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Impaired balance is a key symptom following acute concussion. Unfortunately, the recommended clinical balance assessment lacks sensitivity and discriminative ability, relying on the experience of the clinician for interpretation. The aim of this pilot study is to explore smartphone technology to remotely assess balance impairment in people with acute concussion. A smartphone app was developed to allow the clinician to connect remotely using their personal web browser to the participant's smartphone and collect motion data while instructing the participant to perform the following balance tests: standing on firm and foam surface with eyes opened and closed (FIRMEO, FIRMEC, FOAMEO, and FOAMEC). Outcome measures were processed from the raw acceleration to calculate the average acceleration magnitude from the mean and the root-mean square, with greater values indicating more sway. Eleven healthy controls (HCs) and 11 people with concussion (CON) participated. In all sway measurements, the CON group had significantly (p < 0.05) greater values when standing on a firm surface. In the FOAMEC condition, the CON group had significantly (p < 0.05) greater sway measures only in the AP direction, while significantly greater sway in all directions were found in the CON group in the FOAMEO condition. This study shows that remote balance assessment using a smartphone can discriminate between healthy controls and people with acute concussion. This technology could play an important role in concussion management to assist with determining recovery from concussions and the optimal timing for return to sport. [ABSTRACT FROM AUTHOR]

With the increase in remote learning, the efficient implementation of distant knowledge assessments has become an essential topic. New challenges have arisen that have had to be adequately addressed and successfully solved. As a response, we introduced an assessment patterns catalogue for distant education, handling various challenges by proposing possible solutions. The catalogue presents a collection of proven practises targeting knowledge assessment in digital and distant environments. The paper presents the survey results from the final step of catalogue creation. The objective was to verify its suitability and expedite its use, focusing on several aspects of knowledge assessment. We focused on the perceived assessment patterns' impact on grading objectivity and consistency, as well as students' motivation and satisfaction with an implemented assessment, explored from the students' and teachers' perspectives. We gathered data using a uniform questionnaire distributed between students and teachers, both actively involved in distant knowledge assessment. Detailed data analysis highlighted the patterns with the highest perceived impact on the previously mentioned assessment aspects. We also analysed the top-rated patterns within the pattern categories. The results depict a high overlap between students' and teachers' perspectives, wherein patterns like Pentathlon, Statistical Validator, Game Rules, and Bonus Points were perceived as the patterns with the highest impact on grading objectivity and consistency, as well as the patterns with the most significant impact on students' motivation and satisfaction. [ABSTRACT FROM AUTHOR]

Closed-book summative assessment of student learning, common in pharmacy education, is challenging to administer in a remote setting due to the need for costly and intrusive monitoring technology. Therefore, open-book assessments without monitoring have been considered an alternative in remote settings. The present study investigated the effects of the transition from in-person closed-book to remote open-book format on the students' scores in different assessment categories in a Pharmacokinetics course. The students' performances in the transition cohort (Transition, n = 96) during the in-person and remote periods were compared with those of an in-person cohort (Control, n = 85) during the same periods. Assessments included take-home assignments, daily quizzes, and progress/final examinations. Whereas the take-home assignments were open-book for cohorts and periods, the quizzes and examinations were open-book only for the Transition cohort during the remote period. Only the quiz/examination questions that were identical for both cohorts were included in the analysis. Statistical analysis by a linear, mixed-effects model indicated that the transition did not have any significant impact on the scores of students in the assignments, which were open-book for both cohorts and both periods. However, there were significant increases in the Transition cohort's scores (mean ± SE) during the remote open-book period in both quizzes (+8.4 ± 1.9%) and examination (+6.8 ± 1.5%) questions, compared with the Control cohort who had in-person closed-book assessments. These differences amounted to Cohen's d-effect sizes of 0.61 and 0.59 for the quiz and examination questions, respectively. It is concluded that when the questions are similar, the students' scores in pharmacokinetic assessments are higher (medium effect size) in a remote open-book format compared with the in-person closed-book format. [ABSTRACT FROM AUTHOR]

Although guidelines surrounding COVID-19 have relaxed and school-aged students are no longer required to wear masks and social distance in schools, we have become, as a nation and as a society, more comfortable working from home, learning online, and using technology as a platform to communicate ubiquitously across ecological environments. In the school psychology community, we have also become more familiar with assessing students virtually, but at what cost? While there is research suggesting score equivalency between virtual and in-person assessment, score equivalency alone is not sufficient to validate a measure or an adaptation thereof. Furthermore, the majority of psychological measures on the market are normed for in-person administration. In this paper, we will not only review the pitfalls of reliability and validity but will also unpack the ethics of remote assessment as an equitable practice. [ABSTRACT FROM AUTHOR]

