School of Health and Rehabilitation Sciences, The University, of Queensland, Brisbane, QLD, Australia.
Australian Centre for Health Services Innovation, Kelvin Grove, QLD, Australia.
Int J Lang Commun Disord. 2023 Jul-Aug;58(4):1113-1132. doi: 10.1111/1460-6984.12847. Epub 2023 Jan 26.
A number of practice barriers (e.g., time constraints, patient comorbidities and competing demands) exist as regards the evidence-based assessment of adult language within the acute hospital setting. There is need for an evidence-based, diagnostically validated, adaptable, comprehensive and efficient aphasia assessment. The Brisbane Evidence Based Language Test (EBLT) was developed to meet this need for a clinically appropriate and diagnostically robust assessment measure. Since the release of the EBLT, there has been no detailed investigation into speech and language therapists' (SLT) use and perceptions of the assessment. To inform future research and improvements to the EBLT, a better understanding of current language assessment practices, use and thoughts on the EBLT are required.
To investigate SLTs' current language assessment practices; and to explore the current usage and future directions of the Brisbane EBLT.
METHODS & PROCEDURES: A convergent parallel mixed-methods study design with an electronic survey was utilized. The survey consisted of 16 multiple-choice, multiple-answer and free-text questions that explored respondents' perceptions of current language assessment measures, ideal language assessment features, Brisbane EBLT use, positives and negatives, and future directions for the EBLT. The survey was developed on Qualtrics and disseminated via email, social media and professional networks. Snowball sampling was used. Study inclusion criteria required participants to be qualified SLTs with clinical experience working with patients with aphasia. Quantitative data were analysed via descriptive and correlative statistics, and qualitative data were analysed via content analysis.
OUTCOMES & RESULTS: The survey was completed by 115 SLTs from Australia, New Zealand, the United States, the UK, Canada, France, Lebanon and Belgium. Many respondents identified that a range of assessments is required to meet SLT clinical needs in the assessment of aphasia. Key desirable assessment features reported were: comprehensive, efficient, evidence-based, responsive and flexible. The EBLT was the most frequently used standardized measure reported by respondents (used by 78.63%). The EBLT reportedly has many positive features; however, respondents indicated dislike of the form layout, scoring and responsiveness. The majority of respondents indicated that the development of additional EBLT tests (94.29%) and additional cut-off scores (95.15%) would benefit their clinical practice.
CONCLUSIONS & IMPLICATIONS: The study findings indicate that SLT assessment of language is complex and multifaceted. While the EBLT is reportedly used widely by SLTs, respondents identified areas for further research which would optimize the test's usability within their practice, to ultimately improve patient outcomes.
What is already known on the subject Previous studies have explored existing SLT adult language assessment practices within acute settings; however, the most recent comprehensive study was completed in 2010. In 2020, the development, diagnostic validation, intra- and interrater reliability of the Brisbane EBLT were published. As of yet there has not been an investigation into clinician use and perspectives of the assessment since its release. What this paper adds to existing knowledge This study provides contemporary data about international aphasia assessment practices, as well as descriptive and qualitative information on the current use of the Brisbane EBLT, and the positives, negatives, and future directions for the assessment measure. What are the potential or actual clinical implications of this work? The study suggests that no one language assessment currently satisfies all SLTs' assessment needs. It additionally implies that a large proportion of SLTs believe that it is best practice to use multiple language assessment measures and select these based on the patient's presentation and context. Further research is required to aid the development of additional EBLT test versions and cut-off scores to improve SLT adult language assessment practices.
在急性医院环境中，基于证据的成人语言评估存在许多实践障碍（例如，时间限制、患者合并症和竞争需求）。需要一种基于证据、经过诊断验证、适应性强、全面且高效的失语症评估方法。布里斯班基于证据的语言测试 (EBLT) 的开发是为了满足临床合适和诊断稳健评估措施的需求。自 EBLT 发布以来，尚未对言语治疗师 (SLT) 的使用情况和对评估的看法进行详细调查。为了为未来的研究和改进 EBLT 提供信息，需要更好地了解当前的语言评估实践、使用情况以及对 EBLT 的看法。
调查 SLT 目前的语言评估实践；并探讨布里斯班 EBLT 的当前使用情况和未来方向。
采用了具有电子调查的收敛平行混合方法研究设计。该调查由 16 个多项选择、多项答案和自由文本问题组成，旨在探讨受访者对当前语言评估措施、理想语言评估特征、布里斯班 EBLT 使用情况、优点和缺点以及 EBLT 未来方向的看法。该调查是在 Qualtrics 上开发的，并通过电子邮件、社交媒体和专业网络进行分发。采用了雪球抽样。研究纳入标准要求参与者是具有临床经验的合格 SLT，能够治疗失语症患者。通过描述性和相关性统计分析对定量数据进行分析，通过内容分析对定性数据进行分析。
该调查由来自澳大利亚、新西兰、美国、英国、加拿大、法国、黎巴嫩和比利时的 115 名 SLT 完成。许多受访者认为，需要进行一系列评估才能满足 SLT 在评估失语症方面的临床需求。报告的关键理想评估特征包括：全面、高效、基于证据、响应迅速和灵活。EBLT 是受访者报告使用最频繁的标准化评估方法（78.63%）。EBLT 据称具有许多积极的特点；然而，受访者表示不喜欢表格布局、评分和响应性。大多数受访者表示，开发更多的 EBLT 测试（94.29%）和更多的截止分数（95.15%）将有益于他们的临床实践。
本研究结果表明，SLT 对语言的评估是复杂和多方面的。虽然 EBLT 据报道被 SLT 广泛使用，但受访者确定了进一步研究的领域，这将优化该测试在其实践中的可用性，最终改善患者的预后。
