The agreement between face-to-face and tele-assessment of ataxia severity scales in multiple sclerosis patients with ataxia


Ozvar Senoz G. B., AYVAT F., AYVAT E., KILINÇ M.

Journal of Telemedicine and Telecare, vol.32, no.5, pp.479-490, 2026 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 32 Issue: 5
  • Publication Date: 2026
  • Doi Number: 10.1177/1357633x251369245
  • Journal Name: Journal of Telemedicine and Telecare
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, INSPEC, MEDLINE, Psycinfo, Public Affairs Index
  • Page Numbers: pp.479-490
  • Keywords: ataxia, International Cooperative Ataxia Rating Scale (ICARS), Multiple sclerosis, Scale for the Assessment and Rating of Ataxia (SARA), tele-assessment, telehealth
  • Hacettepe University Affiliated: Yes

Abstract

Background: Tele-assessments are becoming increasingly important to increase access to healthcare services and facilitate patient follow-up. Whether they can provide results with similar accuracy to face-to-face assessments remains relevant. Objective: The aim of this study was to compare the face-to-face and tele-assessment scores of the International Cooperative Ataxia Rating Scale (ICARS) and Assessment and Rating of Ataxia (SARA) in ataxic MS patients and to examine their suitability for tele-assessment. Methods: The participants were assessed both online and face-to-face. Randomization determined which method would be used first to assess the participants. ICARS and SARA were used in the assessments. Face-to-face assessments were conducted as part of routine clinical practice by one researcher, while teleassessments were performed via real-time video by two different researchers. The video was recorded and reassessed one week later. The agreement and correlation between face-to-face and teleassessments were analyzed using intra-class correlation coefficients (ICC), Bland–Altman Plots, and Pearson's/Spearman's correlation coefficients. Results: This study included 20 patients with ataxic MS with an EDSS score of 3.6 ± 0.66. The inter-rater reliability of tele-assessments (ICCICARS = 0.97; ICCSARA = 0.97) achieved excellent reliability. Intra-rater reliability of the tele-assessment was excellent (ICCICARS = 0.99; ICCSARA = 0.99). High correlations were observed in ICARS and SARA scores between face-to-face and tele-assessment methods according to assessors (r > .80 for all). Conclusion: ICARS and SARA are reliable and agreed-upon tests that can be used with tele-assessments, offering similar data to face-to-face methods.