Adapting the Multiple Sclerosis Functional Composite for Telehealth Administration Using Videoconference Delivery: Methodological Considerations and Interrater Reliability.

The sample was small, with 61 participants, and was predominantly women and non-Hispanic white. Demographic data were missing for 2 participants. The study did not compare the tele-MSFC with the in-person MSFC or the EDSS, so concurrent validity was not established. Test-retest reliability was not measured, and the authors state the tele-MSFC should not be used as an endpoint in clinical trials until it is established. Many participants could not complete the 25-foot walk because of home space, fall risk, discomfort, or lack of a helper. The protocol was changed after the first 31 participants, which can make results harder to interpret across the whole sample. Doubling the 12.5-foot walk time to estimate the 25-foot time does not account for differences in gait initiation, termination, and acceleration. When the examiner played the PASAT recording, agreement between the examiner and raters was only moderate to good. Social desirability bias may have influenced feedback from examiners, raters, and participants. A caregiver or helper present during the test may have influenced walking results in inconsistent ways.

Do not read the excellent agreement among raters as proof that the tele-MSFC is equivalent to in-person MSFC testing. The study tested whether people could score the same video consistently and whether the process was feasible. It did not establish test-retest reliability or concurrent validity with the in-person MSFC and EDSS, and the authors state it should not be used as an endpoint in clinical trials.