Background
Methods
The SPEAK-model
Validation
Participants and recruitment
RATS-3 | SPEAK | |
---|---|---|
Inclusion: | First-ever aphasia due to stroke | First-ever aphasia due to stroke |
Aphasia ascertained by a speech and language therapist using the 36-item Token Testa and/or a score < 5 on the ASRS | Aphasia ascertained by a neurologist and a speech and language therapist | |
Testable with the ScreeLing | A score below the cut-off point of the Token Test and/or the ScreeLing | |
Within two weeks of stroke onset | Within two to six days of stroke onset | |
Age between 18 and 85 | Adult | |
Language near-native Dutch | Language near-native Dutch | |
A life expectancy of >six months | ||
Able to tolerate intensive treatment | ||
Exclusion: | A subarachnoid or subdural hemorrhage | |
Success or feasibility of intensive language treatment was severely threatened by: | Presence of one of the following criteria: | |
- severe dysarthria | - severe dysarthria | |
- premorbid dementia | - pre-stroke dementia (suspected or confirmed) | |
- illiteracy | - illiteracy | |
- severe developmental dyslexia | - developmental dyslexia | |
- severe visual perceptual disorders | - severe perceptual disorders of vision or hearing | |
- recent psychiatric history | - psychiatric history |
Prognostic variables
Outcome
Statistical analyses
Handling of missing data
Results
SPEAK cohort (n= 147) Derivation cohort | RATS-3 cohort (n= 131) Validation cohort | |
---|---|---|
Age, mean (SD), in years | 67 (15) | 65 (12) |
Sex, n (%female) | 78 (53%) | 56 (43%) |
Level of education, n (%) | ||
High ■ | 55 (42%) | 60 (46%) |
Low▲ | 74 (57%) | 71 (54%) |
Unknown ♦ | 2 (2%) | 0 |
Type of stroke, n (%) | ||
Non-cardio-embolic infarction | 84 (57%) | 81 (62%) |
Cardio-embolic infarction | 42 (29%) | 23 (18%) |
Intracerebral hemorrhage | 21 (14%) | 24 (18%) |
Unknown ♦ | 0 | 3 (2%) |
Time since onset to inclusion, mean (range), in days | 4 (2–6) | 8 (1–18) |
Barthel Index, median (IQR) ♦ | 15 (7.75–20) | 16 (6–20) |
ScreeLing Phonology score, mean (SD)○ | 14 (6) | 15 (6.5) |
ASRS-scores at baseline, n (%) | ||
Score 0 | 18 (12%) | 17 (13%) |
Score 1 | 28 (19%) | 21 (16%) |
Score 2 | 33 (22%) | 28 (21%) |
Score 3 | 26 (18%) | 38 (29%) |
Score 4 | 27 (18%) | 27 (21%) |
Score 5 | 3 (2%) | 0 |
Missing | 12 (8%) | 0 |