Flu-ID:一种以证据为基础的评估失语症患者流畅性的新方法。

IF 2.3 3区 医学 Q1 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY
Jean K Gordon, Sharice Clough
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引用次数: 0

摘要

目的:评估失语症患者的语言流畅性在诊断上对于确定失语症的类型和严重程度非常重要,在治疗上对于确定适当的治疗目标也非常重要。然而,最近一项对临床医生的调查(Gordon & Clough, 2022 年)显示,用于评估流利性的测量方法和标准存在很大差异,导致可靠性很差。此外,许多流利度测量的特异性较差,因此很难识别潜在的障碍。在此,我们介绍 Flu-ID Aphasia,这是一种以证据为基础的工具,通过捕捉可能影响失语症患者言语流畅性的一系列行为,为评估流畅性提供更多信息:Flu-ID的开发基于先前关于流畅性基础因素的证据(Clough & Gordon, 2020; Gordon & Clough, 2020)以及临床上对流畅性测量的看法(Gordon & Clough, 2022)。通过在 Excel 模板中自动计算流利度行为,可最大限度地提高临床实用性。通过概述全面的转录和编码指南,最大限度地提高了可靠性。作者对代表不同流利程度的 18 个叙述样本进行了独立编码,以检验 Flu-ID 的实用性、可靠性和有效性:结果:总体可靠性非常好,编码者之间的点对点一致性达到 86%。在 12 个维度中,有 10 个维度显示出良好至卓越的可靠性。有效性分析表明,Flu-ID 在某些方面的得分与临床医生的评分相似,但在其他方面存在差异。本文讨论了出现差异的可能原因和影响,以及改进的机会:Flu-ID 评估失语症患者的流畅性时,使用了一套一致而全面的测量方法和半自动化程序来生成个人流畅性档案。本研究中生成的个人流利度档案说明了不同的潜在障碍会导致相似的流利度评分。补充材料包括分析模板、广泛的转录和编码指南、完成样本和快速参考指南。补充材料:https://doi.org/10.23641/asha.27078199。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Flu-ID: A New Evidence-Based Method of Assessing Fluency in Aphasia.

Purpose: Assessing fluency in aphasia is diagnostically important for determining aphasia type and severity and therapeutically important for determining appropriate treatment targets. However, wide variability in the measures and criteria used to assess fluency, as revealed by a recent survey of clinicians (Gordon & Clough, 2022), results in poor reliability. Furthermore, poor specificity in many fluency measures makes it difficult to identify the underlying impairments. Here, we introduce the Flu-ID Aphasia, an evidence-based tool that provides a more informative method of assessing fluency by capturing the range of behaviors that can affect the flow of speech in aphasia.

Method: The development of the Flu-ID was based on prior evidence about factors underlying fluency (Clough & Gordon, 2020; Gordon & Clough, 2020) and clinical perceptions about the measurement of fluency (Gordon & Clough, 2022). Clinical utility is maximized by automated counting of fluency behaviors in an Excel template. Reliability is maximized by outlining thorough guidelines for transcription and coding. Eighteen narrative samples representing a range of fluency were coded independently by the authors to examine the Flu-ID's utility, reliability, and validity.

Results: Overall reliability was very good, with point-to-point agreement of 86% between coders. Ten of the 12 dimensions showed good to excellent reliability. Validity analyses indicated that Flu-ID scores were similar to clinician ratings on some dimensions, but differed on others. Possible reasons and implications of the discrepancies are discussed, along with opportunities for improvement.

Conclusions: The Flu-ID assesses fluency in aphasia using a consistent and comprehensive set of measures and semi-automated procedures to generate individual fluency profiles. The profiles generated in the current study illustrate how similar ratings of fluency can arise from different underlying impairments. Supplemental materials include an analysis template, extensive guidelines for transcription and coding, a completed sample, and a quick reference guide.

Supplemental material: https://doi.org/10.23641/asha.27078199.

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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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