Epworth HealthCare, Richmond, Australia.
Epworth Rehabilitation Camberwell, Camberwell, Australia.
Int J Speech Lang Pathol. 2020 Oct;22(5):537-548. doi: 10.1080/17549507.2019.1701082. Epub 2020 Mar 5.
: To determine the most effective intervention for adults with social communication impairments due to an Acquired Brain Injury (ABI), using standardised outcome measures completed by significant others.: A systematic literature review was conducted. Four electronic databases relevant to the field of speech-language pathology or brain injury were searched: Medline, CINAHL, AMED and Embase. Grey literature, reference lists and citation indexes were also hand searched for additional research. Studies that met the broad inclusion and exclusion criteria were initially screened to determine articles for full text reviews by two independent reviewers. Reviewers independently extracted data from full-text reviews using a data extraction form and performed bias analysis using the Downs and Black quality checklist (Downs, S.H., & Black, N. (1998). The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. Journal of Epidemiology & Community Health, 52, 377-384.). Studies were categorised using a five-phase model of evidence (Robey, R.R., & Schultz, M.C. (1998). A model for conducting clinical-outcome research: An adaptation of the standard protocol for use in aphasiology. Aphasiology, 12, 787-810.).: 681 articles were identified after duplicates were removed. 15 articles were reviewed for full-text analysis. Six studies were ultimately included in the review. Of these, three were randomised controlled trials and three others were not. Four studies delivered intervention solely to the individual with an ABI, one to the communication partner only, and one delivered intervention both to the individual and their communication partner. Intervention programmes ranged from four to 12 weeks and from 12 to 48 hours total contact time. The reviews studies were heterogeneous, which made comparisons difficult. Risk of bias was also present to varying degrees in all studies. The current level of evidence has focussed on efficacy of treatments and effectiveness of treatment is not yet established.: The current level of evidence is not yet established to make clear clinical guidelines on which interventions are most effective, based on significant others' reports. Further research is required, incorporating more rigorous study designs and larger sample sizes to enable accurate conclusions to be drawn.
为了确定针对因后天性脑损伤(ABI)而导致社交沟通障碍的成年人最有效的干预措施,我们使用由重要他人完成的标准化结果测量进行了系统的文献综述。
我们进行了一次系统的文献综述。检索了与言语病理学或脑损伤领域相关的四个电子数据库:Medline、CINAHL、AMED 和 Embase。还通过手工搜索灰色文献、参考文献列表和引文索引来寻找其他研究。最初筛选符合广泛纳入和排除标准的研究,以确定由两名独立审查员进行全文审查的文章。审查员使用数据提取表从全文审查中独立提取数据,并使用唐斯和布莱克质量检查表(Downs,S.H.和 Black,N.(1998)。创建用于评估医疗干预随机和非随机研究方法质量的检查表的可行性。流行病学与社区卫生杂志,52,377-384.)进行偏倚分析。使用五个阶段的证据模型对研究进行分类(Robey,R.R.和 Schultz,M.C.(1998)。用于进行临床结果研究的模型:对失语症中使用的标准方案的改编。失语症,12,787-810.)。
去除重复项后,共确定了 681 篇文章。对 15 篇文章进行了全文分析。最终有 6 项研究被纳入综述。其中,3 项为随机对照试验,3 项非随机对照试验。4 项研究仅向 ABI 个体提供干预,1 项仅向沟通伙伴提供干预,1 项同时向个体及其沟通伙伴提供干预。干预方案从四周到十二周不等,总接触时间从 12 到 48 小时不等。综述研究具有异质性,使得比较困难。所有研究都存在不同程度的偏倚风险。目前的证据水平集中在治疗的疗效上,尚未确定治疗的有效性。
目前的证据水平尚不能明确指出哪些干预措施最有效,因为这些干预措施是基于重要他人的报告。需要进一步的研究,包括更严格的研究设计和更大的样本量,以便得出准确的结论。