Criel Yana, De Groote Evelien, Benbassat Evelyne, Beirinckx Britt, Van Damme Megan, Kong Anthony Pak-Hin, De Letter Miet
Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium.
J Commun Disord. 2025 Jul-Aug;116:106543. doi: 10.1016/j.jcomdis.2025.106543. Epub 2025 Jun 19.
This study aimed to assess the sensitivity, specificity and inter-rater reliability of the Dutch Main Concept Analysis (MCA), a diagnostic tool that evaluates the effectiveness and efficiency of information transfer during verbal discourse production, in people with aphasia (PWA).
The MCA was administered to 30 persons with aphasia (17 fluent, 13 nonfluent). Sensitivity and specificity were assessed through (1) single-subject level comparison of MCA scores to normative data, (2) group-level comparison of MCA scores between PWA and 30 age-matched controls, and (3) ROC-analysis for total main concept score (MCS; effectiveness) and total number of accurate and complete main concepts per minute (AC/min; efficiency). Furthermore, the effect of aphasia type (fluent/nonfluent) and severity on these measures was assessed using a linear regression. Discourse samples were scored by two independent raters to calculate inter-rater reliability.
Over 85 % of PWA showed aberrant outcomes on at least four out of seven MCA outcomes based on single-subject comparison to normative data. ROC analysis revealed that MCS and AC/min are sensitive and specific measures to differentiate between discourse of PWA and unimpaired speakers. Increased aphasia severity was associated with a reduced MCS. Good to excellent inter-rater reliability was achieved for all MCA measures.
The Dutch MCA is a sensitive and specific tool, characterized by a good to excellent inter-rater reliability, for identifying impaired effectiveness and efficiency of verbal information transfer during discourse production in PWA. Aphasia severity, but not type, is a determining factor for the effectiveness of information transfer in PWA.
本研究旨在评估荷兰主要概念分析（MCA）这一诊断工具在失语症患者（PWA）中的敏感性、特异性及评分者间信度。该工具用于评估言语话语生成过程中信息传递的有效性和效率。
对30名失语症患者（17名流利型失语，13名非流利型失语）进行MCA测试。通过以下方式评估敏感性和特异性：（1）将MCA得分与常模数据进行单受试者水平比较；（2）比较PWA与30名年龄匹配的对照组之间的MCA得分；（3）对总主要概念得分（MCS；有效性）和每分钟准确完整主要概念的总数（AC/分钟；效率）进行ROC分析。此外，使用线性回归评估失语症类型（流利型/非流利型）和严重程度对这些指标的影响。由两名独立评分者对语篇样本进行评分，以计算评分者间信度。
基于与常模数据的单受试者比较，超过85%的PWA在MCA的七个结果中至少有四个表现异常。ROC分析显示，MCS和AC/分钟是区分PWA和无语言障碍者语篇的敏感且特异的指标。失语症严重程度增加与MCS降低相关。所有MCA指标的评分者间信度良好至优秀。
荷兰MCA是一种敏感且特异的工具，其评分者间信度良好至优秀，可用于识别PWA在语篇生成过程中言语信息传递有效性和效率受损的情况。失语症严重程度而非类型是PWA信息传递有效性的决定因素。
