Giannakou Ioanna, Lin Dan, Punt David
School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.
School of Health & Life Sciences, Teesside University, Middlesbrough, United Kingdom.
Front Neurosci. 2022 Aug 19;16:912626. doi: 10.3389/fnins.2022.912626. eCollection 2022.
To date, no gold standard exists for the assessment of unilateral spatial neglect (USN), a common post-stroke cognitive impairment, with limited sensitivity provided by currently used clinical assessments. Extensive research has shown that computer-based (CB) assessment can be more sensitive, but these have not been adopted by stroke services yet.
We conducted a systematic review providing an overview of existing CB tests for USN to identify knowledge gaps and positive/negative aspects of different methods. This review also investigated the benefits and barriers of introducing CB assessment tasks to clinical settings and explored practical implications for optimizing future designs.
We included studies that investigated the efficacy of CB neglect assessment tasks compared to conventional methods in detecting USN for adults with brain damage. Study identification was conducted through electronic database searches (e.g., Scopus), using keywords and standardized terms combinations, without date limitation (last search: 08/06/2022). Literature review and study selection were based on prespecified inclusion criteria. The quality of studies was assessed with the quality assessment of diagnostic accuracy studies tool (Quadas-2). Data synthesis included a narrative synthesis, a table summarizing the evidence, and vote counting analysis based on a direction of effect plot.
A total of 28 studies met the eligibility criteria and were included in the review. According to our results, 13/28 studies explored CB versions of conventional tasks, 11/28 involved visual search tasks, and 5/28 other types of tasks. The vote counting analysis revealed that 17/28 studies found CB tasks had either equal or higher sensitivity than conventional methods and positive correlation with conventional methods (15/28 studies). Finally, 20/28 studies showed CB tasks effectively detected patients with USN within different patient groups and control groups (17/28).
The findings of this review provide practical implications for the implementation of CB assessment in the future, offering important information to enhance a variety of methodological issues. The study adds to our understanding of using CB tasks for USN assessment, exploring their efficacy and benefits compared to conventional methods, and considers their adoption in clinical environments.
迄今为止，对于单侧空间忽视（USN）这一常见的中风后认知障碍，尚无评估的金标准，目前使用的临床评估方法敏感性有限。大量研究表明，基于计算机的（CB）评估可能更具敏感性，但中风服务机构尚未采用这些方法。
我们进行了一项系统综述，概述现有的用于USN的CB测试，以识别知识空白以及不同方法的优缺点。本综述还调查了将CB评估任务引入临床环境的益处和障碍，并探讨了优化未来设计的实际意义。
我们纳入了研究CB忽视评估任务与传统方法相比，在检测脑损伤成人的USN方面疗效的研究。通过电子数据库搜索（如Scopus），使用关键词和标准化术语组合进行研究识别，无日期限制（最后一次搜索：2022年6月8日）。文献综述和研究选择基于预先指定的纳入标准。使用诊断准确性研究质量评估工具（Quadas - 2）评估研究质量。数据综合包括叙述性综合、总结证据的表格以及基于效应方向图的投票计数分析。
共有28项研究符合纳入标准并被纳入综述。根据我们的结果，28项研究中有13项探索了传统任务的CB版本，28项中有11项涉及视觉搜索任务，28项中有5项涉及其他类型的任务。投票计数分析显示，28项研究中有17项发现CB任务的敏感性与传统方法相当或更高，且与传统方法呈正相关（28项研究中有15项）。最后，28项研究中有20项表明CB任务能有效检测不同患者组和对照组中的USN患者（28项研究中有17项）。
本综述的结果为未来实施CB评估提供了实际意义，为解决各种方法学问题提供了重要信息。该研究增进了我们对使用CB任务进行USN评估的理解，探索了其与传统方法相比的疗效和益处，并考虑了其在临床环境中的应用。
