Interim Treatment Fidelity for a Randomized Controlled Comparative Effectiveness Trial of Two Variants of Semantic Feature Analysis Treatment for Aphasia.

IF 2.3 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Miranda C Babiak, William D Hula, Alyssa Autenreith, Mary M Nader, Shannon Austermann Hula, Alexander Swiderski, Robert Cavanaugh, Kristen Nunn, Jeffrey P Johnson, Michael Walsh Dickey
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Abstract

Purpose: This study evaluated treatment fidelity for an ongoing randomized controlled trial comparing two variants of semantic feature analysis (SFA) treatment for naming impairment in aphasia. In this trial, participants are being randomized to treatment conditions (many- or few-features) in which they are asked to generate either 11 or five features per SFA trial.

Method: Treatment fidelity was addressed via study design, manualization of the treatment, provider training, and maintenance of daily treatment logs, among other approaches. Fidelity was assessed through protocol adherence checks, interrater reliability of feature counting, and analysis of treatment dosage. Protocol adherence was measured using a 20-item checklist. Interrater reliability was evaluated for feature counts on 10% of treatment sessions. Treatment dosage was analyzed to confirm differentiation between many-features and few-features groups in terms of features generated and exposed and equivalence in terms of total treatment time.

Results: Overall protocol adherence was 99%. Interrater reliability for feature counting showed good-to-excellent agreement. Analysis of treatment dosage in terms of features per trial confirmed clear differentiation between groups, with the many-features group generating or being exposed to approximately 10-11 features per trial compared to four to five features for the few-features group. Analysis of other aspects of dosage also suggested good fidelity to the design.

Conclusions: This ongoing trial of SFA is being implemented with high levels of treatment fidelity. The study demonstrates the importance and feasibility of comprehensive fidelity monitoring in aphasia treatment research. Detailed fidelity procedures and outcomes support interpretation, replication, and clinical implementation of study findings.

Supplemental material: https://doi.org/10.23641/asha.29230937.

语义特征分析两种变体治疗失语症的随机对照疗效比较试验的中期治疗保真度。
目的:本研究评估了一项正在进行的随机对照试验的治疗保真度,该试验比较了语义特征分析(SFA)治疗失语症命名障碍的两种变体。在这项试验中,参与者被随机分配到治疗条件(多特征或少特征)中,他们被要求在每次SFA试验中产生11个或5个特征。方法:通过研究设计、治疗的手工化、提供者培训和日常治疗日志的维护等方法来解决治疗保真度问题。通过方案依从性检查、特征计数的相互可靠性和治疗剂量分析来评估保真度。使用20项检查表来测量方案依从性。在10%的疗程中对特征计数进行评估。对治疗剂量进行分析,确认多特征组和少特征组在产生和暴露特征方面存在差异,在总治疗时间方面存在等效性。结果:总体方案依从性为99%。特征计数的判读信度表现出良好到极好的一致性。根据每次试验的特征对治疗剂量进行分析,证实了组间的明显差异,特征多的组每次试验产生或暴露于大约10-11个特征,而特征少的组每次试验产生或暴露于大约4 - 5个特征。对剂量的其他方面的分析也表明该设计具有良好的保真度。结论:这项正在进行的SFA试验正在以高水平的治疗保真度实施。本研究证明了综合保真度监测在失语治疗研究中的重要性和可行性。详细的保真程序和结果支持研究结果的解释、复制和临床实施。补充资料:https://doi.org/10.23641/asha.29230937。
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来源期刊
American Journal of Speech-Language Pathology
American Journal of Speech-Language Pathology AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION
CiteScore
4.30
自引率
11.50%
发文量
353
审稿时长
>12 weeks
期刊介绍: Mission: AJSLP publishes peer-reviewed research and other scholarly articles on all aspects of clinical practice in speech-language pathology. The journal is an international outlet for clinical research pertaining to screening, detection, diagnosis, management, and outcomes of communication and swallowing disorders across the lifespan as well as the etiologies and characteristics of these disorders. Because of its clinical orientation, the journal disseminates research findings applicable to diverse aspects of clinical practice in speech-language pathology. AJSLP seeks to advance evidence-based practice by disseminating the results of new studies as well as providing a forum for critical reviews and meta-analyses of previously published work. Scope: The broad field of speech-language pathology, including aphasia; apraxia of speech and childhood apraxia of speech; aural rehabilitation; augmentative and alternative communication; cognitive impairment; craniofacial disorders; dysarthria; fluency disorders; language disorders in children; speech sound disorders; swallowing, dysphagia, and feeding disorders; and voice disorders.
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