The main concept analysis: Sensitivity, specificity and inter-rater reliability in Dutch-speaking people with aphasia

IF 1.8 3区医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY

Journal of Communication Disorders Pub Date : 2025-06-19 DOI:10.1016/j.jcomdis.2025.106543

Yana Criel , Evelien De Groote , Evelyne Benbassat , Britt Beirinckx , Megan Van Damme , Anthony Pak-Hin Kong , Miet De Letter

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引用次数: 0

Abstract

Aims

This study aimed to assess the sensitivity, specificity and inter-rater reliability of the Dutch Main Concept Analysis (MCA), a diagnostic tool that evaluates the effectiveness and efficiency of information transfer during verbal discourse production, in people with aphasia (PWA).

Methods

The MCA was administered to 30 persons with aphasia (17 fluent, 13 nonfluent). Sensitivity and specificity were assessed through (1) single-subject level comparison of MCA scores to normative data, (2) group-level comparison of MCA scores between PWA and 30 age-matched controls, and (3) ROC-analysis for total main concept score (MCS; effectiveness) and total number of accurate and complete main concepts per minute (AC/min; efficiency). Furthermore, the effect of aphasia type (fluent/nonfluent) and severity on these measures was assessed using a linear regression. Discourse samples were scored by two independent raters to calculate inter-rater reliability.

Results

Over 85 % of PWA showed aberrant outcomes on at least four out of seven MCA outcomes based on single-subject comparison to normative data. ROC analysis revealed that MCS and AC/min are sensitive and specific measures to differentiate between discourse of PWA and unimpaired speakers. Increased aphasia severity was associated with a reduced MCS. Good to excellent inter-rater reliability was achieved for all MCA measures.

Conclusion

The Dutch MCA is a sensitive and specific tool, characterized by a good to excellent inter-rater reliability, for identifying impaired effectiveness and efficiency of verbal information transfer during discourse production in PWA. Aphasia severity, but not type, is a determining factor for the effectiveness of information transfer in PWA.

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主要概念分析：荷兰语失语症患者的敏感性、特异性和量表间信度

目的本研究旨在评估荷兰主概念分析（Dutch Main Concept Analysis， MCA）在失语症患者（PWA）中的敏感性、特异性和量表间可靠性。MCA是一种评估言语话语产生过程中信息传递有效性和效率的诊断工具。方法对30例失语症患者（流利17例，不流利13例）进行MCA治疗。通过(1)单受试者水平的MCA评分与规范数据的比较，(2)PWA与30名年龄匹配的对照组之间的MCA评分的组水平比较，以及(3)总主要概念评分(MCS；有效性)和每分钟准确完整的主要概念总数(AC/min；效率)。此外，使用线性回归评估失语类型（流利/不流利）和严重程度对这些措施的影响。话语样本由两个独立的评价者评分，以计算评价者之间的信度。结果：与规范数据相比，超过85%的PWA患者在7个MCA结果中至少有4个结果出现异常。ROC分析显示，MCS和AC/min是区分PWA和未受损说话人话语的敏感而具体的指标。失语严重程度的增加与MCS的降低有关。所有MCA测量都达到了良好到优异的评估间信度。结论荷兰语MCA是识别PWA语篇生产过程中言语信息传递有效性和效率受损的一种敏感而特异的工具，具有良好至优异的评者间信度。失语的严重程度，而不是类型，是PWA信息传递有效性的决定因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Communication Disorders AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY-REHABILITATION

CiteScore

3.30

自引率

5.90%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Communication Disorders publishes original articles on topics related to disorders of speech, language and hearing. Authors are encouraged to submit reports of experimental or descriptive investigations (research articles), review articles, tutorials or discussion papers, or letters to the editor ("short communications"). Please note that we do not accept case studies unless they conform to the principles of single-subject experimental design. Special issues are published periodically on timely and clinically relevant topics.