Validation of a New Language Screening Tool for Patients With Acute Stroke

Flamand-Roze, Constance; Falissard, Bruno; Roze, Emmanuel; Maintigneux, Lisa; Beziz, Jonathan; Chacon, Audrey; Join-Lambert, Claire; Adams, David C.; Denier, Christian

doi:10.1161/strokeaha.110.609503

Cited by 117 publications

(149 citation statements)

References 36 publications

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“…Neste contexto, surgiram alguns testes de cabeceira de aplicação rápida, mas cuja capacidade para servir de instrumento de monitorização de evolução clínica é limitada ou não foi estudada. [6][7][8] A gravidade dos défices neurológicos no contexto do AVC é atualmente quantificada por rotina pela National Institute of Health Stroke Scale (NIHSS). 9 Esta escala de cabeceira é rápida, simples e reprodutível.…”

Section: Introductionunclassified

Aphasia Rapid Test: Estudos de Tradução, Adaptação e Validação para a População Portuguesa

et al. 2018

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RESUMOIntrodução: As baterias clássicas de caracterização de afasia são demasiado longas para serem utilizadas no contexto do acidente vascular cerebral agudo ou como ferramenta de monitorização. O Aphasia Rapid Test é uma escala de 26 pontos desenvolvida como teste de cabeceira para avaliar a gravidade da afasia num doente com acidente vascular cerebral em menos de três minutos. O objetivo do estudo é adaptar e validar a escala para o português europeu. ABSTRACT Introduction: Classical aphasia evaluation scales are too long to use in the context of acute stroke or as a monitoring tool. The Aphasia Rapid Test is a 26-point scale developed as a bedside assessment to rate aphasia severity in acute stroke patients in less than 3 minutes. We aimed to adapt and validate this scale for European Portuguese. Material and Methods:We evaluated 56 acute stroke patients in the first and in the seventh days post-stroke. In the seventh day, patients were evaluated by two independent raters, to evaluate inter-rater agreement. To study concurrent validity, the Lisbon Aphasia Examination Battery was applied to a subset of 20 patients. The predictive ability of the Aphasia Rapid Test was assessed at six months, by the aphasia subscale of the National Institutes of Health Stroke Scale. Results: Translation to European Portuguese was based in the French and English versions, considering the words' utilization frequency. The Chronbach's alpha was 0.796. The concordance coefficient between the two raters was excellent (0.985). Correlation between Aphasia Rapid Test and the Lisbon Aphasia Examination Battery was strong (r = -0.958, p < 0.001). The study through BlandAltman graphs corroborated the good inter-rater agreement and concurrent validity of the test. The Aphasia Rapid Test score in the first day is an independent predictor of long-term outcome. Discussion: This study provides reliable results for European Portuguese, with adequate internal consistency, inter-rater agreement and concurrent validity. Conclusion:The Aphasia Rapid Test is a good tool for the evaluation and monitoring of aphasia in stroke patients.

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Section: Introductionunclassified

Aphasia Rapid Test: Estudos de Tradução, Adaptação e Validação para a População Portuguesa

et al. 2018

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“…Patients characteristics including age, gender, history of hypertension, diabetes mellitus, smoking, time from symptom onset to initiation of therapy, stroke signs and severity based on NIHSS and language screening test (LAST) scores (from 0 = global aphasia to 15 = no aphasia; median time to complete LAST: 124 s) [24] , involved vascular territories, and etiologies were routinely entered in our prospective registries. According to LAST testing, aphasia was classified as 'global', 'sensory' (or receptive aphasia/fluent/Wernicke's), 'motor' (as Broca's), 'anomic', 'transcortical motor', 'transcortical sensory', 'transcortical mixed' and 'conduction'.…”

Section: Patients Materials and Methodsmentioning

confidence: 99%

“…Functional recovery was evaluated using NIHSS components, LAST [24] and 'language composite score' at baseline, H24, and day 7 (D7) after stroke onset.…”

