Vaghei Sayed Mohammad Mahdi, Asadi Mozhgan, Mansuri Banafshe
Department of Speech Therapy, School of Rehabilitation Sciences, Semnan University of Medical Sciences, Semnan, Iran.
Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
Int J Lang Commun Disord. 2025 Sep-Oct;60(5):e70097. doi: 10.1111/1460-6984.70097.
Remote assessment through telehealth offers potential benefits for people with aphasia (PWA), particularly where in-person services are limited. However, its diagnostic validity in developing countries remains underexplored due to differences in infrastructure and digital literacy.
To compare in-person and remote administration of the Persian Diagnostic Aphasia Battery-2: Aphasia Quotient 2 (P-DAB2-AQ2) in Persian-speaking PWA and to examine participants' technology use and satisfaction with remote assessment.
Twenty adults with mild to severe aphasia (mean age 55.85 years) completed the P-DAB2-AQ2 both in person and remotely via Skype. The test order was counterbalanced, and administration was conducted by two independent, blinded assessors. Intraclass correlation coefficients (ICCs) and Wilcoxon signed-rank tests were used to analyse score consistency across formats. Participants also completed surveys on prior technology use and satisfaction with remote assessment.
ICCs indicated excellent agreement between in-person and remote AQ2 scores (0.986) and good to excellent agreement for subtests (0.834-0.981). No significant differences were found for individual subtests (p > 0.05), although the total AQ2 score was marginally higher for in-person assessments (p = 0.044). Connected speech showed the highest variability across formats, leading to aphasia type reclassification in four participants. Ten participants showed AQ2 differences > 5 points, primarily among those with severe aphasia. Despite 60% reporting low comfort with technology, 75% were satisfied with remote assessment, and no significant correlation was found between tech experience or satisfaction and performance.
Remote administration of the P-DAB2-AQ2 was reliable and comparable to in-person testing, supporting its clinical feasibility in Iran. However, variability in connected speech scores highlights the need for cautious interpretation. Further studies with larger samples are needed to optimize remote protocols and ensure broader applicability.
What is already known on the subject Telehealth in speech-language pathology (SLP), particularly for aphasia assessment, has shown comparable results to in-person assessments in developed countries. However, challenges such as technological infrastructure and professional readiness hinder its widespread adoption in developing countries like Iran. What this study adds to the existing knowledge This study is the first to compare in-person and remote administration of the Persian Diagnostic Aphasia Battery (P-DAB) in Persian-speaking people with aphasia (PWA). It provides detailed insights into the validity of remote assessments for each subtest, highlighting which areas are less reliable when administered remotely. What are the potential or clinical implications of this work? The findings support the feasibility of using remote assessments to provide speech therapy services in Iran, potentially improving access to rehabilitation for PWA, especially in underserved and rural areas. This could lead to broader implementation of telehealth, ensuring timely intervention and improved quality of life for PWA.
通过远程医疗进行远程评估为失语症患者（PWA）带来了潜在益处，尤其是在面对面服务有限的情况下。然而，由于基础设施和数字素养的差异，其在发展中国家的诊断有效性仍未得到充分探索。
比较波斯语诊断失语症量表-2：失语商数2（P-DAB2-AQ2）在说波斯语的PWA中的面对面和远程施测情况，并考察参与者的技术使用情况以及对远程评估的满意度。
20名轻度至重度失语症成人（平均年龄55.85岁）分别通过面对面和Skype远程完成了P-DAB2-AQ2测试。测试顺序采用平衡设计，由两名独立的、不知情的评估者进行施测。组内相关系数（ICC）和Wilcoxon符号秩检验用于分析不同测试形式下得分的一致性。参与者还完成了关于先前技术使用情况和对远程评估满意度的调查。
ICC表明面对面和远程AQ2得分之间具有极好的一致性（0.986），各子测试的一致性良好至极好（0.834 - 0.981）。各单项子测试未发现显著差异（p > 0.05），尽管面对面评估的AQ2总分略高（p = 0.044）。连贯言语在不同测试形式下的变异性最高，导致4名参与者的失语类型重新分类。10名参与者的AQ2差异> 5分，主要集中在重度失语症患者中。尽管60%的参与者表示对技术的舒适度较低，但75%的人对远程评估感到满意，并且技术经验或满意度与测试表现之间未发现显著相关性。
P-DAB2-AQ2的远程施测是可靠的，且与面对面测试相当，支持其在伊朗的临床可行性。然而，连贯言语得分的变异性凸显了谨慎解读的必要性。需要进行更大样本量的进一步研究，以优化远程测试方案并确保更广泛的适用性。
该主题已有的知识 言语语言病理学（SLP）中的远程医疗，特别是用于失语症评估，在发达国家已显示出与面对面评估相当的结果。然而，诸如技术基础设施和专业准备等挑战阻碍了其在伊朗等发展中国家的广泛应用。本研究对现有知识的补充 本研究首次比较了波斯语诊断失语症量表（P-DAB）在说波斯语的失语症患者（PWA）中的面对面和远程施测情况。它详细深入地探讨了每个子测试远程评估的有效性，突出了远程施测时哪些领域不太可靠。这项工作的潜在或临床意义是什么？研究结果支持在伊朗使用远程评估提供言语治疗服务的可行性，这可能改善PWA获得康复治疗的机会，特别是在服务不足的农村地区。这可能导致远程医疗的更广泛实施，确保PWA得到及时干预并提高生活质量。
