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Stagge F, Lanzi AM, Saylor AK, Cohen ML. Montreal Cognitive Assessment Scores Do Not Associate With Communication Challenges Reported by Adults With Alzheimer's Disease or Parkinson's Disease. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1902-1910. [PMID: 38713811 DOI: 10.1044/2024_ajslp-23-00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2024]
Abstract
PURPOSES Screening for cognitive-communication challenges in people with Alzheimer's disease (AD) or Parkinson's disease (PD) may benefit from multiple kinds of information about the client (e.g., patient-reported, performance-based). The purposes of this report are (a) to describe, using recently published score range descriptors (e.g., "mild," "moderate"), the patient-reported communication challenges of people with AD or PD using the Communicative Participation Item Bank (CPIB) and the Aphasia Communication Outcome Measure (ACOM); and (b) to examine the relationships between the performance-based Montreal Cognitive Assessment (MoCA), a cognitive screener, and patient-reported CPIB and ACOM scores. METHOD Participants were a convenience sample of 49 community-dwelling adults with AD or PD. Participants completed the measures in person as part of a larger assessment battery. RESULTS MoCA total scores ranged from 7 to 28. CPIB T-scores fell in the following ranges: 31% were "within normal limits," 57% reflected "mildly" restricted participation, and 12% reflected "moderately" restricted participation. ACOM T-scores fell in the following ranges: 50% were either "within normal limits" or reflected "mild" impairment, 29% reflected "mild-moderately" impaired functional communication, and 21% reflected "moderately" impaired functional communication. There were only weak and nonsignificant correlations between T-scores on the ACOM or CPIB and scores on the MoCA, and there were no group differences on the ACOM or CPIB between individuals who screened positive versus negative on the MoCA. CONCLUSION When screening individuals with AD or PD, patient-reported communication challenges seem to be complementary to information provided by the MoCA and perhaps most useful in screening for mild communication challenges.
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Affiliation(s)
- Faith Stagge
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Alyssa M Lanzi
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Anna K Saylor
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Matthew L Cohen
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
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Jewell CC, Harnish SM, Brello J, Lanzi AM, Cohen ML. Poststroke Communication Ability Predicts Patient-Informant Discrepancies in Reported Activities and Participation. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:1854-1867. [PMID: 38625105 DOI: 10.1044/2024_ajslp-23-00322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Participation in life situations has been identified by people with aphasia (PWA) as an ultimate outcome of rehabilitation and is often measured with patient-reported outcome measures (PROMs) or informant-reported measures. It is known that PWA and informants do not always produce similar scores on measures of activities and participation. However, systematic differences between PWA and informants and the causes of these differences are not well understood. Here, we investigated these differences as a function of language impairment, perceived level of activity and participation success, and depressive symptoms. METHOD Participants were 29 PWA-informant dyads who completed a performance-based language assessment and three measures related to different aspects of activities and participation. Outcome variables were PWA-informant difference scores in the activities and participation measures. RESULTS PWA ratings of activities and participation were not statistically significantly associated with performance-based language severity. Hierarchical regression models with both language impairment and informant-reported scores as predictor variables explained 53%-71% of the variance in PWA-informant difference scores (all p < .05). In particular, mild communication challenges were associated with the PWA reporting significantly worse participation than the informant perceived. In contrast, more severe communication challenges were associated with the PWA reporting significantly better participation than the informant perceived. DISCUSSION These findings highlight the importance of measuring participation by PROM. The PWA's experience of participation is not related to their level of language impairment and is predictably different from their care partners' perspective. As others have also reported, "mild" aphasia is not so mild to the PWA. Similarly, "severe" may not be so severe to the PWA. Further research is needed to connect these findings with counseling and caregiver education. Research on response processes (e.g., response shift) is also warranted.
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Affiliation(s)
- Courtney C Jewell
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, Newark
| | - Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, Newark
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Alons E, Brauner L, Luinge M, Terwee CB, van Ewijk L, Gerrits E. Identifying Relevant Concepts for the Development of a Communicative Participation Item Bank for Children and Adolescents: A Systematic Review of Existing Instruments. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:1186-1205. [PMID: 38358947 DOI: 10.1044/2024_jslhr-23-00376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE This study aims to systematically identify items that measure communicative participation from measurement instruments that measure (aspects of) communication and/or participation in children and adolescents (5-18 years old) with communication disorders, for developing an item bank. METHOD A systematic literature search was performed in MEDLINE and Embase to search for patient-reported outcome measures (PROMs) or parent reports measuring aspects of communication and/or participation in children and adolescents. The individual items of the included measurement instruments were reviewed on whether they measure communicative participation. The items were then classified into one of the International Classification of Functioning, Disability and Health (ICF) for Children and Youth (World Health Organization, 2007) domains of activities and participation. RESULTS A total of 29 instruments were found, nine PROMs and 20 parent reports. One hundred forty-five items were identified that measure communicative participation. From these 145 items, 74 were retrieved from PROMs (51%), and 71 were retrieved from parent reports (49%). The majority of items were classified in ICF Domain 7, interpersonal interactions and relationships (73.8%), followed by Domain 8, major life areas (13.8%), and Domain 9, community, social, and civic life (8.3%). Only a few items were found in Domains 5 and 6, and none was found in Domains 1, 2, and 4. CONCLUSIONS We identified 145 items potentially useful for developing an item bank addressing communicative participation in children and adolescents with communication disorders. However, item development in collaboration with the target population is needed to ensure that these items fully reflect the construct.
