Scoring written material from the Mini-Mental State Examination: a comparison of face-to-face, fax and video-linked scoring.

We assessed the reliability of scoring written items of the Mini-Mental State Examination (MMSE) using different communication modes: face to face, fax and videoconferencing. A total of 99 MMSEs were recovered from the records of a community mental health team for the elderly. The written parts of the examination (sentence and pentagrams) were scored--in person, using a faxed copy or over the video-link--according to published criteria. Relative to in-person scoring, sentences could be scored reliably when faxed (kappa = 0.80), as could pentagrams (kappa = 0.71). Sentences could be reliably scored over the videoconferencing link (kappa = 0.70), but pentagrams could not (kappa = 0.47). Caution is required before accepting the results of scoring such tests over video-links.