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Wallace SJ, Worrall L, Rose TA, Alyahya RSW, Babbitt E, Beeke S, de Beer C, Bose A, Bowen A, Brady MC, Breitenstein C, Bruehl S, Bryant L, Cheng BBY, Cherney LR, Conroy P, Copland DA, Croteau C, Cruice M, Dipper L, Hilari K, Howe T, Kelly H, Kiran S, Laska A, Marshall J, Murray LL, Patterson J, Pearl G, Quinting J, Rochon E, Rose ML, Rubi‐Fessen I, Sage K, Simmons‐Mackie N, Visch‐Brink E, Volkmer A, Webster J, Whitworth A, Dorze GL. Measuring communication as a core outcome in aphasia trials: Results of the ROMA-2 international core outcome set development meeting. Int J Lang Commun Disord 2023; 58:1017-1028. [PMID: 36583427 PMCID: PMC10946976 DOI: 10.1111/1460-6984.12840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/08/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Evidence-based recommendations for a core outcome set (COS; minimum set of outcomes) for aphasia treatment research have been developed (the Research Outcome Measurement in Aphasia-ROMA, COS). Five recommended core outcome constructs: communication, language, quality of life, emotional well-being and patient-reported satisfaction/impact of treatment, were identified through three international consensus studies. Constructs were paired with outcome measurement instruments (OMIs) during an international consensus meeting (ROMA-1). Before the current study (ROMA-2), agreement had not been reached on OMIs for the constructs of communication or patient-reported satisfaction/impact of treatment. AIM To establish consensus on a communication OMI for inclusion in the ROMA COS. METHODS & PROCEDURES Research methods were based on recommendations from the Core Outcome Measures in Effectiveness Trials (COMET) Initiative. Participants with expertise in design and conduct of aphasia trials, measurement instrument development/testing and/or communication outcome measurement were recruited through an open call. Before the consensus meeting, participants agreed on a definition of communication, identified appropriate OMIs, extracted their measurement properties and established criteria for their quality assessment. During the consensus meeting they short-listed OMIs and participants without conflicts of interest voted on the two most highly ranked instruments. Consensus was defined a priori as agreement by ≥ 70% of participants. OUTCOMES & RESULTS In total, 40 researchers from nine countries participated in ROMA-2 (including four facilitators and three-panel members who participated in pre-meeting activities only). A total of 20 OMIs were identified and evaluated. Eight short-listed communication measures were further evaluated for their measurement properties and ranked. Participants in the consensus meeting (n = 33) who did not have conflicts of interest (n = 29) voted on the top two ranked OMIs: The Scenario Test (TST) and the Communication Activities of Daily Living-3 (CADL-3). TST received 72% (n = 21) of 'yes' votes and the CADL-3 received 28% (n = 8) of 'yes' votes. CONCLUSIONS & IMPLICATIONS Consensus was achieved that TST was the preferred communication OMI for inclusion in the ROMA COS. It is currently available in the original Dutch version and has been adapted into English, German and Greek. Further consideration must be given to the best way to measure communication in people with mild aphasia. Development of a patient-reported measure for satisfaction with/impact of treatment and multilingual versions of all OMIs of the COS is still required. Implementation of the ROMA COS would improve research outcome measurement and the quality, relevance, transparency, replicability and efficiency of aphasia treatment research. WHAT THIS PAPER ADDS What is already known on this subject International consensus has been reached on five core constructs to be routinely measured in aphasia treatment studies. International consensus has also been established for OMIs for the three constructs of language, quality of life and emotional well-being. Before this study, OMIs for the constructs of communication and patient-reported satisfaction/impact of treatment were not established. What this paper adds to existing knowledge We gained international consensus on an OMI for the construct of communication. TST is recommended for inclusion in the ROMA COS for routine use in aphasia treatment research. What are the potential or actual clinical implications of this work? The ROMA COS recommends OMIs for a minimum set of outcomes for adults with post-stroke aphasia within phases I-IV aphasia treatment research. Although not intended for clinical use, clinicians may employ the instruments of the ROMA COS, considering the quality of their measurement properties. The systematic inclusion of a measure of communication, such as TST, in clinical practice could ultimately support the implementation of research evidence and best practices.
