A Telescreening Tool to Detect Aphasia in Patients with Stroke.
BACKGROUND
Early identification of patients with stroke-induced aphasia is essential because it is a significant disability affecting daily life and is linked to poor functional outcome after stroke. However, most patients with stroke are unable to undergo aphasia evaluation and detection and therefore remain undiagnosed. The purpose of this study is to develop a valid, reliable mobile aphasia screening test (MAST) for patients in remote locations.


METHODS
To accomplish this, we enrolled patients with (n=30) and without (n=30) stroke-induced aphasia. A MAST, which adopted the Korean version of the shortened version of the Frenchay Aphasia Screening Test (K-FAST), was designed as an iPad(®) (Apple, Cupertino, CA) application. To validate the MAST, we compared its performance with that of the Korean version of the Western Aphasia Battery (K-WAB) and conventional shortened FAST paper version (K-FAST). We analyzed interrater and internal reliability, using Cronbach's alpha coefficient, and assessed the diagnostic sensitivity, specificity, and power.


RESULTS
There was significant correlation between K-FAST and MAST (intraclass correlation coefficient [ICC]=0.995, p<0.001). MAST also had a high correlation with K-WAB (ICC=0.752, p<0.001). Interrater reliability was very high (ICC=0.999, p<0.001). The test had high sensitivity (90.0%) and specificity (73.3%) with an accuracy of 0.930 (95% confidence interval=0.853-1.000). The MAST is a valid and reliable tool for detecting aphasia in patients with stroke.


CONCLUSIONS
This telescreening test may overcome the limitations of test administration and may be a convenient and cost-effective alternative to the existing aphasia screening tests for patients with stroke.
1 Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital , Seongnam, South Korea .|2 Department of Physical and Rehabilitation Medicine, Soonchunhyang University College of Medicine, Soonchunhyang University Hospital , Seoul, South Korea .
Yoon-Hee
YH
Choi
1 Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital , Seongnam, South Korea .
Hae Kyung
HK
Park
3 Technology Development Office, Advanced Institute of Technology , KT R&D Center, Seoul, South Korea .
Ki-hwan
KH
Ahn
3 Technology Development Office, Advanced Institute of Technology , KT R&D Center, Seoul, South Korea .
Yeon-joo
YJ
Son
1 Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital , Seongnam, South Korea .
Nam-Jong
NJ
Paik
D000328:Adult; D000368:Aged; D001037:Aphasia / Q000175:diagnosis* / Q000209:etiology*; D016022:Case-Control Studies; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications; D014584:User-Computer Interface
e-health; mobile health; rehabilitation; telehealth; telemedicine