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Affiliation(s)
- Eline Alons
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
| | - Laurien Brauner
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
| | - Margreet Luinge
- Centre of Expertise Healthy Ageing and Youth, Education and Society, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Caroline B Terwee
- Epidemiology and Data Science, Amsterdam UMC location Vrije Universiteit, the Netherlands
- Methodology Program, Amsterdam Public Health Research Institute, the Netherlands
| | - Lizet van Ewijk
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
| | - Ellen Gerrits
- Research Centre for Healthy and Sustainable Living, HU University of Applied Sciences Utrecht, the Netherlands
- Department of Languages, Literature and Communication, Institute for Language Sciences, Utrecht University, the Netherlands
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Nudelman CJ, Bottalico P, van Mersbergen M, Nanjundeswaran C. Toward Enhanced Voice-Related Self-Reports: Translation, Cross-Cultural Adaptation, and Validity. J Voice 2024:S0892-1997(24)00089-4. [PMID: 38582724 DOI: 10.1016/j.jvoice.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE This article provides a commentary on voice-related self-reports and presents various shortcomings endemic in the development and validation of these measures. Emphasis is placed on issues of construct validity, translation, and cross-cultural adaptation. Finally, a demonstration is provided to elucidate the importance of cross-cultural adaptation. METHODS An example of a voice-related self-report that lacks cross-cultural adaptation is provided, and a linguistic translation and cross-cultural adaptation process is outlined and demonstrated. A bilingual voice scientist, a bilingual speech-language pathologist (SLP), and two experts in voice-related self-reports completed a multistep linguistic translation and cross-cultural adaptation process and obtained back-translations from five SLPs native to the self-report's source culture. RESULTS Analyses of the back-translations demonstrated that the mean BiLingual Evaluation Understudy (BLEU) scores of the adapted items were higher overall than the back-translations of the original English items. CONCLUSIONS Unvalidated translations of voice-related self-reports are commonly used as a baseline to further translate the measure, and this deteriorates cross-cultural health equity. Cross-cultural adaptation is a crucial, but often overlooked process when translating and adapting self-reports. The present article calls for standardized methodologies with an emphasis on the necessity of careful translation methods and cultural adaptation processes.
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Affiliation(s)
- Charles J Nudelman
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois.
| | - Pasquale Bottalico
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - Chaya Nanjundeswaran
- Department of Audiology & Speech Language Pathology, East Tennessee State University, Johnson City, Tennessee
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Cahill PT, Ferro MA, Ng S, Turkstra LS, Campbell WN. Core outcomes for speech-language services in Ontario schools: a group concept mapping study and guiding framework. BMC Health Serv Res 2024; 24:347. [PMID: 38491356 PMCID: PMC10943816 DOI: 10.1186/s12913-024-10821-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Establishing the most important outcomes for school-based speech-language therapy is essential to guide future research and program evaluation for these services. Many health disciplines have developed core outcomes sets (COS) for this purpose. A COS encompasses the most important outcomes for particular health services as identified by appropriate interested parties. These interested parties usually represent health care providers and those with the health condition. In this paper, we report the development of a guiding framework for a COS for speech-language therapy services in schools in a Canadian context. METHODS Using a group concept mapping method, we identified the outcomes for inclusion in the COS guiding framework through the elicited opinions of key interested parties: speech-language therapists, teachers, and family members of children with speech, language, and communication needs. We extracted 103 statements (potential outcomes) from a previous data set of interview transcripts. We then asked participants to sort the statements into conceptually similar groups, which were aggregated and transformed into a cluster map using multidimensional scaling followed by hierarchical cluster analysis. Participants also rated each statement on 5-point scales for importance and feasibility. We calculated mean ratings for individual statements and for all statements in a cluster, for all participants and for participant groups separately. RESULTS We identified seven core outcomes for school-based speech-language services in Ontario, Canada. These included: classroom-based services, a holistic approach, support for teachers, care coordination, accessible services, family supports, and student success. All outcomes were rated highly for importance. Feasibility ratings were consistently below importance ratings. All participant groups concurred that a holistic approach was the most important outcome and accessible services was the least feasible outcome to achieve. CONCLUSIONS The seven outcomes identified in this study are recommended to guide the development of a full COS to direct future research and program evaluation for school-based speech-language services. These outcomes have not been widely included in previous research and should be incorporated into future research alongside specific intervention outcomes. Data for some outcomes may be available from non-traditional sources such as administrative data sets. Consequently, their use for program evaluations should be accompanied by appropriate institutional support to allow speech-language therapists to make meaningful use of appropriate outcomes data.
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Affiliation(s)
- Peter T Cahill
- School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, Room 403, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada.
| | - Mark A Ferro
- CanChild Centre for Childhood Disability Research, Hamilton, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Canada
| | - Stella Ng
- Department of Speech-Language Pathology, University of Toronto, Toronto, Canada
- Centre for Interprofessional Education, University of Toronto, Toronto, Canada
| | - Lyn S Turkstra
- School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, Room 403, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada
| | - Wenonah N Campbell
- School of Rehabilitation Science, Institute of Applied Health Sciences, McMaster University, Room 403, 1400 Main Street West, Hamilton, ON, L8S 1C7, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, Canada
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Baylor C, Bamer A, Brown C, Jin JL, Teixeira J, Nuara M. The Communicative Participation Item Bank-Gender-Diverse Version: Item Bank Calibration and Short Form. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:952-968. [PMID: 38232175 DOI: 10.1044/2023_ajslp-23-00260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE The purpose of this study was to calibrate an item set for a new version of the Communicative Participation Item Bank (CPIB) specifically for use with gender-diverse clients. This new version contains a new item stem as well as other minor wording changes from the original CPIB in order to be acceptable to gender-diverse respondents. METHOD Survey data on 47 candidate items were collected from 434 transgender individuals: 219 assigned female at birth (AFAB) and 215 assigned male at birth (AMAB). Item response theory analyses included evaluation of unidimensionality, local dependence, fit to a graded response model, and differential item functioning (DIF) between AFAB and AMAB respondents. RESULTS The original set of 47 items was unidimensional, but 16 items were removed due to local dependence, resulting in a final item bank of 31 items. There was no evidence of DIF between AFAB and AMAB participants. Reliability of the full item bank is good (i.e., > 0.8) between T scores of 20 and 76 and high (i.e., > 0.9) between T scores of 20 and 68. The short form had good reliability (i.e., > 0.8) between T scores of 24 and 64. CONCLUSIONS The Communicative Participation Item Bank-Gender-Diverse (CPIB-GD) version provides a new option for person-reported outcome measurement with gender-diverse clients. Clinicians are cautioned to use only the new CPIB-GD with gender-diverse clients, and not the original CPIB due to unacceptable wording in the original version for this population. The original CPIB remains valid and appropriate for the populations for which it was developed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.24993309.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Alyssa Bamer
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Cait Brown
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Jingyu Linna Jin
- Department of Rehabilitation Medicine, University of Washington, Seattle
| | - Jeffrey Teixeira
- Facial Plastic and Reconstructive Surgery-Otolaryngology, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Michael Nuara
- Department of Otolaryngology, Plastic and Reconstructive Surgery, Virginia Mason Franciscan Health, Seattle, WA
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Slavych BK, Zraick RI, Ruleman A. A Systematic Review of Voice-Related Patient-Reported Outcome Measures for Use with Adults. J Voice 2024; 38:544.e1-544.e14. [PMID: 34782227 DOI: 10.1016/j.jvoice.2021.09.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE This paper's purpose is to provide a resource for clinicians and researchers of select voice-related patient-reported outcome measures (PROMs) available in the English language. METHOD A systematic search for voice-related PROMs was conducted between September 2020 and July 17, 2021. Databases included APA PsychInfo, Nursing and Allied Health Source, MEDLINE via the EBSCO interface, and Science Direct. Reference lists for PROMs-related articles were mined for reference to PROMs protocols. RESULTS Thirty voice-related PROMs were identified and categorized as either developed primarily for use in the clinic (n = 12), developed primarily for use in a specific research study (n = 6), or translated into English for publication (n = 12). Twelve PROMs were summarized: Aging Voice Index, Disease Specific Self-Efficacy in Spasmodic Dysphonia, Evaluation of the Ability to Sing Easily, Evaluating Voice Disability - Quality of Life Questionnaire, Glottal Function Index, Linear Analog Scale of Assessment of Voice Quality, Quality of Life in Recurrent Respiratory Papillomatosis, Speech Disability Questionnaire, Trans Woman Voice Questionnaire, Vocal Cord Dysfunction Questionnaire, Vocal Fatigue Index, and the Vocal Tract Discomfort Scale. CONCLUSION The PROMs can be categorized into English-language voice-related PROMs developed primarily for clinical use, English-language PROMs developed primarily for research use, and English-language PROMs translated into English. The extent of reliability and validity testing completed varies in the PROMs developed primarily for clinical use. A PROM's psychometric properties as well as the language in which the PROM was tested, should guide clinicians and researchers as they consider which instrument(s) to use.
