Comparison of the Tele‐Oxford Cognitive Screen to a neuropsychological battery in chronic stroke survivors

TL;DR

This study evaluates a remote cognitive screening tool for stroke survivors, finding it valid and specific for detecting cognitive changes.

Contribution

The study introduces the Tele-OCS as a stroke-specific remote cognitive screening tool with validated performance.

Findings

The Tele-OCS subtasks showed good convergent and divergent validity against neuropsychological tests.

All subtasks had excellent specificity (minimum 80%) but lower sensitivity compared to traditional assessments.

The Tele-OCS reliably measures distinct cognitive domains in stroke survivors.

Abstract

Following an increased need for remote cognitive screening solutions, we aimed to investigate the construct validity and determine initial sensitivity/specificity estimates of the Tele‐OCS, a stroke‐specific remotely administered cognitive screening tool. To this end, a secondary data analysis is presented from 98 stroke survivors from the OX‐CHRONIC longitudinal study (average 4.5 years. post‐stroke). Convergent validity was examined for overall Tele‐OCS performance against MoCA total score, and separately for each of the subtasks against matched neuropsychological tasks. Divergent validity was examined against different neuropsychological tests and presumed to be unrelated self‐reported anxiety, as measured with HADS‐A. Overall, we found that the Tele‐OCS subtasks had good convergent/divergent validity. All subtasks also showed excellent specificity (min 80%), and whilst the cancellation task also showed good sensitivity (80%), all other subtasks came at a cost of lower sensitivity, compared to a more sensitive neuropsychological assessment. The Tele‐OCS provides a brief, remote, first‐line cognitive screening tool that reliably detects cognitive changes where these are clearly present, specifically and validly measuring distinct cognitive domains, which contrasts with a domain‐general cognitive screening approach.