Natalie Gilmore, Michaela Dwyer, Swathi Kiran Boston ... · • SpeechBite • EMBASE • SCOPUS...
Transcript of Natalie Gilmore, Michaela Dwyer, Swathi Kiran Boston ... · • SpeechBite • EMBASE • SCOPUS...
• Widevarietyofoutcomemeasuresusedinaphasiatreatmentresearch(Brady,Kelly,Godwin,Enderby,Campbell,2016;Wallace,Worrall,Rose&LeDorze,2014;Xiong,Bunning,Horton&Hartley,2011)
• NosystemaNcally-establishedbenchmarksonthesemeasurestoshowchange• Createschallengesforcliniciansandresearchersalike
NatalieGilmore,MichaelaDwyer,SwathiKiranBostonUniversityAphasiaResearchLaboratory
Asystema)creviewofoutcomemeasuresu)lizedinaphasiatreatmentresearch,includingmeta-analysis
WorldHealthOrganizaNon(WHO)ICFmodel(WHO,2002)
A-FROM(Kaganetal.,2008)
Usefulframeworksforclassifyingaphasiaassessmentsandinterven)ons
Group Use Ac)on
Loca)on
Associa)on Proper)es
Boyle&Coehlo,1995 Aten,Caligiuri,Holland,1982 Elman,2016
Kertesz,2006 Holland,Fra\ali,&Fromm,1999 Hilari,Byng,Lamping&Smith,2003
Manydifferenttreatmentapproaches
Manydifferentassessmentmeasures
BodyStructure/Func)on Ac)vity/Par)cipa)on QualityofLife
BodyStructure/Func)on Ac)vity/Par)cipa)on QualityofLife
Showingchangefrominterven)onisessen)al
• Inconsistencyinmeasurementuse• Clinicians(Hesketh&Hopcu\,1997;Worrall&Egan,2001;Simmons-Mackie,Threats&Kagan,2004)
• Researchers(Bradyetal.,2016,Wallaceetal.,2014)
• Stepstomanagethischallenge• ImprovingResearchOutcomeMeasurementinAphasia(ROMA)&CoreOutcomeSet(COS)(Wallaceetal.,2014)
• Yet,whatistheaveragechangeonthesemeasures?<-ourprimaryaim• Clinicians->Chooseappropriatetools->Efficacy&reimbursement• Researchers->Selectbestmeasures->Appropriately-poweredstudies&easiermeta-analyses
SpecificAimsofthisproject
Iden)fica)onofoutcomemeasuresusedinbehavioralaphasiatreatmentresearch1
Classifica)onofinterven)onsandoutcomemeasuresaccordingtotheirassocia)onwithhealthandhealth-relateddomainsusingICF&A-FROM
2
Calcula)onofthemeansignificantchangereportedonthemostfrequently-usedandmostrelevantoutcomemeasures3
Methods
• PreferredReporNngItemsforSystemaNcReviewandMeta-analysisProtocol(PRISMA-P)• RegisteredonInternaNonalProspecNveRegisterofSystemaNcReviews(PROSPERO)• Comprehensiveliteraturesearch
• Screening,dataextracNonandraNngofqualityofevidence• 2independentreviewers
LiteratureSearch
• PubMed• CINAHL• PsychInfo• SpeechBite• EMBASE• SCOPUS• WebofScience
• PLoS• Worldcat• NARIC• GoogleScholar• LinguisNc&LanguageBehaviorAbstracts(LLBA)
12databases:
‘aphasia’AND‘treatment’OR‘therapy’OR’intervenNon’OR‘rehabilitaNon’OR‘outcome’OR‘training’OR‘educaNon’AND‘adult’NOT‘primaryprogressiveaphasia’OR‘demenNa’OR‘degluNNondisorders’OR‘transcranialmagneNcsNmulaNon’OR‘transcranialdirectcurrentsNmulaNon’NOT‘pharmaceuNcalpreparaNons’
SampleSearchStrategy:
EligibilityCriteria
Included:• Behavioralaphasiatreatmentstudies• Usedstandardizedoutcomemeasuretomeasurechange• Randomized-controlledtrials,quasi-experimentalstudies,single-subjectdesignsandcasereports(i.e.,Nof3)
Excluded:
• Diagnosesofprimaryprogressiveaphasia,demenNa,traumaNcbraininjury(TBI),voiceimpairment,dysarthriaandapraxiaofspeech(AOS)
• Drugtreatmentsorneuro-modulaNon(e.g.,repeNNvetranscranialmagneNcsNmulaNon(rTMS))
• QualitaNveresearchdesigns• StudiesevaluaNngthevalidityofanassessmenttool
Screening
Included
Eligibility
Iden)fica)on
Recordsiden)fiedthroughdatabasesearching(n=15,809)
Addi)onalrecordsiden)fiedthroughothersources(n=151)
Recordsa[erduplicatesremoved(n=9285)
Titlesandabstractsscreened(n=9285)
Excluded(n=8428)
Full-textar)clesassessedforeligibility(n=858)
Studiesincludedinqualita)vesynthesis(n=310)
Studiesincludedinquan)ta)vesynthesisTBDajerIARC2016
Excludedwithreasons(n=548)Wrongpopula)on=60Notbehavioraltreatment=3Nottreatmentstudy=80Nof1=3Nof2=7Non-English=11Notpeer-reviewed=9Duplicate=9Other=2Nostandardizedmeasure=330Duplicatedataset=29Ongoingstudy=5
MoherD,LiberaNA,TetzlaffJ,AltmanDG,ThePRISMAGroup(2009)PRISMAFlowDiagram
Nextsteps
SelectmeasuresfromeachICFdomainformeta-analysisLikelyopNons:
• RevisedWesternAphasiaBa\ery(WAB)(Kertesz,2006)• CommunicaNveEffecNvenessIndex(CETI)(Lomasetal.,1989)
Conductmeta-analysesforselectsetofmeasures
THANKYOUFORYOURATTENTION!NatalieGilmore,MichaelaDwyer&SwathiKiranBostonUniversityAphasiaResearchLaboratoryPleaseforwardques)[email protected]