Article Text

Protocol
Remote cognitive assessment of older adults in rural areas by telemedicine and automatic speech and video analysis: protocol for a cross-over feasibility study
  1. Alexandra König1,2,
  2. Radia Zeghari2,
  3. Rachid Guerchouche1,2,
  4. Minh Duc Tran1,
  5. François Bremond1,
  6. Nicklas Linz3,
  7. Hali Lindsay4,
  8. Kai Langel5,
  9. Inez Ramakers6,
  10. Pascale Lemoine7,
  11. Vincent Bultingaire7,
  12. Philippe Robert2
  1. 1 STARS Team, Institut National de Recherche en Informatique et en Automatique Centre de Recherche Sophia Antipolis Méditerranée, Sophia Antipolis, France
  2. 2 Cobtek (Cognition-Behaviour-Technology) Lab, FRIS, Universite Cote d'Azur, Nice, France
  3. 3 German Research Centre for Artificial Intelligence Saarbrucken Branch, Saarbrucken, Germany
  4. 4 Deutsches Forschungszentrum fur Kunstliche Intelligenz GmbH Standort Saarbrucken, Saarbrucken, Germany
  5. 5 Janssen Healthcare Innovation, Beerse, Belgium
  6. 6 Maastricht University, Maastricht, The Netherlands
  7. 7 Centre Hospitalier de Digne-les-Bains, Digne-les-Bains, France
  1. Correspondence to Dr Alexandra König; alexandra.konig{at}inria.fr

Abstract

Introduction Early detection of cognitive impairments is crucial for the successful implementation of preventive strategies. However, in rural isolated areas or so-called ‘medical deserts’, access to diagnosis and care is very limited. With the current pandemic crisis, now even more than ever, remote solutions such as telemedicine platforms represent great potential and can help to overcome this barrier. Moreover, current advances made in voice and image analysis can help overcome the barrier of physical distance by providing additional information on a patients’ emotional and cognitive state. Therefore, the aim of this study is to evaluate the feasibility and reliability of a videoconference system for remote cognitive testing empowered by automatic speech and video analysis.

Methods and analysis 60 participants (aged 55 and older) with and without cognitive impairment will be recruited. A complete neuropsychological assessment including a short clinical interview will be administered in two conditions, once by telemedicine and once by face-to-face. The order of administration procedure will be counterbalanced so half of the sample starts with the videoconference condition and the other half with the face-to-face condition. Acceptability and user experience will be assessed among participants and clinicians in a qualitative and quantitative manner. Speech and video features will be extracted and analysed to obtain additional information on mood and engagement levels. In a subgroup, measurements of stress indicators such as heart rate and skin conductance will be compared.

Ethics and dissemination The procedures are not invasive and there are no expected risks or burdens to participants. All participants will be informed that this is an observational study and their consent taken prior to the experiment. Demonstration of the effectiveness of such technology makes it possible to diffuse its use across all rural areas (‘medical deserts’) and thus, to improve the early diagnosis of neurodegenerative pathologies, while providing data crucial for basic research. Results from this study will be published in peer-reviewed journals.

  • telemedicine
  • dementia
  • old age psychiatry
  • health informatics
  • clinical trials
http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors Conceptualisation: AK, RZ, RG, KL, IHGBR, PR; methodology: RZ, AK, IHGBR; software: RG, MDT, FB; validation: RZ, AK, PL, VB; formal analysis: NL, HL, RZ; investigation: RZ, AK, PL, VB; resources: PR, PL, VB; data curation: RG, FB, MDT; writing—original draft preparation: AK, RZ, RG; visualisation: RZ, RG; supervision: PR, FB; project administration: AK, FB; funding acquisition: FB, PR. All authors have read and agreed to the published version of the manuscript.

  • Funding This work is supported by the European Institute for Innovation and Technology (EIT)—Health, grant number 19249.

  • Competing interests We have read and understood BMJ policy on declaration of interests. NL is an employee and shareholder of ki elements UG.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.