Development and diagnostic validation of the Brisbane Evidence-Based Language Test

Alexia Rohde; Suhail A Doi; Linda Worrall; Erin Godecke; Anna Farrell; Robyn O'Halloran; Molly McCracken; Nadine Lawson; Rebecca Cremer; Andrew Wong

doi:10.1080/09638288.2020.1773547

Development and diagnostic validation of the Brisbane Evidence-Based Language Test

Disabil Rehabil. 2022 Feb;44(4):625-636. doi: 10.1080/09638288.2020.1773547. Epub 2020 Jun 22.

Authors

Alexia Rohde^{1

2}, Suhail A Doi³, Linda Worrall², Erin Godecke⁴, Anna Farrell⁵, Robyn O'Halloran⁶, Molly McCracken², Nadine Lawson⁷, Rebecca Cremer⁵, Andrew Wong⁸

Affiliations

¹ Speech Pathology Department, Southern Cross University, Bilinga, Australia.
² Speech Pathology Department, The University of Queensland, Brisbane, Australia.
³ Department of Population Medicine, Qatar University, Doha, Qatar.
⁴ Department of Speech Pathology, Edith Cowan University, Joondalup, Australia.
⁵ Department of Speech Pathology, Royal Brisbane and Women's Hospital, Brisbane, Australia.
⁶ Department of Community and Clinical Allied Health, La Trobe University, Melbourne, Australia.
⁷ Department of Speech Pathology, Princess Alexandra Hospital, Brisbane, Australia.
⁸ Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Australia.

PMID: 32571105
DOI: 10.1080/09638288.2020.1773547

Abstract

Purpose: To describe the development and determine the diagnostic accuracy of the Brisbane Evidence-Based Language Test in detecting aphasia.

Methods: Consecutive acute stroke admissions (n = 100; mean = 66.49y) participated in a single (assessor) blinded cross-sectional study. Index assessment was the ∼45 min Brisbane Evidence-Based Language Test. The Brisbane Evidence-Based Language Test is further divided into four 15-25 min Short Tests: two Foundation Tests (severe impairment), Standard (moderate) and High Level Test (mild). Independent reference standard included the Language Screening Test, Aphasia Screening Test, Comprehensive Aphasia Test and/or Measure for Cognitive-Linguistic Abilities, treating team diagnosis and aphasia referral post-ward discharge.

Results: Brisbane Evidence-Based Language Test cut-off score of ≤157 demonstrated 80.8% (LR+ =10.9) sensitivity and 92.6% (LR- =0.21) specificity. All Short Tests reported specificities of ≥92.6%. Foundation Tests I (cut-off ≤61) and II (cut-off ≤51) reported lower sensitivity (≥57.5%) given their focus on severe conditions. The Standard (cut-off ≤90) and High Level Test (cut-off ≤78) reported sensitivities of ≥72.6%.

Conclusion: The Brisbane Evidence-Based Language Test is a sensitive assessment of aphasia. Diagnostically, the High Level Test recorded the highest psychometric capabilities of the Short Tests, equivalent to the full Brisbane Evidence-Based Language Test. The test is available for download from brisbanetest.org.Implications for rehabilitationAphasia is a debilitating condition and accurate identification of language disorders is important in healthcare.Language assessment is complex and the accuracy of assessment procedures is dependent upon a variety of factors.The Brisbane Evidence-Based Language Test is a new evidence-based language test specifically designed to adapt to varying patient need, clinical contexts and co-occurring conditions.In this cross-sectional validation study, the Brisbane Evidence-Based Language Test was found to be a sensitive measure for identifying aphasia in stroke.

Keywords: Aphasia; diagnosis; evidence-based; sensitivity and specificity; stroke; test.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aphasia* / diagnosis
Cross-Sectional Studies
Humans
Language
Language Tests
Stroke* / complications
Stroke* / diagnosis