Graduate Program in Health & Rehabilitation Sciences, University of Western Ontario, London, Canada.
School of Communication Sciences and Disorders, University of Western Ontario, London, Canada.
Am J Speech Lang Pathol. 2019 Feb 21;28(1):204-210. doi: 10.1044/2018_AJSLP-18-0048.
Purpose The misuse of standardized assessments has been a long-standing concern in speech-language pathology and traditionally viewed as an issue of clinician competency and training. The purpose of this article is to consider the contribution of communication breakdowns between test developers and the end users to this issue. Method We considered the misuse of standardized assessments through the lens of the 2-communities theory, in which standardized tests are viewed as a product developed in 1 community (researchers/test developers) to be used by another community (frontline clinicians). Under this view, optimal test development involves a conversation to which both parties bring unique expertise and perspectives. Results Consideration of the interpretations that standardized tests are typically validated to support revealed a mismatch between these and the interpretations and decisions that speech-language pathologists typically need to make. Test development using classical test theory, which underpins many of the tests in our field, contributes to this mismatch. Application of item response theory could better equip clinicians with the psychometric evidence to support the interpretations they desire but is not commonly found in the standardized tests used by speech-language pathologists. Conclusions Advocacy and insistence on the consideration of clinical perspectives and decision making in the test validation process is a necessary part of our role. In improving the nature of the statistical evidence reported in standardized assessments, we can ensure these tools are appropriate to fulfill our professional obligations in a clinically feasible way.
目的
在言语病理学中，标准化评估的滥用一直是一个长期存在的问题，传统上被视为临床医生能力和培训的问题。本文旨在探讨测试开发者和最终用户之间沟通不畅对这一问题的贡献。
方法
我们通过 2 个社区理论的视角来考虑标准化评估的滥用问题，该理论将标准化测试视为在一个社区（研究人员/测试开发者）中开发的产品，供另一个社区（一线临床医生）使用。根据这种观点，最佳的测试开发涉及到一个对话，双方都带来了独特的专业知识和观点。
结果
对标准化测试通常支持的解释的考虑揭示了这些解释与言语治疗师通常需要做出的解释和决策之间的不匹配。在我们领域中使用的许多测试所基于的经典测试理论的测试开发促成了这种不匹配。应用项目反应理论可以为临床医生提供更好的心理计量学证据来支持他们所需的解释，但在言语治疗师使用的标准化测试中并不常见。
结论
倡导并坚持在测试验证过程中考虑临床观点和决策是我们角色的必要组成部分。通过改进标准化评估中报告的统计证据的性质，我们可以确保这些工具以临床可行的方式适当履行我们的专业义务。
