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

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 4.5yrs 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 which 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.