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Addressing patients’ communication support needs through speech-language pathologist-nurse information-sharing: Employing ethnography to understand the acute stroke context
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A Systematic Review of Studies Describing the Effectiveness, Acceptability, and Potential Harms of Place-Based Interventions to Address Loneliness and Mental Health Problems
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Understanding and Supporting Peer Relationships in Adolescents with Acquired Brain Injury: A Stakeholder Engagement Study
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Operationalising treatment success in aphasia rehabilitation
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Breitenstein, C.; Hilari, K.; Menahemi-Falkov, M.; Rose, M. L.; Wallace, S. J.; Brady, M. C.; Hillis, A. E.; Kiran, S.; Szaflarski, J. P.; Tippett, D. C.; Visch-Brink, E.; Willmes, K.. - : Routledge, 2022
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Abstract:
Background Treatment success is the desired outcome in aphasia rehabilitation. However, to date, there is a lack of consensus on what defines a 'successful' result on a given aphasia outcome measurement instrument (OMI). Aim In this methodological paper, we present strategies for how to define and measure treatment success on a given OMI at the group-level, as well as for an individual person with aphasia. The latter is particularly important when research findings from group studies are clinically implemented for individuals in rehabilitation. Scope We start by presenting methods to calculate the average statistically significant change across several (group) studies (e.g., standardised mean difference, raw unstandardised mean difference) for a given OMI. Such metrics are useful to summarise the overall effect of the intervention of interest, particularly in meta-analyses. However, benchmarks based on group effects are not feasible for assessing an individual participant’s treatment success and thus for determining the proportion of patients who had a beneficial response to therapy (overall response rate of an intervention). We therefore recommend a distribution-based approach to determine benchmarks of a statistically significant treatment response at the individual level, i.e., the 'smallest detectable change' for a given OMI, which refers to the smallest change that can be detected by the OMI beyond measurement error. However, the statistical significance of an individual treatment effect does not necessarily correspond to its clinical impact. This requires an additional indicator. The benchmark to determine a clinically relevant improvement on a given OMI is the 'minimal important change'. The minimally important change is defined as the smallest OMI change score perceived as important by the relevant stakeholder group (i.e., people with aphasia, their relatives/caregivers, clinicians). It therefore requires relating the individual OMI change scores to 'anchors', i.e., meaningful external criteria, preferably based on patient-perceived therapy success. Currently, there is no consensus regarding the optimal 'anchors' and their respective definition of clinically important change in aphasia outcome research. Conclusions/Recommendations Operationalising individual treatment success based on both statistically significant and (patient-reported) clinically meaningful benchmarks is a key priority in aphasia rehabilitation. Availability of such measures will (a) facilitate estimates of therapy response rate in intervention studies and thus optimise therapeutic decisions and (b) provide stakeholder groups (e.g., the society, the stroke team, people with aphasia, family, clinicians, healthcare professionals) with objective, statistically reliable and meaningful feedback on individual treatment response in the clinical setting.
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Keyword:
RA0421 Public health. Hygiene. Preventive Medicine; RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
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URL: https://doi.org/10.1080/02687038.2021.2016594 https://openaccess.city.ac.uk/id/eprint/28001/ https://openaccess.city.ac.uk/id/eprint/28001/3/MIAT_operationalising-treatment-success_3rd-revision_ACCEPTED%20CLEAN.pdf
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Time for talk: The work of reflexivity in developing empirical understanding of speech and language therapist and nursing interaction on stroke wards
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Developing, monitoring, and reporting of fidelity in aphasia trials: Core recommendations from the Collaboration of Aphasia Trialists (CATs) Trials for Aphasia Panel
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Edinburgh Postnatal Depression Scale (EPDS) for screening for depression in the first year post delivery in a low-resourced rural setting in Kenya ...
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Edinburgh Postnatal Depression Scale (EPDS) for screening for depression in the first year post delivery in a low-resourced rural setting in Kenya ...
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Investigating the Folk Concept of Pain: Implication & Projection ...
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Semantic dimensions of depressions: a Demonstrative Choice Task ...
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Bilingualism effects on cognition in autistic children are not all-or-nothing: The role of socioeconomic status in intellectual skills in bilingual autistic children ...
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Bilingualism effects on cognition in autistic children are not all-or-nothing: The role of socioeconomic status in intellectual skills in bilingual autistic children ...
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French-Canadian Translation and Cultural Adaptation of the Clinical Opiate Withdrawal Scale: The COWS-FC ...
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French-Canadian Translation and Cultural Adaptation of the Clinical Opiate Withdrawal Scale: The COWS-FC ...
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Detecting Prejudice From Egalitarianism: Why Black Americans Don’t Trust White Egalitarians’ Claims ...
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Detecting Prejudice From Egalitarianism: Why Black Americans Don’t Trust White Egalitarians’ Claims ...
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Verbal fluency in Bipolar Disorder: protocol for a systematic review and meta-analysis ...
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Cortical Morphological Changes in Congenital Amusia: Surface-Based Analyses
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In: Front Psychiatry (2022)
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Psychometric Assessment of the Persian Translation of the Interpersonal Mindfulness Scale With Undergraduate Students
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In: Front Psychiatry (2022)
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