Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Measurement properties of frenchay aphasia screening test across different languages: A COSMIN systematic review.(University of Kelaniya, Sri Lanka, 2023) Jayasingha, J.A.P.P.; Ariyasena, A.D.K.; Siriwardhana, D.D.BACKGROUND: Aphasia is a language disorder that occurs due to damage to the brain; the left side of the brain contributes more towards language. Aphasia may cause problems in understanding, speaking, reading, or writing (American Speech-Language-Hearing Association, 2022a). The main goals of speech therapy treatments are to enhance communication, restore speech and language ability as much as possible, and teach different communication strategies (Schulman, 2020). Frenchay Aphasia Screening test (FAST) is used to identify aphasia (Enderby et al., 1987). The best-evaluated and most widely used aphasia assessment is the Frenchy aphasia screening test (Salter et al., 2006). No matter how valid this original tool is, a systematic review is yet to be conducted collating the psychometric properties of the FAST test across different languages. It is therefore important to summarize the measurement properties in those studies to analyzed the methodological quality of those validation studies. It will aid in identifying research gaps and inform future research. The study describes the measurement properties of Frenchay Aphasia Screening Test across different languages. OBJECTIVE/S: This systematic review aimed to appraise and summarize the psychometric properties of the Frenchay Aphasia Screening Test across different languages. METHODS: This study was conducted as a systematic review and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 2020 guideline. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD - 383989). Research studies were searched using the following electronic databases: MEDLINE, EMBASE, PsychInfo, AMED, CINAHL Plus, and Web of Science. Reference lists of selected articles were also searched, and a forward citation search was done through Google Scholar. Studies were included if they presented at least one psychometric measurement property described in the consensus-based standards for the selection of health states measurement instrument (COSMIN) risk of bias checklist. Study selection involved two stages: 1) title and abstract screening and 2) full-text review. Disagreements between the two reviewers were discussed in both stages until a consensus was researched. The inter-rater reliability between the two raters was good (kappa=0.76) during the full-text review. The methodological quality of studies on measurement properties was assessed using the COSMIN risk of bias checklist. Data were synthesized according to the COSMIN guidelines. RESULTS: One hundred fifty-two articles were screened; 143 articles were excluded, and nine articles were selected for full-text review; four articles were included from full-text review. Overall, seven articles were included. This review included the original English version and six translations/adaptations of FAST. Two independent reviewers were involved in the article selection to avoid bias. According to the results, the PROM development studies on FAST were low. When considering the methodological quality of 16 measurement properties, hypothesis testing was rated as high as it was analyzed in four studies, and in each of those studies, it was rated as sufficient. The results were inconsistent and insufficient for other measurement properties to make conclusions. CONCLUSION/S: Based on the overall findings, only hypothesis testing demonstrated high-quality evidence for Frenchay Aphasia Screening Test. Furthermore, due to insufficient results, it was not possible to come to a conclusion about the measurement properties of content validity, internal consistency, cross-cultural validity, reliability, and criterion validity of the Frenchay aphasia screening test.Item Measurement properties of instruments assessing Aphasia impact on social participation: A COSMIN systematic review(University of Kelaniya, Sri Lanka, 2023) de Za, T.A.P.; Munasinghe, T.U.; Siriwardhana, D.D.BACKGROUND: Aphasia is a language disorder that significantly limits a person's social participation. Patient-reported outcome measures (PROMs) of social participation play an important role in clinical practice to identify activity limitations and participation restrictions. Even though PROMs of the impact of aphasia on social participation are used to measure this aspect, their suitability is unclear. It is crucial that these PROMs demonstrate adequate measurement properties, such as validity, reliability and responsiveness for the intended population. Additionally, people with aphasia are excluded from research due to communication deficits. However, their involvement during assessment tool development is crucial to construct high-quality assessments. OBJECTIVE/S: The objective of this study is to critically appraise and summarize the measurement properties of instruments assessing the impact of aphasia on social participation using COSMIN criteria, to map the domains of instruments that assess the impact of aphasia on social participation against the social participation domains framework introduced by the ICF and to compare the measurement properties of the included instruments that are created with and without direct patient involvement. METHODS: The study protocol was developed with adherence to the statement of PRISMA-P, and the study was registered in PROSPERO (CRD-384044). A comprehensive electronic search was conducted in MEDLINE, EMBASE, CINAHL Plus, PsycINFO, AMED, and Web of Science Core Collection databases, and a secondary search was performed in Web of Science and Google Scholar. Studies on the development and testing measurement properties of instruments assessing the impact of aphasia on social participation were included in this review. The quality of evidence regarding measurement properties of the selected tools, including risk of bias, was evaluated against COSMIN criteria. RESULTS: Four articles featuring three instruments (Community Integration Questionnaire (CIQ), Social Activities Checklist (SOCACT), and Stroke Social Network Scale (SSNS)) assessing the impact of aphasia on social participation were identified. The quality of evidence for ‘CIQ’ development, reliability, and construct validity were ‘satisfactory’. The quality of evidence for ‘SSNS’ PROM development was ‘low- very serious risk of bias’. However, ‘satisfactory’ evidence was reported for construct validity. CIQ and SOCACT instruments showed good face validity. Compared to other instruments, SSNS reported satisfactory involvement of persons with aphasia during instrument development. The quality of evidence for internal consistency was only evaluated for two instruments due to a lack of evidence. There was no evidence for content validity, measurement error, measurement invariance, criterion validity and responsiveness. CONCLUSION/S: Instruments that exclusively measure the impact of aphasia on social participation have limited evidence of measurement properties. Further work is required to update and investigate the missing 13 measurement properties of these instruments. Based on the available evidence, the Community Integration Questionnaire can be recommended to measure the impact of aphasia on social participation.Item Speech therapy interventions for acquired apraxia of speech: An updated systematic review(American Speech-Language-Hearing Association, 2023) Munasinghe, T.U.; Ariyasena, W.A.A.D.K.; Siriwardhana, D.D.PURPOSE: This systematic review aims to summarize and evaluate the available literature on speech and language therapy interventions for acquired apraxia of speech since 2012. METHOD: A systematic search in six electronic databases was performed from 2013 to 2020. The following primary outcomes were summarized: (a) improvement in targeted behaviors, (b) generalization, and (c) maintenance of outcomes. Moreover, studies were evaluated for the level of evidence and the clinical phase. RESULTS: Of the 3,070 records identified, 27 studies were included in this review. The majority of the studies (n = 22) used articulatory kinematic approaches followed by intersystemic facilitation/reorganization treatments (n = 4) and other approaches (n = 1). According to the classes defined in Clinical Practice Guideline Process Manual (Gronseth et al., 2017), one was Class II, 10 were Class III, 10 were Class III-b (fulfill Class III criteria except for independence of assessors' criterion), and five were Class IV. In terms of clinical phase, one study classified as Phase III, 10 as Phase II, and 15 as Phase I. CONCLUSIONS: Among the interventions for apraxia of speech, articulatory kinematic treatments have become prominent over the last 8 years. Focusing on self-administrated therapies, use of technology for therapy administration and development of treatments that focus on apraxia of speech and aphasia simultaneously were identified as new advancements in the apraxia of speech literature. The methodological quality, clinical phase, and level of evidence of the studies have improved within the past 8 years. Large-scale randomized controlled trials for articulatory kinematic approaches and future studies on other treatment approaches are warranted.