Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study

Wallace, Sarah J., Worrall, Linda, Rose, Tanya and Le Dorze, Guylaine (2016) Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study. Aphasiology, 31 6: 643-673. doi:10.1080/02687038.2016.1186265

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Author Wallace, Sarah J.
Worrall, Linda
Rose, Tanya
Le Dorze, Guylaine
Title Which treatment outcomes are most important to aphasia clinicians and managers? An international e-Delphi consensus study
Journal name Aphasiology   Check publisher's open access policy
ISSN 0268-7038
Publication date 2016-05-23
Year available 2016
Sub-type Article (original research)
DOI 10.1080/02687038.2016.1186265
Open Access Status Not Open Access
Volume 31
Issue 6
Start page 643
End page 673
Total pages 31
Place of publication Abingdon, Oxon, United Kingdom
Publisher Routledge
Language eng
Formatted abstract
Background: Clinicians have expressed frustration at the lack of strong evidence for aphasia treatments. Inconsistent outcome measurement practices across treatment trials have negatively impacted the quality and strength of evidence for aphasia interventions. Core outcome sets (COSs; minimum sets of outcomes/outcome measures) are increasingly being used to maximise the quality, relevancy, transparency, and efficiency of health treatment research. The current study is the third in a trilogy of stakeholder perspectives to inform the development of a COS for aphasia treatment research.

Aim: To identify essential aphasia treatment outcomes from the perspective of an international sample of clinicians and managers working in aphasia rehabilitation.

Methods & Procedures: A three-round e-Delphi exercise was conducted with aphasia clinicians and managers. In total, 265 clinicians and 53 managers (n = 318) from 25 countries participated in round 1. In round 1, participants responded to the open-ended question, “In your opinion, what are the most important outcomes (results) from aphasia treatment?” Responses were analysed using inductive content analysis. In rounds 2 and 3, 153 and 137 participants respectively rated the importance of each outcome generated in round 1 using a nine-point rating scale. Outcomes reaching predefined consensus criteria were further analysed using the International Classification of Functioning Disability and Health (ICF) coding.

Outcomes & Results: Analysis of round 1 participant responses produced 1709 codes, which were condensed into 90 subcategories, 25 categories, and 4 themes. In rounds 2 and 3, a total of 51 outcomes reached consensus. The two outcomes with the highest levels of consensus both related to communication between the person with aphasia and their family/carers/significant others. Outcomes relating to people with aphasia most frequently linked to the ICF activity/participation component (52%), whilst outcomes relating to family/carers/significant others were evenly divided between the ICF activity/participation component (36%) and environmental factors (36%).

Conclusions: Consensus was reached on 51 essential aphasia treatment outcomes. Very high levels of consensus (97–99%) between clinicians were achieved for outcomes relating to communication between the person with aphasia and their communication partner/s, suggesting that in the clinical environment improved dyadic communicative interaction is an important indicator of treatment success. The high proportion of outcomes linking to the ICF activity/participation component highlights the importance of measuring outcomes beyond impairment, both in clinical and research settings. These findings will be combined with other stakeholder perspectives and a systematic review of outcome measures to develop a COS for aphasia treatment research.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 5 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 1 times in Scopus Article | Citations
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Created: Tue, 24 May 2016, 19:17:43 EST by Sarah Wallace on behalf of School of Health & Rehabilitation Sciences