JMIR Publications

ABSTRACT

Background:

Workplace mild traumatic brain injuries are frequently associated with persistent symptoms leading to a reduction in productivity at work or even disability. People who sustain workplace injuries frequently need rehabilitation and support and the challenges of delivering these services was heightened during the COVID-19 pandemic as injured workers had to be cared for remotely. Currently, clinicians are conducting both in-person and virtual (remote) concussion assessments, however, the measures that are being used to complete these assessments have undocumented psychometric properties. This study will document psychometric properties of the clinical measures that are being used remotely and their ability to produce similar results to in-person assessments.

Objective:

Through this method comparison study, we aim to: 1) evaluate sensitivity of the measures included in a virtual assessment toolkit when compared to an in-person assessment and 2) determine the inter-rater and intra-rater reliability of the measures included in a virtual assessment toolkit.

Methods:

Patient-participants (people living with acquired brain injuries) will attend two assessments (in-person and virtual) at the Ottawa Hospital. The two assessments will be identical consisting of the measures included in our virtual concussion assessment toolkit that was previously developed, which includes finger-to-nose testing, the Vestibular/Ocular Motor Screening tool, balance testing, cervical spine range of motion, saccades testing, and evaluation of effort. All virtual assessments will occur using the Microsoft Teams platform and will be audio-video recorded. The clinician-assessor and patient-participant will complete a feedback form following completion of the assessments. A different clinician will also document the findings on observed videos of the virtual assessment shortly after completion of both in person and virtual assessments and approximately one month later. Inter-rater reliability will be assessed by comparing the second clinician’s observation with the first clinician’s initial virtual assessment. Intra-rater reliability will be evaluated by comparing second clinician’s observation with their own assessment, conducted approximately one month later. Sensitivity will be documented by comparing the findings (identification of abnormality) of the in-person assessment completed by the initial clinician-assessor with the findings of the second clinician-assessor on the observation of the recording of the virtual assessment.

Results:

The study recruitment is expected to be completed by September 2024.

Conclusions:

Currently, it is unknown if completing concussion assessments virtually produce similar results to the in-person assessment. This work will act as a first step to determining the similarity of the virtual assessment to the matching in-person assessment and will provide information on the reliability of the virtual assessment.