The Scale for Assessment and Rating of Ataxia Is Reliable and Valid in the Telehealth Setting for Patients with Cerebellar Ataxia

Abstract

Abstract Objective Health care has increasingly expanded into a hybrid in-person/telehealth model. Patients with a variety of health conditions, including cerebellar ataxia, have received virtual health evaluations; however, it remains unknown whether some outcome measures clinicians utilize in the telehealth setting are reliable and valid. The goal of this project is to evaluate the psychometric properties of the Scale for Assessment and Rating of Ataxia (SARA) for patients with cerebellar ataxia in the telehealth setting. Methods Nineteen individuals with cerebellar impairments were recruited on a voluntary basis. Participants completed two 30-minute testing sessions during which a clinical examination and the SARA were performed. One session was performed in person and the other session was assessed remotely. Outcome measure performance was video recorded in both environments and independently scored by 4 additional raters with varying levels of clinical experience (ranging from 6 months to 29 years). Concurrent validity was assessed with the Spearman rank order correlation coefficient (α < .05), comparing the virtual SARA scores to their gold standard in-person scores. Interrater reliability was evaluated with the ICC(2,4) (α < .05). Results Fourteen of the 19 participants completed both in-person and telehealth SARA evaluations. We found that the in-person SARA and the telehealth SARA have large concurrent validity (Spearman rho significant at the 2-tailed α of .01 = 0.90; n = 14). Additionally, raters of varying years of experience had excellent interrater reliability for both the in-person SARA [ICC(2,4) = 0.97; n = 19] and the telehealth SARA [ICC(2,4) = 0.98; n = 14]. Conclusion Our results show that the telehealth SARA is comparable to the in-person SARA. Additionally, raters of varying years of clinical experience were found to have excellent interrater reliability scores for both remote and in-person SARA evaluations. Impact Our study shows that the SARA can be used in the telehealth setting for patients with ataxia.