Simple Summary: The five times sit to stand (5STS) test is widely used to measure functional lower extremity strength. However, the psychometric properties of the 5STS test when performed remotely is unknown. This study determined the feasibility, reliability, and safety of the remote five times sit to stand test (5STS) in 37 patients scheduled to undergo gastrointestinal cancer surgery. Participants completed the 5STS test both face-to-face and remotely, with the order randomised. The study provides supporting evidence that the remote 5STS test is feasible, reliable, and safe in patients with gastrointestinal cancer and can be used in both clinical and research settings. Background: To determine the feasibility, reliability, and safety of the remote five times sit to stand test (5STS) test in patients with gastrointestinal cancer. Methods: Consecutive adult patients undergoing surgical treatment for lower gastrointestinal cancer at a major referral hospital in Sydney between July and November 2022 were included. Participants completed the 5STS test both face-to-face and remotely, with the order randomised. Outcomes included measures of feasibility, reliability, and safety. Results: Of fifty-five patients identified, seventeen (30.9%) were not interested, one (1.8%) had no internet coverage, and thirty-seven (67.3%) consented and completed both 5STS tests. The mean (SD) time taken to complete the face-to-face and remote 5STS tests was 9.1 (2.4) and 9.5 (2.3) seconds, respectively. Remote collection by telehealth was feasible, with only two participants (5.4%) having connectivity issues at the start of the remote assessment, but not interfering with the tests. The remote 5STS test showed excellent reliability (ICC = 0.957), with limits of agreement within acceptable ranges and no significant systematic errors observed. No adverse events were observed within either test environment. Conclusions: Remote 5STS for the assessment of functional lower extremity strength in gastrointestinal cancer patients is feasible, reliable, and safe, and can be used in clinical and research settings. [ABSTRACT FROM AUTHOR]

Featured Application: The same tool could be used repeatedly to track the changes in CMJ performance. Average jump heights should be analyzed. Practitioners and sports professionals without extensive knowledge of assessment could self-administer CMJ tests using these devices. Mobile applications and portable assessments make remote self-assessment of the countermovement jump (CMJ) test possible. This study aimed to investigate the concurrent validity and test–retest reliability of three portable measurement systems for CMJ. Thirty physically active college students visited the laboratory twice, with two days in between, and performed three jumps each day. All jumps were recorded by My Jump 2, HomeCourt, and the Takei Vertical Jump Meter (TVJM) simultaneously. Results indicated significant differences among the three systems (p < 0.01). HomeCourt tended to present the highest jump height mean value (46.10 ± 7.57 cm) compared with TVJM (42.02 ± 8.11 cm) and My Jump 2 (40.85 ± 7.86 cm). High concurrent validities among assessments were found (r = 0.85–0.93). Good to excellent reliability of jump assessments was demonstrated (ICC3,1 = 0.80–0.96). Reliable coefficients of variation were shown in all measurements (2.58–5.92%). Significant differences were revealed among the three apparatuses while they demonstrated high intra-device test–retest reliability. TVJM was the most reliable, and average jump heights were recommended for analysis. [ABSTRACT FROM AUTHOR]

