Clinical Medicine (Sep 2024)
Utilising accessible and reproducible neurological assessments in clinical studies: Insights from use of the Neurological Impairment Scale in the multi-centre COVID-CNS study
- Ali M. Alam,
- Glynn W. Webb,
- Ceryce Collie,
- Sashini Mariathasan,
- Yun Huang,
- Orla Hilton,
- Rajish Shil,
- Katherine C. Dodd,
- James B. Lilleker,
- Craig J. Smith,
- Ava Easton,
- Arina Tamborska,
- Rhys H. Thomas,
- Nicholas W.S. Davies,
- Thomas M. Jenkins,
- Michael Zandi,
- Laura Benjamin,
- Mark A. Ellul,
- Tom Solomon,
- Thomas A. Pollak,
- Tim Nicholson,
- Gerome Breen,
- Daniel J. van Wamelen,
- Nicholas W. Wood,
- Benedict D. Michael
Affiliations
- Ali M. Alam
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Glynn W. Webb
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Ceryce Collie
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Sashini Mariathasan
- National Hospital for Neurology and Neurosurgery, London, UK
- Yun Huang
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Orla Hilton
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Rajish Shil
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Katherine C. Dodd
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
- James B. Lilleker
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
- Craig J. Smith
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
- Ava Easton
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK; Encephalitis International, Malton, UK
- Arina Tamborska
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Rhys H. Thomas
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
- Nicholas W.S. Davies
- Department of Neurology, Charing Cross Hospital, London, UK
- Thomas M. Jenkins
- Sheffield Institute for Translational Neuroscience, University of Sheffield, UK
- Michael Zandi
- National Hospital for Neurology and Neurosurgery, London, UK
- Laura Benjamin
- National Hospital for Neurology and Neurosurgery, London, UK
- Mark A. Ellul
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK
- Tom Solomon
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK; The Pandemic Institute, Liverpool, UK
- Thomas A. Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Tim Nicholson
- Section of Cognitive Neuropsychiatry, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Gerome Breen
- Institute of Psychiatry, Psychology & Neuroscience; Social, Genetic & Developmental Psychiatry Centre, King's College London, London, UK
- Daniel J. van Wamelen
- Institute of Psychiatry, Psychology & Neuroscience, Department of Neuroimaging, King's College London, London, UK
- Nicholas W. Wood
- Department of Clinical and Movement Neurosciences, University College London, UCL Queen Square Institute of Neurology, London, UK
- Benedict D. Michael
- Infection Neuroscience Laboratory, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, NIHR HPRU for Emerging and Zoonotic Infection, Liverpool, UK; Corresponding author.
- Journal volume & issue
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Vol. 24,
no. 5
p. 100241
Abstract
Reproducible and standardised neurological assessment scales are important in quantifying research outcomes. These scales are often performed by non-neurologists and/or non-clinicians and must be robust, quantifiable, reproducible and comparable to a neurologist's assessment. COVID-CNS is a multi-centre study which utilised the Neurological Impairment Scale (NIS) as a core assessment tool in studying neurological outcomes following COVID-19 infection. We investigated the strengths and weaknesses of the NIS when used by non-neurology clinicians and non-clinicians, and compared performance to a structured neurological examination performed by a neurology clinician. Through our findings, we provide practical advice on how non-clinicians can be readily trained in conducting reproducible and standardised neurological assessments in a multi-centre study, as well as illustrating potential pitfalls of these tools.
