Research Center for Child Mental Development, Chiba University, Chiba, Japan.
Department of Rehabilitation, Mitsuwadai General Hospital, Chiba, Japan.
Folia Phoniatr Logop. 2022;74(3):195-208. doi: 10.1159/000519381. Epub 2021 Sep 10.
Evaluation of multiple domains, such as language, articulation, and cognitive function, is frequently required in neurological communicative disorders. The purpose of this study was to investigate the performance of a 10-min screening scale for estimating aphasia, dysarthria, and cognitive dysfunction using a multicenter, large-sized consecutive series.
We conducted a multicenter validation study that included 314 patients with brain injury between February 1 and June 31, 2018, from 20 medical centers across Japan. The Screening Test for Aphasia and Dysarthria (STAD) was developed in Japan in 2009, and a previous smaller-scale retrospective study established its high to moderate validity. All patients had undergone the STAD, and 212 of them underwent the Western Aphasia Battery or Assessment of Motor Speech for Dysarthria. The effect size on all 29 items and receiver operating curves of 3 sections of the STAD were analyzed based on external criteria, which were decided considering the clinical diagnosis of aphasia, dysarthria, and cognitive dysfunction. Correlations between the STAD and reference tests were calculated.
The phi coefficients of 23 out of 29 items exceeded the moderate effect size of 0.3 toward the targeted disorder. Overall, there was a good balance between sensitivity (82-92%) and specificity (77-78%), with moderate to large positive and negative likelihood ratios (3.7-4.19 and 0.1-0.23). The Pearson's r between the verbal section and Western Aphasia Battery Aphasia Quotient, the articulation section and Assessment of Motor Speech for Dysarthria, and the nonverbal section and Western Aphasia Battery Nonlinguistic Skills were 0.89, 0.70, and 0.79, respectively.
We demonstrated that the STAD has acceptable content and concurrent validity for the assessment of communicative function in patients with brain injury. This short screening tool can be useful in specific contexts, such as in early bedside investigations, to obtain a quick summary of communicative function prior to the administration of other tests, and in cases where more in-depth testing is not feasible.
在神经交流障碍中，经常需要评估多个领域，如语言、发音和认知功能。本研究的目的是通过多中心、大样本连续系列研究，探讨使用 10 分钟筛查量表评估失语症、构音障碍和认知功能障碍的性能。
我们进行了一项多中心验证研究，纳入了 2018 年 2 月 1 日至 6 月 31 日来自日本 20 个医学中心的 314 名脑损伤患者。筛查失语症和构音障碍测试（STAD）于 2009 年在日本开发，之前的小规模回顾性研究已经证实其具有较高到中度的有效性。所有患者均接受了 STAD 测试，其中 212 名患者接受了西方失语症成套测验或构音障碍评估的运动言语测试。根据外部标准分析了 29 项测试中的所有 29 项和 3 个部分的接收者操作曲线的效应大小，这些标准是根据失语症、构音障碍和认知功能障碍的临床诊断来决定的。计算了 STAD 与参考测试之间的相关性。
29 项测试中有 23 项的 phi 系数超过了 0.3 的中度效应大小，针对目标障碍。总的来说，敏感性（82-92%）和特异性（77-78%）之间存在良好的平衡，具有中等至大的阳性和阴性似然比（3.7-4.19 和 0.1-0.23）。言语部分与西方失语症成套测验失语症商数、发音部分与构音障碍评估的运动言语测试以及非言语部分与西方失语症成套测验非言语技能之间的 Pearson r 分别为 0.89、0.70 和 0.79。
我们证明 STAD 对脑损伤患者的交流功能评估具有可接受的内容和同时效度。这种简短的筛查工具在特定情况下可能很有用，例如在早期床边检查中，在进行其他测试之前快速总结交流功能，以及在无法进行更深入测试的情况下。