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Affiliation(s)
- Bonnie K Slavych
- Communication Disorders program, University of Central Missouri, Warrensburg, Missouri, USA.
| | - Richard I Zraick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando, Florida, USA
| | - Alice Ruleman
- Communication Disorders program, University of Central Missouri, Warrensburg, Missouri, USA
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Verma H, Kumar S, Sharma A, Mishra R, Nagamani B. Swallowing dysfunction between the community-living older adults with and without comorbid conditions using Patient-Reported Outcome Measures (PROM). Geriatr Nurs 2024; 56:64-73. [PMID: 38301436 DOI: 10.1016/j.gerinurse.2023.12.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 02/03/2024]
Abstract
OBJECTIVE The present study aimed to investigate older adults' perspective on their swallowing physiology using a PROM tool. The study further explored the swallowing issues among older adults with and without comorbid conditions. METHOD One hundred twenty-two (122) participants participated in the e-survey. A questionnaire was developed to assess the swallowing deficits among older adults, and Eating Assessment Tool-10 (EAT-10) was administered to assess the PROM. RESULTS The results revealed that 40% of older adults with comorbid conditions had EAT-10 scores greater than 3, suggesting swallowing deficits. A significant difference was observed between the two groups with respect to swallowing deficits, as reported on EAT-10. CONCLUSION Based on the results, it can be delineated that swallowing deficits emerge with aging. More of older adults with comorbid conditions reported swallowing deficits in comparison to those without comorbid conditions. Hence, their nutritional and health status gets compromised, leading to poor quality of life.
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Affiliation(s)
- Himanshu Verma
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sourabh Kumar
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Atul Sharma
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Roshani Mishra
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Banumathy Nagamani
- Speech & Hearing Unit, Department of Otolaryngology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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Go TWW, Ho EC. Suboptimal usage of hearing aids in adults with hearing loss: Singapore audiologists' perspective and current practice. Singapore Med J 2024:00077293-990000000-00069. [PMID: 38189380 DOI: 10.4103/singaporemedj.smj-2022-040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/11/2022] [Indexed: 01/09/2024]
Affiliation(s)
| | - Eu Chin Ho
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore
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Moya-Galé G, Kim Y, Fabiano L. Raising Awareness About Language- and Culture-Specific Considerations in the Management of Dysarthria Associated With Parkinson's Disease Within the United States. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-9. [PMID: 37902554 DOI: 10.1044/2023_jslhr-23-00365] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
PURPOSE The purpose of this article is to raise awareness about the importance of diverting from English-centric approaches in the management of dysarthria associated with Parkinson's disease (PD) in the United States, and embracing a language- and culture-specific perspective when working with linguistically and culturally diverse populations within the context of culturally responsive, precision medicine. METHOD This tutorial is divided into two primary components: a critical review of language universal and language-specific characteristics of dysarthria associated with PD and their relationship with speech intelligibility, and a practical guide to culturally responsive evidence-based practice for speech-language pathologists. CONCLUSIONS We offer a framework for linguistically and culturally appropriate considerations when working with clients with dysarthria associated with PD. While "universal" representations of dysarthria may be part of the big picture, language-specific contributions to speakers' intelligibility should be carefully examined to maximize treatment outcomes. Additionally, an evidence-based model that fully embraces clients' wishes and values within the context of culturally responsive, precision medicine should be prioritized, a practice that may include the use of interpreters.
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Lapin B, Cohen ML, Corsini N, Lanzi A, Smith SC, Bennett AV, Mayo N, Mercieca-Bebber R, Mitchell SA, Rutherford C, Roydhouse J. Development of consensus-based considerations for use of adult proxy reporting: an ISOQOL task force initiative. J Patient Rep Outcomes 2023; 7:52. [PMID: 37266745 DOI: 10.1186/s41687-023-00588-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 05/04/2023] [Indexed: 06/03/2023] Open
Abstract
AIMS Many large-scale population-based surveys, research studies, and clinical care allow for inclusion of proxy reporting as a strategy to collect outcomes when patients are unavailable or unable to provide reliable self-report. Prior work identified an absence of methodological guidelines regarding proxy reporting in adult populations, including who can serve as a proxy, and considerations for data collection, analysis, and reporting. The primary objective of this work by the ISOQOL Proxy Task Force was to review documents and clinical outcome assessment measures with respect to proxy reporting and to develop, through consensus, considerations for proxy reporting. METHODS We assembled an international group with clinically relevant and/or methodological expertise on proxy use in adult populations. We conducted a targeted review of documentation based on regulatory, non-regulatory, professional society, and individual measure sources. Using a standardized collection form, proxy-related information was extracted from each source including definitions of a proxy, characteristics of a proxy, domains addressable or addressed by a proxy, and observer-reporting. RESULTS The definition of proxy was inconsistent across 39 sources, except regulatory documents which defined a proxy as a person other than the patient who reports on an outcome as if she/he were the patient. While proxy report was discouraged in regulatory documentation, it was acknowledged there were instances where self-report was impossible. Many documentation sources indicated proxies would be well-justified in certain contexts, but did not indicate who could act as a proxy, when proxies could be used, what domains of patient health they could report on, or how data should be reported. Observer-reported outcomes were typically defined as those based on observed behaviors, however there was not a consistent differentiation between proxy and observer reporting. Based on information extracted from these resources, we developed a checklist of considerations when including proxy-reported measures or using proxies in study design, data collection, analysis, interpretation and reporting of proxy reported data. CONCLUSION Our targeted review highlights a lack of clarity in capturing, interpreting and reporting data from proxies in adult populations. We provide a checklist of considerations to assist researchers and clinicians with including proxies in research studies and clinical care. Lastly, our review identified areas where further guidance and future research are necessary.
