Measuring communication as a core outcome in aphasia trials: Results of the ROMA‐2 international core outcome set development meeting
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Date
2022-12-30
Authors
Wallace, Sarah J.
Worrall, Linda
Rose, Tanya A.
Alyahya, Reem S. W.
Babbitt, Edna
Beeke, Suzanne
de Beer, Carola
Bose, Arpita
Bowen, Audrey
Brady, Marian C.
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Published Version
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.
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Keywords
Aphasia , Consensus , Core outcome set , Recommendations , Stroke
Citation
Wallace, S.J., Worrall, L., Rose, T.A., Alyahya, R.S.W., Babbitt, E., Beeke, S., De Beer, C., Bose, A., Bowen, A., Brady, M.C., Breitenstein, C., Bruehl, S., Bryant, L., Cheng, B.B.Y., Cherney, L.R., Conroy, P., Copland, D.A., Croteau, C., Cruice, M., Dipper, L., Hilari, K., Howe, T., Kelly, H., Kiran, S., Laska, A., Marshall, J., Murray, L.L., Patterson, J., Pearl, G., Quinting, J., Rochon, E., Rose, M.L., Rubi‐Fessen, I., Sage, K., Simmons‐Mackie, N., Visch‐Brink, E., Volkmer, A., Webster, J., Whitworth, A. and Dorze, G.L. (2022) ‘Measuring communication as a core outcome in aphasia trials: Results of the ROMA‐2 international core outcome set development meeting’, International Journal of Language & Communication Disorders, (12 pp). https://doi.org/10.1111/1460-6984.12840.