A Feasibility Study Involving Recruitment and Screening for Aphasia in Acute Stroke: Emerging Viability of the English Adaptation of the Language Screening Test (LASTen)

Abstract

Objectives We describe recruitment feasibility for language screening in acute stroke using the English adaptation the Language Screening Test (LASTen), originally developed in French. We also elucidate preliminary measurement properties of LASTen in patients with and without aphasia. Design Prospective eligibility tracking, recruitment, and screening for aphasia using the 2 parallel forms, LASTen-A and LASTen-B. Setting The Neurovascular Unit and the Transient Ischemic Attack and Minor Stroke Unit of a tertiary care hospital. Participants Stroke patients (N=12) with hyperacute to subacute stroke. Interventions Not applicable Main Outcome Measures Numbers of eligible patients and recruitment viability, individual performance indicators for both LASTen versions (15 points each) in 12 patients grouped by aphasia status, and reliability of the 2 parallel forms. Results There were 25 eligible stroke patients over 1 month. All 12 recruited patients consented to testing. The patients ranged in age from 29 to 85 years, and 5 were women. Three patients had intracerebral hemorrhage, and 6 had aphasia (mild to severe). The median LASTen scores in patients with and without aphasia were 10 (interquartile range, 8) and 15 (interquartile range, 0), respectively. Five patients had discrepant scores across versions involving a 1-point difference. One patient with aphasia had a 5-point difference, demonstrating improvement on the second version. The Pearson correlation coefficient was 0.95 for parallel form reliability. Conclusions Our study confirmed that LASTen appears to function as designed. There was score heterogeneity for patients with aphasia and desired ceiling effects for those without aphasia, alongside excellent parallel form reliability. The findings provide the impetus for a large-scale diagnostic accuracy trial in acute stroke patients.