (PANESS) timed motor section.

Abstract

Demand for telehealth services has increased in many settings as a means of reducing patient burden and increasing access to care. It is therefore critical to understand if clinical tools validated for in-person use are feasible to administer via telehealth and, if so, how results may vary from those obtained in-person. The Revised Physical and Neurological Examination of Subtle Signs (PANESS) is a validated assessment of pediatric neuromotor functioning that is sensitive to detecting motor dysfunction in youth. The Timed Motor section of the PANESS is an ideal candidate for telehealth administration given its strong inter-rater reliability when scored via video review. Here, we preliminarily examined the feasibility of administering the Timed Motor section of PANESS via videoconferencing and its equivalence with in-person administration. We administered the Timed Motor section of the PANESS in-person and via videoconferencing in 25 typically developing youth ages 10-18 (including n = 11 who had clinically recovered from concussion). All were able to complete the assessment via videoconference. We observed moderate to excellent reliability of scores obtained in-person and via videoconference (intraclass correlations ranging from .743 to .971). Results suggest that the Timed Motor Section of the PANESS can be administered remotely in typically developing youth (including those with a history of concussion) and that the scores obtained are stable with in-person scores. Future work is needed to examine the feasibility and equivalence of telehealth-based PANESS administration in clinical settings and patient populations.