The Screening Test for Aphasia and Dysarthria (STAD) for patients with neurological communicative disorders: a large-scale, multicenter validation study in Japan
The Screening Test for Aphasia and Dysarthria (STAD) for patients with neurological communicative disorders: a large-scale, multicenter validation study in Japan
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针对神经沟通障碍患者的失语症和构音障碍 (STAD) 筛查测试：日本的一项大规模、多中心验证研究
DOI：
10.1159/000519381
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发表时间：
2021
影响因子：
1
通讯作者：
Shimizu Eiji
中科院分区：
文献类型：
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作者：
Araki Kentaro;Hirano Yoshiyuki;Kozono Machiko;Fujitani Junko;Shimizu Eiji
引言：在神经性交流障碍中，经常需要评估多个领域，如语言、发音和认知功能。本研究的目的是调查10分钟筛选量表的性能，估计失语症，构音障碍，认知功能障碍，使用多中心，大规模的连续series.Methods：我们进行了一项多中心验证研究，包括314例脑损伤2月1日至6月31日，2018年，从日本各地的20个医疗中心。失语症和构音障碍筛查测试（STAD）于2009年在日本开发，之前的一项小规模回顾性研究确定了其高至中等有效性。所有患者均接受了STAD检查，其中212例接受了西方失语症成套检查或构音障碍运动言语评估。基于外部标准分析STAD 3个部分的所有29个项目和受试者操作曲线的效应量，外部标准是考虑失语症、构音障碍和认知功能障碍的临床诊断而决定的。结果：29个项目中有23个项目的相关系数超过了目标障碍的中效量0.3。总体而言，灵敏度（82-92%）和特异性（77-78%）之间保持了良好的平衡，阳性和阴性似然比（3.7-4.19和0.1-0.23）为中等到大。言语部分与西方失语症成套测验失语商、构音部分与构音障碍运动言语评定、非言语部分与西方失语症成套测验非语言技能的Pearson相关系数分别为0.89、0.70和0.79。结论：STAD具有可接受的内容和并行效度，可用于脑损伤患者的交际功能评定。这种简短的筛查工具在特定的情况下是有用的，例如在早期的床边调查中，在进行其他测试之前获得沟通功能的快速总结，以及在更深入的测试不可行的情况下。
Introduction:Evaluation of multiple domains, such as language, articulation, and cognitive function, is frequently required in neurological communicative disorders. The purpose of this study was to investigate the performance of a 10-min screening scale for estimating aphasia, dysarthria, and cognitive dysfunction using a multicenter, large-sized consecutive series.Methods:We conducted a multicenter validation study that included 314 patients with brain injury between February 1 and June 31, 2018, from 20 medical centers across Japan. The Screening Test for Aphasia and Dysarthria (STAD) was developed in Japan in 2009, and a previous smaller-scale retrospective study established its high to moderate validity. All patients had undergone the STAD, and 212 of them underwent the Western Aphasia Battery or Assessment of Motor Speech for Dysarthria. The effect size on all 29 items and receiver operating curves of 3 sections of the STAD were analyzed based on external criteria, which were decided considering the clinical diagnosis of aphasia, dysarthria, and cognitive dysfunction. Correlations between the STAD and reference tests were calculated.Results:Thephicoefficients of 23 out of 29 items exceeded the moderate effect size of 0.3 toward the targeted disorder. Overall, there was a good balance between sensitivity (82–92%) and specificity (77–78%), with moderate to large positive and negative likelihood ratios (3.7–4.19 and 0.1–0.23). The Pearson’srbetween the verbal section and Western Aphasia Battery Aphasia Quotient, the articulation section and Assessment of Motor Speech for Dysarthria, and the nonverbal section and Western Aphasia Battery Nonlinguistic Skills were 0.89, 0.70, and 0.79, respectively.Conclusion:We demonstrated that the STAD has acceptable content and concurrent validity for the assessment of communicative function in patients with brain injury. This short screening tool can be useful in specific contexts, such as in early bedside investigations, to obtain a quick summary of communicative function prior to the administration of other tests, and in cases where more in-depth testing is not feasible.