Section: Patients Materials and Methodsmentioning

confidence: 99%

Thrombolysis in Stroke Patients with Isolated Aphasia

Denier

Chassin²,

Vandendries³

et al. 2016

Cerebrovasc Dis

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Background: Data about evolution of aphasia following stroke are rare and controversial especially following fibrinolysis. The aim of this study was to describe the early clinical patterns of isolated aphasia in consecutive stroke patients with or without thrombolysis. Methods: Clinical and radiological data of consecutive stroke patients were routinely entered in prospective registry. Patients were considered aphasic when NIHSS (National Institutes of Health Stroke Scale) item 9 >0. ‘Isolated aphasia' was defined by aphasic patients without motor limb deficit. We created a ‘composite language score' obtained by summing the NIHSS items 1b, 1c and 9, which reflects language-processing ability. Recovery of functions was evaluated as measured by global NIHSS, composite language score and language screening test (LAST) at baseline, H24 and day 7 (D7). ‘Mild deficit' was defined as global NIHSS <5. Results: A total of 100 consecutive patients met study criteria for isolated aphasia. Twenty-five underwent thrombolysis and 75 did not. There was no difference between the 2 groups concerning demographic characteristics, involved territories and presence of arterial occlusion, initial median NIHSS, composite language and LAST scores at entrance. Evolution was significantly better in thrombolysed patient for the 3 testings: NIHSS, composite language score and LAST at D7 (respective p = 0.0002; p = 0.01 and p = 0.004). Similar results were found when we focused on the subgroups of patients with initial ‘mild' deficits (p = 0.01; p = 0.0003 and p = 0.007). No symptomatic hemorrhagic transformation occurred following thrombolysis. Conclusion: These data strongly suggest that thrombolysis is safe and effective in patients with ‘isolated aphasia,' even if the global NIHSS score is <5.

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“…12,19,21,[23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] The various items of these scales were submitted to 5 stroke neurologists (A.D.S., J.D.K., R.B., R.-J.V.H., and S.D.R. ), 2 neurolinguistic experts (P.M. and P.P.…”

Section: Scale Developmentmentioning

confidence: 99%

Unassisted Assessment of Stroke Severity Using Telemedicine

Hooff

Smedt

Raedt

et al. 2013

Stroke

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This prospective monocentric study was approved by the Medical Ethics Committee of the Universitair Ziekenhuis Brussel. Patients were recruited over an 8-week period at the Stroke Unit and at the Emergency Department of the Universitair Ziekenhuis Brussel. Patients with unstable vital functions and those for whom telestroke examination would delay any diagnostic or therapeutic intervention were excluded. All patients or their proxy gave written informed consent before the evaluation. Patient characteristics of the study corpus of 45 subjects with suspicion of acute stroke are described in the online-only Data Supplement (Table I).Background and Purpose-Quantification of stroke severity through telemedicine consultation is challenging and relies on professional support at the patient's bedside. We aimed to develop a novel scale for assessing stroke severity through telemedicine without assistance from a third party (Unassisted TeleStroke Scale [UTSS]). Methods-Stroke severity was assessed in 45 patients with suspicion of acute stroke by bedside examination using the National Institutes of Health Stroke Scale (NIHSS) and by teleconsultation using the UTSS. Scale reliability was evaluated by intrarater and interrater variability, internal consistency, and rater agreement. Concurrent and predictive validity were tested by relating the UTSS with the NIHSS and long-term outcome (modified Rankin Scale and mortality at 6 months). Clinimetric analysis of the UTSS was obtained via the Rasch model. Results-The mean examination time for the UTSS was 3.1 minutes (SD, 1.1) versus 8.5 minutes for the NIHSS (SD, 2.6; P<0.001). Both UTSS and NIHSS showed excellent intrarater variability (r=0.97 and 0.98; P<0.001) and interrater variability (r=0.96 and 0.98; P<0.001), as well as excellent internal consistency and rater agreement. The UTSS correlated strongly with the NIHSS and was identified as an independent predictor of stroke outcome in logistic regression analysis. Rasch analysis indicated that the UTSS represents a unidimensional scale of stroke severity. Conclusions-The UTSS is a rapid, reliable, and valid tool for unassisted assessment of stroke severity through telemedicine. (Stroke. 2013;44:1249-1255.)

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Validation of a New Language Screening Tool for Patients With Acute Stroke

Cited by 117 publications

References 36 publications

Aphasia Rapid Test: Estudos de Tradução, Adaptação e Validação para a População Portuguesa

Aphasia Rapid Test: Estudos de Tradução, Adaptação e Validação para a População Portuguesa

Thrombolysis in Stroke Patients with Isolated Aphasia

Unassisted Assessment of Stroke Severity Using Telemedicine

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