A tele-assessed 6MWT (TL 6MWT) could be an alternative method of evaluating functional capacity in patients with diabetes mellitus type 2 (DM2). This study aimed to assess the validity and reliability of a TL 6MWT. The functional capacity of 28 patients with DM2 (75% men) aged 61 ± 13 years was evaluated twice via an indoor, center-based 6MWT (CB 6MWT) and twice outside each patient's home via a web-based platform TL 6MWT. The study showed a high statistically significant correlation between the CB and TL 6MWT (Pearson's r = 0.76, p < 0.001). Reliability testing showed no statistically significant differences in the distance covered (CB1: 492 ± 84 m and CB2: 506 ± 86 m versus TL1: 534 ± 87 m and TL2: 542 ± 93 m, respectively) and in the best distance of the TL 6MWT (545 ± 93 m) compared to the best CB distance (521 ± 83 m). Strong internal reliability for both the CB (intraclass correlation coefficient (ICC) = 0.93) and the TL 6MWT (ICC = 0.98) was found. The results indicate that a TL 6MWT performed outdoors can be a highly valid and reliable tool to assess functional capacity in patients with DM2. No learning effect between the TL and CB assessment was found, minimizing the need for repetition. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic had a major impact on emergency medical communication centres (EMCC). A live video facility was made available to second-line physicians in an EMCC with a first-line paramedic to receive emergency calls. The objective of this study was to measure the contribution of live video to remote medical triage. The single-centre retrospective study included all telephone assessments of patients with suspected COVID-19 symptoms from 01.04.2020 to 30.04.2021 in Geneva, Switzerland. The organisation of the EMCC and the characteristics of patients who called the two emergency lines (official emergency number and COVID-19 number) with suspected COVID-19 symptoms were described. A prospective web-based survey of physicians was conducted during the same period to measure the indications, limitations and impact of live video on their decisions. A total of 8957 patients were included, and 2157 (48.0%) of the 4493 patients assessed on the official emergency number had dyspnoea, 4045 (90.6%) of 4464 patients assessed on the COVID-19 number had flu-like symptoms and 1798 (20.1%) patients were reassessed remotely by a physician, including 405 (22.5%) with live video, successfully in 315 (77.8%) attempts. The web-based survey (107 forms) showed that physicians used live video to assess mainly the breathing (81.3%) and general condition (78.5%) of patients. They felt that their decision was modified in 75.7% (n = 81) of cases and caught 7 (7.7%) patients in a life-threatening emergency. Medical triage decisions for suspected COVID-19 patients are strongly influenced by the use of live video.

Studies have reported persistent symptoms in patients hospitalized for COVID-19 up to 6 months post-discharge; however, sequalae beyond 6 months are unknown. This study aimed to investigate the clinical status of COVID-19 patients one year after hospital discharge and describe the factors related to poor outcomes. We conducted a single-center, prospective, cohort study of patients in Le Havre hospital (France) between 1 March 2020 and 11 May 2020. Baseline characteristics were collected from medical charts (including KATZ index and Clinical Frailty scale (CFS)), and a remote assessment was conducted 12 months after discharge. The main outcomes were the scores of the physical and mental components (PCS and MCS) of the Short-Form 36 (SF-36) and performance on the one-minute sit-to-stand test (STST1′). Scores <50% of the predicted values were considered as poor, and univariate and multivariate analyses were undertaken to investigate factors related to poor outcomes. Remote assessment was performed for 128 of the 157 (82%) eligible patients. Twenty-two patients were admitted to the intensive care unit (ICU), 45 to the intermediate care unit (IU), and 61 to the general ward (GW). Patients who spent time in ICU were more independent and younger. A large proportion of the sample had poor physical (30%) and mental health (27%) and a poor functional exercise capacity (33%) at the remote assessment. Higher levels of frailty at admission and hospital discharge were, respectively, associated with a higher risk of poor functional exercise capacity (StdOR 3.64 (95%CI 1.39–10.72); p = 0.01) and a higher risk of poor mental health (StdOR 2.81 (95%CI 1.17–7.45); p = 0.03). Long-term outcomes following hospitalization for COVID-19 infection may be negative for at least one year after discharge. Remote follow-up assessment could be highly beneficial for COVID-19 patients. [ABSTRACT FROM AUTHOR]

