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Cited by 77Delphi Technique in ResearchMedical Practices and RehabilitationNeurobiology of Language and Bilingualism

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

Wallace, Sarah J., Worrall, Linda, Rose, Tanya, Le Dorze, Guylaine·2017·Aphasiology
DOI 10.1080/02687038.2016.1186265
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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.Aims: 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.

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  • Wallace and colleagues proposed a core outcome set for aphasia that defines a minimum group of outcomes for routine administration.

    “Wallace and colleagues proposed a core outcome set (COS)13,15–18 for aphasia, specifying a minimum set of outcomes that should be administered to persons with aphasia as standard practice (i.e., WAB, The Scenario Test, General Health Questionnaire-12, SAQOL-39g) to increase consistency.”

    From Benchmarks of Significant Change After Aphasia Rehabilitation (2019) · cites this paper as [15]

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Authors
Wallace, S. J., Worrall, L., Rose, T., & Le Dorze, G.
Affiliations
The University of Queensland (AU)
Corresponding author
Worrall, Linda
ORCID
Venue
Aphasiology
Publisher
Informa UK Limited
Published
2016-05-23
Volume
31
Issue
6
Pages
643-673
ISSN
  • 0268-7038 (ISSN-L)
  • 1464-5041
DOI
10.1080/02687038.2016.1186265
OpenAlex
W2399835201
Cited by
77
References
50
Citations by year
2026: 2 · 2025: 9 · 2024: 6 · 2023: 5 · 2022: 11 · 2021: 10 · 2020: 6 · 2019: 5 · 2018: 11 · 2017: 9 · 2016: 3
FWCI
26.68
Type
journal article
Language
en
Open access
closed
Locations
Aphasiology (publishedVersion)
Topics
  • Social Sciences › Sociology and Political Science › Delphi Technique in Research
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neurobiology of Language and Bilingualism
Keywords
aphasia, core outcome set, stakeholder perspectives, International Classification of Functioning, Disability and Health, activities and participation, outcome measurement, aphasia rehabilitation, dyadic communication, consensus building, evidence-based practice

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