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The following is a summary of “ALS Motor Observational Telemedicine Objective Rasch-Built Assessment,” published in the January 2025 issue of Neurology by Fournier et al. 

Telemedicine is now central to ALS care, but a standardized method for tracking neurologic changes remotely is lacking. 

Researchers conducted a retrospective study to develop a standardized telemedicine-based motor examination scale for tracking ALS progression. Rasch methodology was used to validate the scale and enhance its psychometric properties. 

They developed a 25-item telemedicine examination scale assessing movement in bulbar muscles, neck, trunk, and extremities, with input from an ALS expert panel and patient advisors. The study, approved by the Emory IRB, involved adults with ALS capable of undergoing a video telemedicine evaluation. Rasch analyses optimized item responses and scoring. Test-retest reliability was assessed with 2 separate examinations by different examiners within 7 days. Construct validity was evaluated by correlating with the rasch-built overall ALS disability scale (ROADS) and revised ALS functional rating scale (ALSFRS-R). 

The results showed that 258 PALS were assessed using the ALS Motor Observational Telemedicine Objective Rasch-built assessment. After Rasch analyses, 3 items were removed, and 8 items had consolidated response categories. The final 22-item ALS MOTOR scale met Rasch model criteria. Inter-rater reliability was 95%. The ALS MOTOR had a 0.78 (95% CI 0.72–0.83) correlation with ALSFRS-R and 0.81 (95% CI 0.76–0.85) correlation with ROADS. 

Investigators developed the ALS MOTOR as a reliable tool for remote ALS progression tracking in clinical care and research. Rasch methodology optimized its psychometric properties, with ongoing longitudinal and external validation studies. 

Source: neurology.org/doi/10.1212/CPJ.0000000000200432