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Affiliation(s)
- Sarah J. Wallace
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Linda Worrall
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Tanya A. Rose
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
| | - Reem S. W. Alyahya
- Communication and Swallowing Disorders DepartmentKing Fahad Medical CityRiyadhSaudi Arabia
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Edna Babbitt
- Department of Physical Medicine and Rehabilitation, Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Suzanne Beeke
- Deparment of Psychology and Language SciencesUniversity College LondonLondonUK
| | - Carola de Beer
- Faculty of Linguistics and Literary Studies & Medical School OWLUniversity of BielefeldBielefeldGermany
| | - Arpita Bose
- School of Psychology and Clinical Language SciencesUniversity of ReadingReadingUK
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science CentreNorthern Care Alliance & University of ManchesterManchesterUK
| | - Marian C. Brady
- Nursing, Midwifery and Allied Health Professionals Research UnitGlasgow Caledonian UniversityGlasgowUK
| | - Caterina Breitenstein
- Department of Neurology with Institute of Translational NeurologyUniversity of MünsterMünsterGermany
| | - Stefanie Bruehl
- St. Mauritius Rehabilitation Centre, Meerbusch, Germany
- Medical Faculty, Heinrich‐Heine University Duesseldorf, Duesseldorf, Germany
- Clinical and Cognitive NeurosciencesDepartment of Neurology, RWTH Aachen UniversityGermany
| | - Lucy Bryant
- University of Technology Sydney Graduate School of Health, Faculty of HealthSydneyNSWAustralia
| | - Bonnie B. Y. Cheng
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Leora R. Cherney
- Department of Physical Medicine and Rehabilitation, Feinberg School of MedicineNorthwestern UniversityChicagoILUSA
| | - Paul Conroy
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science CentreNorthern Care Alliance & University of ManchesterManchesterUK
| | - David A. Copland
- School of Health and Rehabilitation SciencesThe University of QueenslandBrisbaneQLDAustralia
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- Centre of Research Excellence in Aphasia Recovery and RehabilitationAustralia
| | - Claire Croteau
- School of Speech–Language Pathology and Audiology, Centre for Interdisciplinary Research in Rehabilitation of Greater MontrealFaculty of Medicine, Université de MontréalMontrealQCCanada
| | - Madeline Cruice
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Lucy Dipper
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Katerina Hilari
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Tami Howe
- School of Audiology and Speech SciencesUniversity of British ColumbiaVancouverBCCanada
| | - Helen Kelly
- School of Clinical TherapiesUniversity College CorkCorkIreland
| | - Swathi Kiran
- Department of Speech, Language, and Hearing SciencesBoston UniversityBostonMAUSA
| | - Ann‐Charlotte Laska
- Department of Clinical SciencesKarolinska Institutet Danderyd HospitalStockholmSweden
| | - Jane Marshall
- School of Health and Psychological Sciences, CityUniversity of LondonLondonUK
| | - Laura L. Murray
- School of Communication Sciences and DisordersWestern UniversityLondonONCanada
| | - Janet Patterson
- Research ServiceVA Northern California Health Care SystemMartinezCAUSA
| | - Gill Pearl
- Speakeasy Specialist Aphasia CentreBuryUK
| | - Jana Quinting
- Speech Language Pathology, Department of Rehabilitation and Special Education, Faculty of Human SciencesUniversity of CologneCologneGermany
| | - Elizabeth Rochon
- Department of Speech–Language Pathology and Rehabilitation Sciences InstituteUniversity of TorontoToronto, ONCanada
| | - Miranda L. Rose
- Queensland Aphasia Research CentreBrisbaneQLDAustralia
- School of Allied Health, Human Services and SportLa Trobe UniversityBundooraVICAustralia
| | - Ilona Rubi‐Fessen
- Speech Language Pathology, Department of Rehabilitation and Special Education, Faculty of Human SciencesUniversity of CologneCologneGermany
- RehaNova Rehabilitation HospitalCologneGermany
| | - Karen Sage
- Faculty of Health and EducationManchester Metropolitan UniversityManchesterUK
| | - Nina Simmons‐Mackie
- Communication Sciences & DisordersSoutheastern Louisiana UniversityHammondLAUSA
| | - Evy Visch‐Brink
- Department of NeurologyErasmus UniversityRotterdamthe Netherlands
| | - Anna Volkmer
- Deparment of Psychology and Language SciencesUniversity College LondonLondonUK
| | - Janet Webster
- School of Education, Communication and Language SciencesNewcastle UniversityNewcastle upon TyneUK
| | - Anne Whitworth
- School of Health SciencesCollege of Health and MedicineUniversity of TasmaniaHobartAustralia
| | - Guylaine Le Dorze
- School of Speech–Language Pathology and Audiology, Centre for Interdisciplinary Research in Rehabilitation of Greater MontrealFaculty of Medicine, Université de MontréalMontrealQCCanada
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