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Affiliation(s)
- Brittany Lapin
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, JJN3, Cleveland, OH, 44195, USA.
- Center for Outcomes Research and Evaluation, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
| | - Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE, USA
| | - Nadia Corsini
- Clinical and Health Sciences, Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, SA, Australia
| | - Alyssa Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE, USA
| | - Sarah C Smith
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Antonia V Bennett
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nancy Mayo
- School of Physical and Occupational Therapy, Divisions of Clinical Epidemiology, Geriatrics, Experimental Medicine, Department of Medicine, Center for Outcomes Research and Evaluation (CORE) McGill University Health Centre (MUHC)-Research Institute, McGill University, Montreal, Canada
| | | | - Sandra A Mitchell
- Outcomes Research Branch, Healthcare Delivery Program, National Cancer Institute, Bethesda, MD, USA
| | - Claudia Rutherford
- Faculty of Medicine and Health, The University of Sydney Susan Wakil School of Nursing and Midwifery, Cancer Care Research Unit (CCRU), The University of Sydney, Sydney, NSW, Australia
- Faculty of Science, School of Psychology, Sydney Quality of Life Office, The University of Sydney, Sydney, NSW, Australia
| | - Jessica Roydhouse
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, RI, USA
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Cahill PT, Ng S, Dix L, Ferro MA, Turkstra L, Campbell WN. Outcomes management practices in tiered school-based speech-language therapy: A Canadian example. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2023; 58:786-801. [PMID: 36426768 DOI: 10.1111/1460-6984.12822] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/28/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Measuring, assessing and managing outcomes in school practice environments is difficult due to the complex nature of school communities as well as the recent shift in service-delivery models towards tiered approaches. In tiered approaches, multiple levels of service are offered to better match students' needs. Each level of service may require different outcomes and management techniques. Research to date on outcomes has focused on measuring outcomes in medical settings, leaving a substantive gap in the literature regarding practice in schools. AIMS The first aim was to explore how school-based speech-language therapists approached outcomes management as their clinical programmes transitioned to tiered service-delivery models The second aim was to describe the successes and challenges in outcomes management reported by clinicians in this context. METHODS & PROCEDURES A secondary deductive-inductive content analysis was performed using qualitative interviews with 24 clinical managers and senior therapists from schools across Ontario, Canada. Using a framework of outcomes measurement, assessment and management in schools based on previous research studies, data were grouped into broad categories deductively, and then the content of each category was further explored using inductive coding. Iterative peer debriefing and reflexive journaling were key strategies to increase the trustworthiness of the results. FINDINGS & RESULTS Participants reported measuring and qualitatively assessing seven key outcomes for school-based practice. These included: (1) student progress and achievement, (2) student participation and inclusion in the school community, (3) stakeholder perspectives, (4) 'buy-in', (5) expanded capacities, (6) responsiveness to needs and (7) accountability to systems. Participants reported more challenges than successes in outcomes management during this transition to tiered services. Challenges were attributed to idiosyncratic organizational barriers, the transition to tiered models and the philosophy of working within the educational system. CONCLUSIONS & IMPLICATIONS School-based speech-language therapists measure, assess and manage multiple outcomes relevant to school-based practice in tiered service-delivery models. Many challenges remain. Solutions to support meaningful, systematic and proactive outcomes management in schools should address the broader set of outcomes relevant to tiered service-delivery models and the unique practice context of the educational system, while remaining responsive to idiosyncratic organizational factors. Sustained clinical-research collaboration and knowledge exchange is recommended. WHAT THIS PAPER ADDS What is already known on the subject Systematic, proactive collection and interpretation of outcomes has long been encouraged within speech-language therapy. However, implementing outcomes management in clinical practice remains a substantial challenge. Additionally, research on outcomes to date has focused on medical practice environments, to the exclusion of school-based practice. What are the potential or actual clinical implications of this work? Outcomes management is valued in school practice environments; however, the current repertoire of techniques for outcomes management are a poor match for school-based practice. Clinicians in schools would benefit from the development of contextually relevant, meaningful and feasible outcomes management tools.
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Affiliation(s)
- Peter T Cahill
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Stella Ng
- Department of Speech-Language Pathology, University of Toronto, Toronto, ON, Canada
- Centre for Interprofessional Education, University of Toronto, Toronto, ON, Canada
| | - Leah Dix
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
| | - Mark A Ferro
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Lyn Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - Wenonah N Campbell
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, Hamilton, ON, Canada
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Mattila-Rautiainen S, Venojärvi M, Rautiainen H, Keski-Valkama A. The impact on physical performance, pain and psychological wellbeing of chronic low back pain patients during 12-weeks of equine- facilitated therapy intervention. Front Vet Sci 2023; 10:1085768. [PMID: 36998640 PMCID: PMC10043450 DOI: 10.3389/fvets.2023.1085768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
Equine - Facilitated Therapy (EFT), an equine environment, and horses themselves can meet many physical and mental health needs beyond diagnostic categories. The horse's ability to produce a walk-like movement and the participant's ability to connect to non-judgemental living creatures, both of which can benefit participation and construct a positive self-image for chronic pain patients. The objective of this study is to evaluate the impact of EFT on perceived physical performance, level of pain, pain acceptance, depression and anxiety, and quality of life within a 12-week intervention for chronic low back pain (LBP) patients. Twenty-two LBP patients received EFT led by physical therapists as part of the public health services. A mixed method design combining quantitative and qualitative methods was employed to detect the outcome of the intervention. The data were collected via questionnaires, interviews, and patient data repositories. An interview was voluntary for participants and included questions of one's health, visits to the pain clinic during 6 months and an open-ended question about the intervention. The coding of the data was completed independently by two persons using thematizing. The welfare of the attending horses was taken into consideration in basic training and for the research setting. Statistical analysis and paired t-tests detected the changes during a 12-week intervention. The results suggest a significant increase in Canadian Occupational Performance Measure (COPM) levels of satisfaction with self-selected performances. The Raitasalo's version of Beck's Depression Inventory (RBDI) level of anxiety and Chronic Pain Acceptance Questionnaire (CPAQ) did not change, whereas a decline in the amount of perceived RBDI depression was found combined with increased levels of SF-36 Mental Change Scores and COPM satisfaction with performance. Only two of the 22 participants returned with reoccurring symptoms after 6 months to the pain clinic. The participant interviews revealed three important domains of experience during coding: physical-, psychological-, and social that link to the research question and suggest impact for the recovery from the human-animal interaction.
