A standardization study of the Italian version of Frenchay Aphasia Screening Test in aphasic patients and control subjects

Transcription

1 9 th European Congress of Speech and Language Therapy Palazzo dei Congressi & Palazzo degli Affari, Florence, Italy 8/9 May 2015 A standardization study of the Italian version of Frenchay Aphasia Screening Test in aphasic patients and control subjects Jessica Bonelli Speech and Language Therapist Santi Centorrino U.O.Rehabilitation Az.USL7, Siena Fabio Ferretti A.O.U.S. Le Scotte, Siena Giovanna Carlucci Stroke Unit A.O.U. Careggi Neuroscience Department, Univeristy of Florence

2 LINGUISTIC SCREENING..WHY? To establish the presence and the gravity of aphasia in acute patients to take early decisions about the kind of treatment to monitor the evolution of the disorder providing a repeatable measure ONE OF THE MOST VALID SCREENING TEST FOR APHASIA IS

3 THE FRENCHAY APHASIA SCREENING TEST (FAST) Devised by Pamela M.Enderby, Victorine A.Wood, Derick T.Wade (Bristol Stroke Unit of Frenchay Hospital, Bristol, UK) in nd Edition in The current version is the 3rd, published by STASS Publication in The Frenchay Aphasia Screening Test was developed for use by non-specialists, such as junior medical staff, nurses, occupational therapists and others. This test is brief (3-10 minutes) and simple to administer, can be used in a busy ward or home situation and has good reliability when used by non-specialists. TEST STRUCTURE and LANGUAGE DOMAINS: 4 sections: COMPREHENSION (2 subtest); VERBAL EXPRESSION (2 subtest); READING; WRITING. Shortened version: COMPREHENSION (2 subtest) and VERBAL EXPRESSION (2 subtest).

4 THE FRENCHAY APHASIA SCREENING TEST (FAST) SCIENTIFIC LITERATURE: high reliability; (Enderby 1987; Enderby 1996; O Neill 1990) the most accurate of 6 screening test in term of specificity and sensitivity; (Salter 2006) the most widely used and thoroughly evaluated tool found within the stroke research literature. Recommended as a screening tool by international guidelines American Speech- Language-Hearing Association ASHA and italian guidelines Federazione Logopedisti Italiani FLI ISS (Istituto Superiore di Sanità). In Italy: translate by Posteraro et al. to identify aphasics subjects for his Italian version of Stroke and Aphasia Quality of Life Scale 39 (SAQOL-39). AIM OF THIS STUDY: to develop an italian version (I-FAST) of Frenchay Aphasia Screening Test and to test the reliability and validity of the I-FAST.

5 Italian version of Frenchay Aphasia Screening Test (FAST): I-FAST Cultural adaptation of the stimolus card: from «River Scene» to «Country Scene»; Test structure and language domains were unchanged; Instructions changed in respect to the original linguistic and spatial characteristics of the image.

6 ITALIAN STANDARDIZATION OF I-FAST SAMPLE I-FAST was administered to 288 subjects from different regions of Italy: 186 non-aphasic (healthy or non-aphasic brain injured patients) Regions: Toscana, Sicilia, Campania, Puglia, Calabria, Veneto, Lazio, Emilia Romagna, Marche, Basilicata, Liguria, Lombardia, Abruzzo, Molise, Sardegna, Umbria e Friuli Venezia Giulia. 102 aphasic patients The presence of aphasia was documented with a standardized clinical logopaedic or neurologic examination. In most cases aphasia was consequence of stroke; 3 other cases of: TIA (Transient Ischemic Attack), ABI (Acquired Brain Injury) and neurodegenerative desease. Regions: Toscana, Campania, Lazio, Veneto, Lombardia, Sardegna, Sicilia, Emilia Romagna, Umbria, Piemonte, Abruzzo e Puglia. Frequency % Valid % Absolute % NON Aphasic ,4 64,4 64,4 Valid Aphasic ,6 35,6 100,0 Tot ,0 100,0

