Conversation as an Outcome of Aphasia Treatment: A Systematic Scoping Review

Abstract

Purpose: Conversation-focused speech-language pathology services are a top priority for people living with aphasia, but little is known about how researchers measure conversation as an outcome of treatment. This scoping review was undertaken to systematically review the evidence regarding the measurement of conversation in aphasia studies and to identify current practices and existing gaps. Method: A systematic literature search was conducted for studies published between January 1995 and September 2019 in multiple electronic databases. Covidence software was used to manage search results, study selection, and data charting processes. Data were extracted from each study and then collated and organized to elucidate the breadth of approaches, tools, or procedures oriented to measuring conversation as an outcome and identify gaps in the existing literature. Results: The systematic search of the literature resulted in 1,244 studies. A total of 64 studies met inclusion criteria and were included in the review. The review summarizes the various tools and procedures used to measure conversation as an outcome of aphasia intervention, including variations in data collection and analysis procedures. The review also evaluates the quality of conversation measures in terms of psychometric properties and informal measures of validity. There was a total of 211 measures used across the 64 studies. Conclusions: While there was no clear measure that was objectively superior, several measures show promise and warrant future exploration. Some of the orientations, conceptualizations, and procedures we have presented can be seen as options that might be included in a future conversation-focused core outcome set. Supplemental Material: https://doi.org/10.23641/asha.21514062

Towards efficient, ecological assessment of interaction: A scoping review of co‐constructed communication

“…A relatively small number of studies ( n = 37) has generated a large number of measures ( n = 95). This echoes findings elsewhere of a proliferation of measures of discourse (Bryant et al., 2016; Pritchard et al., 2017) and conversation (Azios et al., 2022). In the current review, measures included those from a formal analytic approach (such as Generic Structure Potential) as well as informal measures developed for the specific study.…”

“…For the latter, decisions regarding which denominator to use will potentially influence findings (Herbert et al, 2008). Another key finding of the current review relates to a relative absence of psychometric profiling: most measures of co-constructed communication require further investigation of rater reliability, test-retest reliability and validity; again, this echoes findings from the broader discourse literature (Azios et al, 2022;Pritchard et al, 2017). Interrater reliability data are available for 53 measures; however, these were usually based on percentage agreement, which is no longer the accepted standard (Feng, 2014).…”

“…In the current review, measures included those from a formal analytic approach (such as Generic Structure Potential) as well as informal measures developed for the specific study. In a recent review of conversation outcome measures, Azios et al (2022) note not only a lack of consensus regarding what to measure, but also disagreement as to how to measure the behaviour of interest.…”

“…In a recent review of conversation outcome measures, Azios et al. (2022) note not only a lack of consensus regarding what to measure, but also disagreement as to how to measure the behaviour of interest. The authors highlighted that some measures of conversation are based on raw data while others are analysed and reported as proportional data.…”