iReadMore: optimisation and personalisation of a post-stroke reading therapy app

旨在优化iReadMore在“推出”试验背景下的可用性和临床有效性开发患者特定的治疗算法根据已完成的患者数据开发预测算法，该算法将提供新入组患者可以合理预期实现的可能效应大小的估计。背景和合理性iReadMore是一款针对成人失语症患者的阅读治疗应用程序。中枢性失读症是成人获得性阅读障碍中最常见的类型。它通常是作为一种广义的语言障碍称为失语症的一部分。中风是失语症的主要原因，但头部受伤、脑肿瘤和痴呆也是主要原因。仅在英国，就有超过350，000人患有失语症;其中约三分之二的人患有中央失读症。虽然标准的言语和语言治疗（SALT）可以改善失语症患者的预后，但达到这一目标所需的“剂量”（>100小时）是目前失语症患者在NHS接受的平均剂量的10倍。结果（在《大脑》杂志上进行了修订）表明，这种疗法对训练过的物品效果很好。经过平均35小时的治疗，患者的阅读准确率提高了9%。标准化效应量是“大”（科恩的d = 1.38）反应时间也显着改善。我们现在计划"推出“iReadMore治疗适合谁可以上网的病人使用。我们希望优化治疗，并将通过测试一系列假设来实现，所有这些假设都旨在提高iReadMore的可用性和/或临床有效性。我们有道德上的认可。

Aims To optimize the usability and clinical effectiveness of iReadMore in the context of a 'rollout' trial To develop patient-specific therapy algorithms To develop a predictive algorithm from completed patients' data that will provide estimates of likely effect sizes that incoming patients can reasonably expect to achieve Background and rationaleiReadMore is a reading therapy app for adult aphasic patients. It contains diagnostic, therapeutic (practice-based) and outcome components.Central alexia is the commonest type of acquired reading disorder in adults. It is usually encountered as part of a generalized language disorder known as aphasia. Stroke is the leading cause of aphasia but head-injury, brain tumours and dementia also figure prominently. In the UK alone, there are more than 350,000 people with aphasia; around 2/3rds of these will have central alexia. While standard speech and language therapy (SALT) improves outcomes in patients with aphasia, the 'dose' needed to achieve this (>100 hours) is ~10 times more than the average aphasic patient current receives on the NHS.We have recently completed a phase II trial of iReadMore therapy in a group of patients with central alexia. The results (which are in revision with the journal Brain) demonstrate that the therapy works well on trained items. After an average of 35 hours therapy, patients improved their reading accuracy by 9%. The standardized effect size was "large" (Cohen's d = 1.38) Reaction times also significantly improved.We now plan to 'rollout' iReadMore therapy for suitable patients to use who have internet access. We wish to optimize the therapy and will do so by testing a series of hypotheses, all aimed at improving the usability and/or clinical effectiveness of iReadMore. We have ethical approval in place.