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Affiliation(s)
| | - Mika Venojärvi
- Sports and Exercise Medicine, University of Eastern Finland, Kuopio, Finland
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14
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Gallée J, Cartwright J, Volkmer A, Whitworth A, Hersh D. "Please Don't Assess Him to Destruction": The R.A.I.S.E. Assessment Framework for Primary Progressive Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:391-410. [PMID: 36763839 DOI: 10.1044/2022_ajslp-22-00122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
PURPOSE Speech-language pathologists (SLPs) assess people with primary progressive aphasia (PPA) through measurements of speech, language, communication, and well-being, with the aims of identifying challenges and strengths, monitoring change, and informing treatment directions and supports. The purpose of this clinical focus article is to highlight the necessity for person-centered assessment specific to PPA and to conceptualize a framework that acknowledges the multifaceted nature of assessment for this population. In this framework, the unique challenges posed by a diagnosis of PPA are addressed with the aim to provide practical guidance for clinicians and to support reflection on current practices. METHOD In clinical and research practice, assessment of people with PPA requires an ever-evolving approach that is centered on the client. In this clinical focus article, a discussion-based consensus process was used to synthesize authentic longitudinal experiences of people with PPA to explore assessment approaches, tools, and philosophies. RESULTS This analysis of person-centered assessment identifies seven essential components of assessment in PPA that set the foundation for the five steps of the R.A.I.S.E. Assessment framework. These components each contribute to a clear definition of assessment that reveals clients' competencies with a strengths-based focus; prioritizes the reciprocity of benefits; promotes dynamic assessment; and recognizes the complexity, evolution of assessment over time, and advocacy. CONCLUSIONS This clinical focus article takes a novel look at assessment in PPA by stepping away from assessment practices that focus on revealing deficits and decline and, instead, provides practical recommendations through the conceptualization of a PPA-specific assessment framework. The R.A.I.S.E. Assessment framework is grounded in principles of uplifting clients through person-centered assessment, keeps pace with best practice in PPA intervention, and contributes to a supportive experience for clients and families in the face of a progressive diagnosis over time.
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Affiliation(s)
- Jeanne Gallée
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA
- Evergreen Speech & Hearing Clinic, Redmond, WA
| | - Jade Cartwright
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Anna Volkmer
- Division of Psychology and Language Sciences, University College London, United Kingdom
| | - Anne Whitworth
- School of Health Sciences, University of Tasmania, Launceston, Australia
| | - Deborah Hersh
- Speech Pathology, School of Allied Health, Curtin University, Perth, Western Australia, Australia
- Speech Pathology, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- School of Allied Health Sciences and Practice, Adelaide University, South Australia, Australia
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15
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Lanzi AM, Saylor AK, Dedrick RF, Bourgeois MS, Cohen ML. The Functional External Memory Aid Tool Version 2.0: A How-To Clinical Guide. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:96-106. [PMID: 36525628 PMCID: PMC10023140 DOI: 10.1044/2022_ajslp-22-00178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 08/09/2022] [Accepted: 08/29/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Although compensatory cognitive rehabilitation is a common treatment approach for adults with cognitive-communication disorders, there are few assessment tools available to support clinicians in developing person-centered treatment plans. In addition to understanding a client's cognitive and functional abilities, it is also important to understand how they compensate for their weaknesses, specifically with external aids (e.g., calendars, notes), in everyday life. The Functional External Memory Aid Tool (FEMAT) is a performance-based measure that quantifies and describes external aid use during task completion. METHOD The purpose of this clinical focus article is to educate and equip clinicians to administer and interpretate the FEMAT with adult clients with cognitive-communication disorders. This clinical focus article describes the theoretical motivation for the FEMAT as well as the administration, scoring, and interpretation procedures for Version 2.0 of the measure. A hypothetical case example is included to illustrate how to use the FEMAT to develop person-centered goals and treatment plans. CONCLUSIONS The FEMAT is psychometrically sound, clinically relevant, free, easily accessible, and quick to administer and provides data that are complementary to data obtained from traditional performance-based and/or patient-reported measures. This clinical focus article describes new resources that are available to help clinicians administer and interpret Version 2.0 of the FEMAT when serving adults with cognitive-communication disorders. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21651311.
