Utilising accessible and reproducible neurological assessments in clinical studies: Insights from use of the Neurological Impairment Scale in the multi-centre COVID-CNS study

• Published in: Clinical medicine (London, England) Vol. 24; no. 5; pp. 100241 - 6
• Main Authors: Alam, Ali M., Webb, Glynn W., Collie, Ceryce, Mariathasan, Sashini, Huang, Yun, Hilton, Orla, Shil, Rajish, Dodd, Katherine C., Lilleker, James B., Smith, Craig J., Easton, Ava, Tamborska, Arina, Thomas, Rhys H., Davies, Nicholas W.S., Jenkins, Thomas M., Zandi, Michael, Benjamin, Laura, Ellul, Mark A., Solomon, Tom, Pollak, Thomas A., Nicholson, Tim, Breen, Gerome, van Wamelen, Daniel J., Wood, Nicholas W., Michael, Benedict D.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2024; Royal College of Physicians; Elsevier
• Subjects: Ataxia; Clinical study; COVID-19; COVID-19 - diagnosis; Humans; Infections; Nervous System Diseases - diagnosis; Neurologic Examination - methods; Neurologic Examination - standards; Neurological assessment; Neurology; Neurosciences; Outcome tool; Reproducibility of Results; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Severity of Illness Index; United Kingdom > UK; COVID-19; Neurology; Neurological assessment; Outcome tool; Clinical study
• ISSN: 1470-2118; 1473-4893
• DOI: 10.1016/j.clinme.2024.100241

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.