ObjectiveDuring the COVID-19 pandemic, many research studies were adapted, including
our longitudinal study examining cognitive impairment (CI) in systemic lupus
erythematosus (SLE). Cognitive testing was switched from in-person to
virtual. This analysis aimed to determine if the administration method
(in-person vs. virtual) of the ACR-neuropsychological battery (ACR-NB)
affected participant cognitive performance and classification.MethodsData from our multi-visit, SLE CI study included demographic, clinical, and
psychiatric characteristics, and the modified ACR-NB. Three analyses were
undertaken for cognitive performance: (1) all visits, (2) non-CI group
visits only and (3) intra-individual comparisons. A retrospective
preferences questionnaire was given to participants who completed the ACR-NB
both in-person and virtually.ResultsWe analysed 328 SLE participants who had 801 visits (696 in-person and 105
virtual). Demographic, clinical, and psychiatric characteristics were
comparable except for ethnicity, anxiety and disease-related damage. Across
all three comparisons, six tests were consistently statistically
significantly different. CI classification changed in 11/71 (15%)
participants. 45% of participants preferred the virtual administration
method and 33% preferred in-person.ConclusionsOf the 19 tests in the ACR-NB, we identified one or more problems with eight
(42%) tests when moving from in-person to virtual administration. As the use
of virtual cognitive testing will likely increase, these issues need to be
addressed – potentially by validating a virtual version of the ACR-NB. Until
then, caution must be taken when directly comparing virtual to in-person
test results. If future studies use a mixed administration approach, this
should be accounted for during analysis.