Pritchard Madeleine, Hilari Katerina, Cocks Naomi, Dipper Lucy
Division of Language and Communication Science, City University, London, UK.
School of Psychology and Speech Pathology, Curtin University, Perth, WA, Australia.
Int J Lang Commun Disord. 2017 Nov;52(6):689-732. doi: 10.1111/1460-6984.12318. Epub 2017 May 31.
Discourse is fundamental to everyday communication, and is an increasing focus of clinical assessment, intervention and research. Aphasia can affect the information a speaker communicates in discourse. Little is known about the psychometrics of the tools for measuring information in discourse, which means it is unclear whether these measures are of sufficient quality to be used as clinical outcome measures or diagnostic tools.
To profile the measures used to describe information in aphasic discourse, and to assess the quality of these measures against standard psychometric criteria.
METHODS & PROCEDURES: A scoping review method was employed. Studies were identified using a systematic search of Scopus, Medline and Embase databases. Standard psychometric criteria were used to evaluate the measures' psychometric properties.
The current review summarizes and collates the information measures used to describe aphasic discourse, and evaluates their quality in terms of the psychometric properties of acceptability, reliability and validity. Seventy-six studies described 58 discourse information measures, with a mean of 2.28 measures used per study (SD = 1.29, range = 1-7). Measures were classified as 'functional' measures (n = 33), which focused on discourse macrostructure, and 'functional and structural' measures (n = 25), which focused on micro-linguistic and macro-structural approaches to discourse. There were no reports of the acceptability of data generated by the measures (distribution of scores, missing data). Test-retest reliability was reported for just 8/58 measures with 3/8 > 0.80. Intra-rater reliability was reported for 9/58 measures and in all cases percentage agreement was reported rather than reliability. Per cent agreement was also frequently reported for inter-rater reliability, with only 4/76 studies reporting reliability statistics for 12/58 measures; this was generally high (>.80 for 11/12 measures). The majority of measures related clearly to the discourse production model indicating content validity. A total of 36/58 measures were used to make 41 comparisons between participants with aphasia (PWA) and neurologically healthy participants (NHP), with 31/41 comparisons showing a difference between the groups. Four comparisons were made between discourse genres, with two measures showing a difference between genres, and two measures showing no difference.
There is currently insufficient information available to justify the use of discourse information measures as sole diagnostic or outcome measurement tools. Yet the majority of measures are rooted in relevant theory, and there is emerging evidence regarding their psychometric properties. There is significant scope for further psychometric strengthening of discourse information measurement tools.
语篇对于日常交流至关重要，并且日益成为临床评估、干预和研究的重点。失语症会影响说话者在语篇中传达的信息。对于测量语篇中信息的工具的心理测量学特性知之甚少，这意味着尚不清楚这些测量方法的质量是否足以用作临床结局指标或诊断工具。
剖析用于描述失语症语篇中信息的测量方法，并根据标准心理测量学标准评估这些测量方法的质量。
采用了范围综述法。通过系统检索Scopus、Medline和Embase数据库来识别研究。使用标准心理测量学标准来评估测量方法的心理测量学特性。
本综述总结并整理了用于描述失语症语篇的信息测量方法，并根据可接受性、可靠性和有效性等心理测量学特性评估了它们的质量。76项研究描述了58种语篇信息测量方法，每项研究平均使用2.28种测量方法（标准差=1.29，范围=1至7）。测量方法分为“功能性”测量方法（n=33），侧重于语篇宏观结构，以及“功能性和结构性”测量方法（n=25），侧重于语篇的微观语言和宏观结构方法。没有关于这些测量方法所生成数据的可接受性（分数分布、缺失数据）的报告。仅对58种测量方法中的8种报告了重测信度，其中3/8>0.80。对58种测量方法中的9种报告了评分者内信度，并且在所有情况下报告的都是百分比一致性而非信度。对于评分者间信度也经常报告百分比一致性，只有4/76项研究报告了58种测量方法中12种的信度统计数据；总体而言这一数据较高（12种测量方法中有11种>.80）。大多数测量方法与语篇生成模型有明确关联，表明具有内容效度。总共使用58种测量方法中的36种对失语症患者（PWA）和神经功能正常的参与者（NHP）进行了41次比较，其中31/41次比较显示两组之间存在差异。对语篇体裁进行了4次比较，有两种测量方法显示体裁之间存在差异，两种测量方法显示无差异。
目前没有足够的信息来证明将语篇信息测量方法用作唯一的诊断或结局测量工具是合理的。然而，大多数测量方法都基于相关理论，并且关于它们的心理测量学特性也有新出现的证据。语篇信息测量工具在心理测量学方面有很大的进一步强化空间。
