Operationalising treatment success in aphasia rehabilitation

Breitenstein, Caterina; Hilari, Katerina; Menahemi-Falkov, Maya; Rose, Miranda; Wallace, Sarah; Brady, Marian C.; Hillis, Argye E.; Kıran, Swathi; Szaflarski, Jerzy P.; Tippett, Donna C.; Visch-Brink, Evy; Hinckeldey, Klaus Willmes-von

doi:10.1080/02687038.2021.2016594

Cited by 22 publications

(19 citation statements)

References 142 publications

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“…The German version of the questionnaire (or specific items of it) could serve as a self‐reported outcome measure and as an independent external anchor to which the results of performance‐based outcome measures could be related to when defining their minimal important change value. This development of ‘Minimal Important Change benchmarks […] should be a key research endeavour’ (Breitenstein et al., 2022, p. 25).…”

Section: Discussionmentioning

confidence: 99%

Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire—German version

Thumbeck

Webster

Domahs

2023

Intl J Lang & Comm Disor

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BackgroundReading comprehension is frequently impaired in persons with aphasia (PWA). For goal‐setting and outcome measurement, speech and language therapists (SLTs) need to determine an individual's perspective of their reading difficulties and everyday reading activities. The Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire provides a person‐centred tool to find out the individual perception of reading functions, reading‐related emotions and reading activities in PWA. It was developed and evaluated in English. So far, there is no equivalent instrument in German.AimsTo translate and adapt the CARA reading questionnaire into German language and culture, to evaluate its practicability and acceptance, and to provide the first psychometric properties of the German version.Methods & ProceduresBased on translation and adaptation guidelines, we conducted two forward translations that were merged and then adapted. A back translation was prepared and compared with the original version. It was found to be semantically equivalent by one of the authors of the original version. We performed pilot testing with 12 PWA, and the pilot version was adapted according to the comments of these participants. We then collected data on self‐reported perception of reading and on psychometric properties of the translated and adapted German version. A total of 22 German‐speaking PWA completed the questionnaire at least five times during an intervention study. We analysed retest reliability with Spearman correlation, internal consistency with Cronbach's alpha, internal responsiveness with the standardized response mean, as well as the relationship between outcomes of the questionnaire and text comprehension measures using repeated measures correlations.Outcomes & ResultsOur data suggest good practicability and acceptance of the German version of the CARA reading questionnaire as well as appropriate validity, reliability and sensitivity to measure therapy‐induced change. We found moderate correlations between outcomes of the questionnaire and text‐level reading speed.Conclusions & ImplicationsThe German version of the CARA reading questionnaire could be helpful in intervention planning and goal‐setting with German‐speaking PWA. By using the questionnaire, SLTs can find out about a person's individual perception of reading difficulties as well as individually relevant reading activities. The questionnaire provides a tool to measure change and is therefore valuable to demonstrate self‐reported individual progress. As reading speed seems to be an indicator of personal perception of reading difficulty, it is important to consider reading speed in reading interventions and in reading comprehension assessments.WHAT THIS PAPER ADDSWhat is already known on the subject Reading comprehension is frequently impaired in PWA. Reading preferences, the perception of difficulties and the impact on everyday life reading activities are specific to the individual and thus need to be known for goal‐setting, intervention planning and monitoring of change. As part of a comprehensive assessment of reading, Morris et al. developed a person‐centred English language questionnaire for this purpose. So far, there is no equivalent tool in German.What this paper adds to the existing knowledge In this study, we translated and adapted the questionnaire to German language and culture, and analysed its validity and reliability with German‐speaking PWA. We demonstrated that the German version is accessible for German‐speaking PWA, and that it has appropriate validity, reliability and sensitivity to measure self‐reported change. Outcomes of the questionnaire correlate with text level reading speed.What are the potential or actual clinical implications of this work? The German version of the questionnaire could be a valuable self‐reported outcome measure to assess individual perceptions of reading and to measure progress (as perceived by an individual) as a consequence of recovery or intervention in either clinical or research settings. As reading speed might be an indicator of everyday life reading as perceived by an individual, it should be considered in reading assessments and interventions.

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Section: Discussionmentioning

confidence: 99%

Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire—German version

Thumbeck

Webster

Domahs

2023

Intl J Lang & Comm Disor

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“…Sharing the latest aphasia research • Standardizing terminology, 28,29 assessments, [30][31][32] and intervention reporting [33][34][35] • International consensus tutorials aiming to advance aphasia study designs 23,24,35,36 • International consensus on aphasia research agenda 37 • International consensus on cross-linguistic adaptations of outcome measurement instruments 32 Advancing the research involvement of people living with aphasia…”

Section: Knowledgementioning

confidence: 99%

“…• Cross-national systematic reviews, [15][16][17][18] observational, 19 and clinical [20][21][22] trials • Cross-national special journal issues (https://www.tandfonline.com/toc/paph20/36/4), article series, 23,24 or projects (https://www.aphasiatrials.org/wp-content/uploads/2023/10/10-year-report-for-CATs-final-10th-Oct-2023.pdf) [25][26][27] on aphasia-related topics • Cross-national research funding (list in Supplemental Material)…”