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Affiliation(s)
- Alyssa M. Lanzi
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
| | - Anna K. Saylor
- Department of Communication Sciences & Disorders, University of Delaware, Newark
| | - Robert F. Dedrick
- Department of Educational and Psychological Studies, University of South Florida, Tampa
| | - Michelle S. Bourgeois
- Department of Communication Sciences & Disorders, University of South Florida, Tampa
| | - Matthew L. Cohen
- Department of Communication Sciences & Disorders, University of Delaware, Newark
- Delaware Center for Cognitive Aging Research, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
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16
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Cohen ML, Harnish SM, Lanzi AM, Brello J, Hula WD, Victorson D, Nandakumar R, Kisala PA, Tulsky DS. Establishing severity levels for patient-reported measures of functional communication, participation, and perceived cognitive function for adults with acquired cognitive and language disorders. Qual Life Res 2022; 32:1659-1670. [PMID: 36572789 PMCID: PMC10172211 DOI: 10.1007/s11136-022-03337-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE To empirically assign severity levels (e.g., mild, moderate) to four relatively new patient-reported outcome measures (PROMs) for adults with acquired cognitive/language disorders. They include the Communicative Participation Item Bank, the Aphasia Communication Outcome Measure, and Neuro-QoL's item banks of Cognitive Function (v2.0) and Ability to Participate in Social Roles and Activities (v1.0). METHOD We conducted 17 focus groups that comprised 22 adults with an acquired cognitive/language disorder from stroke, Parkinson's disease, or traumatic brain injury; 30 care partners of an adult with an acquired cognitive/language disorder; and 42 speech-language pathologists who had experience assessing/treating individuals with those and other cognitive/language disorders. In a small, moderated focus-group format, participants completed "PROM-bookmarking" procedures: They discussed hypothetical vignettes based on PROM item responses about people with cognitive/language disorders and had to reach consensus regarding whether their symptoms/function should be categorized as within normal limits or mild, moderate, or severe challenges. RESULTS There was generally good agreement among the stakeholder groups about how to classify vignettes, particularly when they reflected very high or low functioning. People with aphasia described a larger range of functional communication challenges as "mild" compared to other stakeholder types. Based on a consensus across groups, we present severity levels for specific score ranges for each PROM. CONCLUSION Standardized, stakeholder-informed severity levels that aid interpretation of PROM scores can help clinicians and researchers derive better clinical meaning from those scores, for example, by identifying important clinical windows of opportunity and assessing when symptoms have returned to a "normal" range.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA. .,Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus, OH, 43210, USA
| | - William D Hula
- Geriatric Research, Education, and Clinical Center, VA Health Care System, and Department of Communication Sciences and Disorders, University of Pittsburgh, Pittsburgh, PA, USA
| | - David Victorson
- School of Medicine Department of Medical Social Science, Northwestern University, Chicago, IL, 60611, USA
| | - Ratna Nandakumar
- University of Delaware School of Education, Newark, DE, 19713, USA
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
| | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.,Department of Physical Therapy, University of Delaware, Newark, DE, 19713, USA
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17
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Wallace SE, Patterson J, Purdy M, Knollman-Porter K, Coppens P. Auditory Comprehension Interventions for People With Aphasia: A Scoping Review. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2022; 31:2404-2420. [PMID: 36252946 DOI: 10.1044/2022_ajslp-21-00297] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE This scoping review examined studies reporting restorative treatments designed to improve auditory comprehension in people with aphasia. METHOD We searched eight databases using keywords aphasia, auditory comprehension, treatment, intervention, and rehabilitation, for studies published between 1970 and 2020. Searches returned 170 records, and after applying exclusionary criteria, 28 articles remained. For each article, two authors independently extracted data on study design parameters, participant characteristics, treatment protocol, and treatment outcomes, including generalization. RESULTS Studies were categorized by treatment focus: direct auditory (n = 7), mixed auditory (n = 13), or indirect (n = 8). Study designs were group (n = 12), single-subject experimental design (n = 11), or case study (n = 5). Fifteen studies had a control condition and/or a control group. Thirteen studies included two to 10 participants. Aphasia severity and auditory comprehension severity were infrequently reported, and most participants were greater than 1-year poststroke. Treatment targets and tasks varied. Sessions ranged from 8 to 240 min, once or more per week, for eight to 60 total sessions over 2-20 weeks. Impairment-based outcome measures were typically used. Improvement and generalization were regularly reported; however, authors frequently did not report statistical significance. CONCLUSIONS A variety of treatments have addressed auditory comprehension deficits in people with aphasia, with many reporting improvements in auditory comprehension for some people. However, the variability in treatment tasks and delivery and outcome measurements preclude confidently offering specific clinical recommendations for implementing auditory comprehension treatments. Gaps identified by the current study may guide the development and exploration of transparent, repeatable, patient-centered treatments. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21291345.
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Affiliation(s)
- Sarah E Wallace
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | - Janet Patterson
- Research Service, VA Northern California Health Care System, Martinez
| | - Mary Purdy
- Department of Communication Disorders, Southern Connecticut State University, New Haven
| | | | - Patrick Coppens
- Department of Communication Sciences and Disorders, State University of New York College at Plattsburgh
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18
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Baker E, Masso S, Huynh K, Sugden E. Optimizing Outcomes for Children With Phonological Impairment: A Systematic Search and Review of Outcome and Experience Measures Reported in Intervention Research. Lang Speech Hear Serv Sch 2022; 53:732-748. [PMID: 35394819 DOI: 10.1044/2022_lshss-21-00132] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
PURPOSE Reporting of outcome and experience measures is critical to our understanding of the effect of intervention for speech sound disorders (SSD) in children. There is currently no agreed-upon set of measures for reporting intervention outcomes and experiences. In this article, we introduce the Speech Outcome Reporting Taxonomy (SORT), a tool designed to assist with the classification of outcome and experience measures. In a systematic search and review using the SORT, we explore the type and frequency of these measures reported in intervention research addressing phonological impairment in children. Given the integral relationship between intervention fidelity and intervention outcomes, reporting of fidelity is also examined. METHOD Five literature databases were searched to identify articles written or translated into English published between 1975 and 2020. Using the SORT, outcome and experience measures were extracted and categorized. The number of intervention studies reporting fidelity was determined. RESULTS A total of 220 articles met inclusion criteria. The most frequently reported outcome domain was broad generalization measures (n = 142, 64.5%), followed by specific measures of generalization of an intervention target (n = 133, 60.5%). Eleven (5.0%) articles reported measures of the impact of the phonological impairment on children's activity, participation, quality of life, or others. Twenty articles (9.1%) reported on parent, child, or clinician experience or child engagement. Fidelity data were reported for 13.4% of studies of interventions. CONCLUSIONS The measurement of intervention outcomes is challenging yet important. No single type of measure was reported across all articles. Through using tailored measures closely related to intervention targets in combination with a universal set of measures of intelligibility, the impact of phonological impairment on children's lives, and the experience of receiving and providing intervention, researchers and clinicians could work together to progress insights and innovations in science and practice for children with SSD. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19497803.