Simple Summary: To expand the reach of lifestyle interventions among cancer survivors, in-person anthropometric and physical performance assessments were adapted to remote means and evaluated for feasibility, safety, validity, and reliability. Cancer survivors and supportive partners (n = 112) were approached to participate in three sessions (two remote and one in-person) of anthropometric and physical performance testing and results were compared. There was 98% uptake and no adverse events. ICCs for remote assessments ranged from moderate (8' timed walk = 0.47), to strong (8' get-up-and-go = 0.74), to very strong (30 s chair stand = 0.80; sit-and-reach = 0.86; 2 min step test = 0.87; back scratch = 0.90; weight = 0.93; and waist circumference = 0.98) (p-values < 0.001). One-hundred percent concordance was found for side-by-side and semi-tandem balance and 87.5–90.3% for tandem stances. No significant differences between remote and in-person assessments were found for weight, 8' timed walk, and 8' get-up-and-go. Remote anthropometric and physical performance assessments are reliable, valid, acceptable, and safe among cancer survivors and supportive partners. (1) Background: Anthropometric and physical performance testing is commonly done in lifestyle research and is traditionally performed in-person. To expand the scalability of lifestyle interventions among cancer survivors, in-person assessments were adapted to remote means and evaluated for feasibility, safety, validity, and reliability. (2) Methods: Cancer survivors and supportive partners were approached to participate in three anthropometric and physical performance testing sessions (two remote/one in-person). Correlations, concordance, and differences between testing modes were evaluated. (3) Results: 110-of-112 individuals approached for testing participated (98% uptake); the sample was 78% female, 64% non-Hispanic White, of mean age 58 years and body mass index = 32.4 kg/m2. ICCs for remote assessments ranged from moderate (8' walk = 0.47), to strong (8' get-up-and-go = 0.74), to very strong (30 s chair stand = 0.80; sit-and-reach = 0.86; 2 min step test = 0.87; back scratch = 0.90; weight = 0.93; waist circumference = 0.98) (p-values < 0.001). Perfect concordance (100%) was found for side-by-side and semi-tandem balance, and 87.5–90.3% for tandem balance. No significant differences between remote and in-person assessments were found for weight, 8' walk, and 8' get-up-and-go. No adverse events occurred and 75% indicated no preference or preferred virtual testing to in-person. (4) Conclusions: Remote anthropometric and physical performance assessments are reliable, valid, acceptable, and safe among cancer survivors and supportive partners. [ABSTRACT FROM AUTHOR]

Parkinson's disease medication treatment planning is generally based on subjective data obtained through clinical, physician-patient interactions. The Personal KinetiGraph™ (PKG) and similar wearable sensors have shown promise in enabling objective, continuous remote health monitoring for Parkinson's patients. In this proof-of-concept study, we propose to use objective sensor data from the PKG and apply machine learning to cluster patients based on levodopa regimens and response. The resulting clusters are then used to enhance treatment planning by providing improved initial treatment estimates to supplement a physician's initial assessment. We apply k-means clustering to a dataset of within-subject Parkinson's medication changes—clinically assessed by the MDS-Unified Parkinson's Disease Rating Scale-III (MDS-UPDRS-III) and the PKG sensor for movement staging. A random forest classification model was then used to predict patients' cluster allocation based on their respective demographic information, MDS-UPDRS-III scores, and PKG time-series data. Clinically relevant clusters were partitioned by levodopa dose, medication administration frequency, and total levodopa equivalent daily dose—with the PKG providing similar symptomatic assessments to physician MDS-UPDRS-III scores. A random forest classifier trained on demographic information, MDS-UPDRS-III scores, and PKG time-series data was able to accurately classify subjects of the two most demographically similar clusters with an accuracy of 86.9%, an F1 score of 90.7%, and an AUC of 0.871. A model that relied solely on demographic information and PKG time-series data provided the next best performance with an accuracy of 83.8%, an F1 score of 88.5%, and an AUC of 0.831, hence further enabling fully remote assessments. These computational methods demonstrate the feasibility of using sensor-based data to cluster patients based on their medication responses with further potential to assist with medication recommendations. [ABSTRACT FROM AUTHOR]

Since conventional screening tools for assessing frailty phenotypes are resource intensive and unsuitable for routine application, efforts are underway to simplify and shorten the frailty screening protocol by using sensor-based technologies. This study explores whether machine learning combined with frailty modeling could determine the least sensor-derived features required to identify physical frailty and three key frailty phenotypes (slowness, weakness, and exhaustion). Older participants (n = 102, age = 76.54 ± 7.72 years) were fitted with five wearable sensors and completed a five times sit-to-stand test. Seventeen sensor-derived features were extracted and used for optimal feature selection based on a machine learning technique combined with frailty modeling. Mean of hip angular velocity range (indicator of slowness), mean of vertical power range (indicator of weakness), and coefficient of variation of vertical power range (indicator of exhaustion) were selected as the optimal features. A frailty model with the three optimal features had an area under the curve of 85.20%, a sensitivity of 82.70%, and a specificity of 71.09%. This study suggests that the three sensor-derived features could be used as digital biomarkers of physical frailty and phenotypes of slowness, weakness, and exhaustion. Our findings could facilitate future design of low-cost sensor-based technologies for remote physical frailty assessments via telemedicine. [ABSTRACT FROM AUTHOR]