7 ITALIAN STANDARDIZATION OF I-FAST SAMPLE Sex Frequency % Valid % Absolute % Female ,4 55,6 55,6 Valid Male ,6 44,4 100,0 Tot ,0 100,0 Report Age MA SD NON Aphasic 52,37 19,877 Aphasic 70,10 13,105 Tot. 58,65 19,680 Age NON Aphasic Aphasic Tot. Report Sex MA SD Female 53,50 20,173 Male 50,62 19,418 Tot. 52,37 19,877 Female 72,30 12,765 Male 68,22 13,214 Tot. 70,10 13,105 Female 59,02 20,189 Male 58,18 19,093 Tot. 58,65 19,680

8 VALIDITY OF I-FAST RASCH ANALYSIS SUMMARY OF 170 MEASURED (NON-EXTREME) persons RAW MODEL INFIT OUTFIT SCORE COUNT MEASURE ERROR MNSQ ZSTD MNSQ ZSTD MEAN S.D MAX MIN REAL RMSE 7.41 ADJ.SD SEPARATION 2.28 person RELIABILITY.84 MODEL RMSE 7.04 ADJ.SD SEPARATION 2.42 person RELIABILITY.85 S.E. OF person MEAN = MAXIMUM EXTREME SCORE: 86 persons SUMMARY OF 6 MEASURED (NON-EXTREME) items RAW MODEL INFIT OUTFIT SCORE COUNT MEASURE ERROR MNSQ ZSTD MNSQ ZSTD MEAN S.D MAX MIN REAL RMSE 1.03 ADJ.SD 7.00 SEPARATION 6.83 item RELIABILITY.98 MODEL RMSE 1.01 ADJ.SD 7.01 SEPARATION 6.96 item RELIABILITY.98 S.E. OF item MEAN = UMEAN= USCALE= item RAW SCORE-TO-MEASURE CORRELATION = -.99 TESTED SUBJECTS VALIDITY: MEAN INFIT(MNSQ) 1.00 SD 0.1 I-FAST VALIDITY: MEAN INFIT(MNSQ) 0.96 SD -0.3 TESTED SUBJECTS RELIABILITY: 0.84 I-FAST RELIABILITY: 0.98

9 RELIABILITY OF I-FAST CRONBACH S α Reliability Cronbach s α N of Items,931 6 MA scale if item excluded Variance scale if item excluded Correct tot. item Cronbach s α if item excluded Comprehension Img. 1 20,54 40,070,784,922 Comprehension Img. 2 20,27 38,721,834,916 Verbal Expression: sub-test 1 20,06 40,277,809,921 Verbal Expression: sub-test 2 20,54 36,023,860,910 Reading 20,52 35,211,838,913 Writing 20,98 30,625,823,928

10 CUT-OFF DETERMINATION ROC CURVE (Receiver Operating Charateristics) The best cut-off (in term of specificity and sensitivity) is represented by the closest point at the top on the left of this diagram, obtain with the following formula: cut-off I-FAST: 24 (sensitivity=0,871; specificity=0,812) Shortened version cut-off I-FAST-R: 16 (sensitivity=0,882; specificity=0,762)

11 CONCLUSIONS Analysis suggest the usefulness of I-FAST as a reliable and valid screening tool for the detection of aphasia and tracking of its progress for Italian subjects. In the light of these results we hope that I-FAST could become a common screening tool among SLT and non-specialists.

12 SPECIAL THANKS TO Prof. Pamela Enderby for her interest in our research and for allowing us to present our results today. We remind that the copywrite of the original Frenchay Aphasia Screening Test (FAST) is held by STASS Publication.

13 FIND I-FAST WHERE? Waiting for further news about I-FAST, please contact us if you are interested in having a copy of the Italian version of Frenchay Aphasia Screening Test (I-FAST). We ll send you a copy! Jessica Bonelli Santi Centorrino jessica.bonelli@yahoo.it s.centorrino@usl7.toscana.it

14 THANK YOU