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Affiliation(s)
- Elise Baker
- School of Health Sciences, Western Sydney University, New South Wales, Australia.,South Western Sydney Local Health District, Liverpool, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Sarah Masso
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia.,Charles Sturt University, Bathurst, New South Wales, Australia
| | - Kylie Huynh
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia
| | - Ellie Sugden
- School of Health Sciences, Western Sydney University, New South Wales, Australia
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19
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Cohen ML, Harnish SM, Lanzi AM, Brello J, Victorson D, Kisala PA, Nandakumar R, Tulsky DS. Adapting a Patient-Reported Outcome Bookmarking Task to be Accessible to Adults With Cognitive and Language Disorders. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4403-4412. [PMID: 34699261 DOI: 10.1044/2021_jslhr-21-00071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Background Patient-reported outcome (PRO) measures produce scores that do not always have obvious clinical meaning. The PRO-bookmarking procedure is a new and promising way to make PRO measures more meaningful and interpretable. However, the materials and procedures of the task may benefit from adaptations to be more accessible to individuals with cognitive and language disorders. Aims This study aims to provide an overview of the iterative refinement process used to modify the materials and procedures of the PRO-bookmarking task so that they are more accessible to adults with acquired cognitive and language impairments. Method and Procedures Our team of health psychologists, neuropsychologists, and speech-language pathologists (SLPs) conducted two focus groups with SLPs and care partners of people with aphasia using the same PRO-bookmarking materials and procedures as previous reports. These PRO-bookmarking materials and procedures were then refined iteratively based on discussion with those who participated in focus groups and among the research team, and three more times in the course of 16 additional focus groups of different stakeholders: people with Parkinson's disease, aphasia, or traumatic brain injury; care partners of people with those conditions; and SLPs who have experience with those, and other adult-acquired conditions. Outcomes and Results The PRO-bookmarking materials and procedures underwent four iterations to make them clearer, simpler, and more accessible. For example, the materials included more structured text and graphic supports where appropriate and the procedures were clustered into smaller discrete tasks and displayed graphically when possible and appropriate. Conclusions PRO-bookmarking materials and procedures were made simpler and more structured to increase their accessibility to adults with cognitive and language impairments. In fact, these adaptations made the tasks simpler and clearer for all types of stakeholders.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark
- Center for Health Assessment Research and Translation, University of Delaware, Newark
| | - Stacy M Harnish
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark
| | - Jennifer Brello
- Department of Speech and Hearing Science, The Ohio State University, Columbus
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Pamela A Kisala
- Center for Health Assessment Research and Translation, University of Delaware, Newark
| | | | - David S Tulsky
- Center for Health Assessment Research and Translation, University of Delaware, Newark
- Department of Physical Therapy, University of Delaware, Newark
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20
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Cohen ML, Lanzi AM, Boulton AJ. Clinical Use of PROMIS, Neuro-QoL, TBI-QoL, and Other Patient-Reported Outcome Measures for Individual Adult Clients with Cognitive and Language Disorders. Semin Speech Lang 2021; 42:192-210. [PMID: 34261163 DOI: 10.1055/s-0041-1731365] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Patient-reported outcome measures (PROMs) assess health outcomes from the patient's perspective. The National Institutes of Health has invested in the creation of numerous PROMs that comprise the PROMIS, Neuro-QoL, and TBI-QoL measurement systems. Some of these PROMs are potentially useful as primary or secondary outcome measures, or as contextual variables for the treatment of adults with cognitive/language disorders. These PROMs were primarily created for clinical research and interpretation of group means. They also have potential for use with individual clients; however, at present there is only sparse evidence and direction for this application of PROMs. Previous research by Cohen and Hula (2020) described how PROMs could support evidence-based practices in speech-language pathology. This companion article extends upon that work to present clinicians with implementation information about obtaining, administering, scoring, and interpreting PROMs for individual clients with cognitive/language disorders. This includes considerations of the type and extent of communication support that is appropriate, implications of the relatively large measurement error that accompanies individual scores and pairs of scores, and recommendations for applying minimal detectable change values depending on the clinician's desired level of measurement precision. However, more research is needed to guide the interpretation of PROM scores for an individual client.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware.,Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware
| | - Aaron J Boulton
- Center for Health Assessment Research and Translation, University of Delaware, Newark, Delaware
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21
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Baylor C, Eadie T, Yorkston K. The Communicative Participation Item Bank: Evaluating, and Reevaluating, Its Use across Communication Disorders in Adults. Semin Speech Lang 2021; 42:225-239. [PMID: 34261165 DOI: 10.1055/s-0041-1729947] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Patient-reported outcomes (PROs) are essential in patient-centered, evidence-based practice in speech-language pathology. PROs respect individuals who live with communication disorders as key stakeholders providing a critically unique perspective on consequences of communication disorders, and whether interventions bring about meaningful changes. Some PROs focus on specific communication symptoms such as voice or language symptom severity, while others focus on broader constructs such as quality of life. Many PROs target specific diagnostic groups. This article presents the Communicative Participation Item Bank (CPIB), a PRO that measures communicative participation restrictions. The CPIB was based on the concept of participation, or engagement in life situations, as defined in the World Health Organization's International Classification of Functioning, Disability, and Health. It was designed to be relevant for adults across different communication disorders to facilitate clinical and research activities that may involve either comparing or aggregating data across communication disorders. The CPIB follows current PRO development protocols including systematic guidance from stakeholders through cognitive interviews, and the measurement methods of Item Response Theory that allow precise and adaptive assessment. This article reviews use of the CPIB across different diagnostic groups, and identifies needs for future efforts to expand the relevance of the CPIB further.
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Affiliation(s)
- Carolyn Baylor
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
| | - Tanya Eadie
- Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington
| | - Kathryn Yorkston
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington
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22
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Hernandez NJ, Bislick L, Engelhoven A, Hunting Pompon R. Self-Report and Caregiver Proxy-Report Agreement of Perceived Chronic Stress and Mutuality in Poststroke Aphasia. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1700-1710. [PMID: 34048661 DOI: 10.1044/2021_ajslp-20-00248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Background People with aphasia (PWA) report higher levels of stress in comparison to stroke survivors without aphasia. If untreated, chronic stress is known to have detrimental effects to the body and brain and can negatively impact health and well-being. According to extant literature, self- and proxy-report agreement on objective domains is higher than on subjective domains, like chronic stress. In addition, high levels of mutuality, also known as shared feelings between two people, have been strongly associated with low levels of stress in stroke survivors. Little is known, however, of the agreement between self-report and caregiver proxy-report on perceived chronic stress or mutuality in PWA. Purpose The proposed study sought to examine (a) the degree of agreement between caregiver proxy-report and PWA self-report on perceived stress and (b) the relationship between perceived stress and mutuality between PWA and their caregivers. Method The Modified Perceived Stress Scale and the Mutuality Scale were administered to 21 PWA/caregiver dyads. An independent-samples t test was conducted to determine if there were significant differences in perceived stress and mutuality as reported by PWA, their caregiver, and their caregiver's proxy-report. A Pearson correlation was performed to determine the level of agreement across questionnaires. Results There was a moderate correlation between the proxy-report and self-report for perceived stress. On average, proxy-reports for perceived stress were significantly higher than PWA self-reports. Overall, mutuality was high among the dyads. There was moderate agreement between caregiver's mutuality and proxy-report agreement on perceived stress. Lastly, our findings do not indicate that caregiver's perceived stress influenced their perception of the PWA's perceived stress. Conclusion The results of this study provide support for the use of proxy-derived information in perceived stress with the use of a mutuality scale.