Section: Research Collaborationmentioning

confidence: 99%

“…Together with the CATs Chair and Deputy Chair, the 14 working group (Deputy) Leads and 6 Officers form the Executive Committee, which have been meeting quarterly over the past 10 years, bearing testament to members’ commitment for enhancing aphasia research quality and the careers of ESRs/JSRs in aphasia rehabilitation. Projects developed collaboratively, with participation of ESRs/JSRs, secured external funding of the equivalent of >10 million US$ to date and CATs collaborations have inspired >50 peer-reviewed publications, including in general medicine/stroke journals (see References 7–55 , and the 2023 CATs report [https://www.aphasiatrials.org/wp-content/uploads/2023/10/10-year-report-for-CATs-final-10th-Oct-2023.pdf]). The latest testimony to the success of the collaboration is that CATs is the recipient of the international Robin Tavistock Award 2023 (https://aphasiatavistocktrust.org/robin-tavistock-award/).…”

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confidence: 99%

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Invaluable Benefits of 10 Years of the International Collaboration of Aphasia Trialists (CATs)

Breitenstein,

Wallace,

Gilmore

et al. 2024

Stroke

Self Cite

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Aphasia research has traditionally been considered a (unidisciplinary) niche topic in medical science. The international Collaboration of Aphasia Trialists (CATs) is a global collaboration of multidisciplinary aphasia researchers. Over the past 10 years, CATs has collectively taken a rigorous approach to systematically address persistent challenges to aphasia research quality. This article summarizes the achievements over the past decade. CATs’ achievements include: standardizing terminology, advancing aphasia research design by aphasia expert consensus recommendations, developing a core data set and intervention descriptors, facilitating the involvement of people with the language impairment aphasia in the research process, translating, and adapting assessment tools into global languages, encouraging data sharing, developing innovative secondary data analysis methodologies and promoting the transparency and accessibility of high quality aphasia research reports. CATs’ educational and scientific achievements over the past 10 years far exceed what individual researchers in the field could have ever achieved.

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“…Bayesian models, for both individual participants and groups, are often well-suited to smaller sample sizes and recommended for convergence and fit challenges in frequentist mixed-effects models (Bates et al, 2015). Bayesian models for groups of participants readily provide estimates of effect sizes and associated credible intervals for individuals, which allows researchers not only to establish whether a treatment worked on average, but also to identify the number of participants for whom there is reliable evidence of a treatment effect -a critical need for future aphasia research (Breitenstein et al, 2022).…”

Section: Generalized Linear Mixed-effects Modelsmentioning

confidence: 99%

Reproducibility in Small- N Treatment Research: A Tutorial Using Examples From Aphasiology

Cavanaugh

Quique

Swiderski

et al. 2023

J Speech Lang Hear Res

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Purpose: Small- N studies are the dominant study design supporting evidence-based interventions in communication science and disorders, including treatments for aphasia and related disorders. However, there is little guidance for conducting reproducible analyses or selecting appropriate effect sizes in small- N studies, which has implications for scientific review, rigor, and replication. This tutorial aims to (a) demonstrate how to conduct reproducible analyses using effect sizes common to research in aphasia and related disorders and (b) provide a conceptual discussion to improve the reader's understanding of these effect sizes. Method: We provide a tutorial on reproducible analyses of small- N designs in the statistical programming language R using published data from Wambaugh et al. (2017). In addition, we discuss the strengths, weaknesses, reporting requirements, and impact of experimental design decisions on effect sizes common to this body of research. Results: Reproducible code demonstrates implementation and comparison of within-case standardized mean difference, proportion of maximal gain, tau-U, and frequentist and Bayesian mixed-effects models. Data, code, and an interactive web application are available as a resource for researchers, clinicians, and students. Conclusions: Pursuing reproducible research is key to promoting transparency in small- N treatment research. Researchers and clinicians must understand the properties of common effect size measures to make informed decisions in order to select ideal effect size measures and act as informed consumers of small- N studies. Together, a commitment to reproducibility and a keen understanding of effect sizes can improve the scientific rigor and synthesis of the evidence supporting clinical services in aphasiology and in communication sciences and disorders more broadly. Supplemental Material and Open Science Form: https://doi.org/10.23641/asha.21699476

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Operationalising treatment success in aphasia rehabilitation

Abstract: This paper is part of a special series of papers in Aphasiology on Methodological Issues in Aphasia Trials. The series comprises tutorial-type papers with core recommendations for aphasia intervention studies and randomised controlled trials. The series is guest edited

Cited by 22 publications

References 142 publications

Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire—German version

Comprehensive Assessment of Reading in Aphasia (CARA) reading questionnaire—German version

Invaluable Benefits of 10 Years of the International Collaboration of Aphasia Trialists (CATs)

Reproducibility in Small- N Treatment Research: A Tutorial Using Examples From Aphasiology

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