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Affiliation(s)
| | - Lauren Bislick
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | - Amy Engelhoven
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
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23
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Roydhouse JK, Cohen ML, Eshoj HR, Corsini N, Yucel E, Rutherford C, Wac K, Berrocal A, Lanzi A, Nowinski C, Roberts N, Kassianos AP, Sebille V, King MT, Mercieca-Bebber R. The use of proxies and proxy-reported measures: a report of the international society for quality of life research (ISOQOL) proxy task force. Qual Life Res 2021; 31:317-327. [PMID: 34254262 DOI: 10.1007/s11136-021-02937-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 12/15/2022]
Abstract
AIMS Proxy reports are often used when patients are unable to self-report. It is unclear how proxy measures are currently in use in adult health care and research settings. We aimed to describe how proxy reports are used in these settings, including the use of measures developed specifically for proxy reporting in adult health populations. METHODS We systematically searched Medline, PsycINFO, PsycTESTS, CINAHL and EMBASE from database inception to February 2018. Search terms included a combination of terms for quality of life and health outcomes, proxy-reporters, and health condition terms. The data extracted included clinical context, the name of the proxy measure(s) used and other descriptive data. We determined whether the measures were developed specifically for proxy use or were existing measures adapted for proxy use. RESULTS The database search identified 17,677 possible articles, from which 14,098 abstracts were reviewed. Of these, 11,763 were excluded and 2335 articles were reviewed in full, with 880 included for data extraction. The most common clinical settings were dementia (30%), geriatrics (15%) and cancer (13%). A majority of articles (51%) were paired studies with proxy and patient responses for the same person on the same measure. Most paired studies (77%) were concordance studies comparing patient and proxy responses on these measures. DISCUSSION Most published research using proxies has focused on proxy-patient concordance. Relatively few measures used in research with proxies were specifically developed for proxy use. Future work is needed to examine the performance of measures specifically developed for proxies. SYSTEMATIC REVIEW REGISTRATION PROSPERO No. CRD42018103179.
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Affiliation(s)
- Jessica K Roydhouse
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
- Department of Health Services, Policy & Practice, Brown University School of Public Health, Providence, RI, USA.
| | - Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE, USA
| | - Henrik R Eshoj
- Department of Hematology, Quality of Life Research Center, Odense University Hospital, Odense, Denmark
| | - Nadia Corsini
- Rosemary Bryant AO Research Centre, University of South Australia, Adelaide, SA, Australia
| | - Emre Yucel
- Amgen, Global Health Economics, Thousand Oaks, CA, USA
- Bristol Myers Squibb, New York, NY, USA
| | - Claudia Rutherford
- Cancer Nursing Research Unit (CNRU), Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Katarzyna Wac
- Quality of Life Technologies Lab, University of Geneva, Geneva, Switzerland
- Quality of Life Technologies Lab, University of Copenhagen, Copenhagen, Denmark
| | - Allan Berrocal
- Quality of Life Technologies Lab, University of Geneva, Geneva, Switzerland
| | - Alyssa Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, Newark, DE, USA
| | - Cindy Nowinski
- Departments of Medical Social Sciences and Neurology, Northwestern University Feinberg School of Medicine, Evanston, IL, USA
| | - Natasha Roberts
- Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia
- Queensland University of Technology, Brisbane, QLD, Australia
| | - Angelos P Kassianos
- Department of Applied Health Research, University College London, London, UK
| | - Veronique Sebille
- SPHERE, University of Nantes, University of Tours, INSERM, Nantes, France
- Department of Methodology and Biostatistics, Nantes University Hospital, Nantes, France
| | - Madeleine T King
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
| | - Rebecca Mercieca-Bebber
- Faculty of Medicine, Sydney Medical School, Central Clinical School, The University of Sydney, Sydney, NSW, Australia
- NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia
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24
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Cohen ML, Boulton AJ, Lanzi AM, Sutherland E, Hunting Pompon R. Psycholinguistic features, design attributes, and respondent-reported cognition predict response time to patient-reported outcome measure items. Qual Life Res 2021; 30:1693-1704. [PMID: 33555446 PMCID: PMC8178143 DOI: 10.1007/s11136-021-02778-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/20/2021] [Indexed: 11/14/2022]
Abstract
Purpose Patient-reported outcome measures (PROMs) vary in their psycholinguistic complexity. This study examined whether response time to PROM items is related to psycholinguistic attributes of the item and/or the self-reported cognitive ability of the respondent. Methods Baseline data from Wave 2 of the Quality of Life in Neurological Disorders (Neuro-QoL) development study were reanalyzed. That sample contained 581 adults with neurological disorders and whose self-reported cognitive abilities were quantified by the Neuro-QoL v2.0 Cognitive Function Item Bank. 185 Neuro-QoL items were coded for several psycholinguistic variables and design attributes: number of words and syllables, mean imageability of words, mean word frequency, mean age of word acquisition, and response format (e.g., about symptom frequency or task difficulty). Data were analyzed with linear and generalized linear mixed models. Results Main effects models revealed that slower response times were associated with respondents with lower self-reported cognitive abilities and with PROM items that contained more syllables, less imageable (e.g., more abstract) words, and that asked about task difficulty rather than symptom frequency. Interaction effects were found between self-reported cognition and those same PROM attributes such that people with worse self-reported cognitive abilities were disproportionately slow when responding to items that were longer (more syllables), contained less imageable words, and asked about task difficulty. Conclusion Completing a PROM requires multiple cognitive skills (e.g., memory, executive functioning) and appraisal processes. Response time is a means of operationalizing the amount or difficulty of cognitive processing, and this report indicates several aspects of PROM design that relate to a measure’s cognitive burden. However, future research with better experimental control is needed. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-021-02778-5.
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Affiliation(s)
- Matthew L Cohen
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA. .,Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA.
| | - Aaron J Boulton
- Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, 19713, USA
| | - Alyssa M Lanzi
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA
| | - Elyse Sutherland
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA
| | - Rebecca Hunting Pompon
- Department of Communication Sciences and Disorders, University of Delaware, 100 Discovery Blvd 6th Floor, Newark, DE, 19713, USA
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