A Telescreening Tool to Detect Aphasia in Patients with Stroke

BACKGROUND: Early identification of patients with stroke-induced aphasia is essential because it is a significant disability affecting daily life and is linked to poor functional outcome after stroke. However, most patients with stroke are unable to undergo aphasia evaluation and detection and therefore remain undiagnosed. The purpose of this study is to develop a valid, reliable mobile aphasia screening test (MAST) for patients in remote locations. MATERIALS AND METHODS: To accomplish this, we enrolled patients with (n=30) and without (n=30) stroke-induced aphasia. A MAST, which adopted the Korean version of the shortened version of the Frenchay Aphasia Screening Test (K-FAST), was designed as an iPad(®) (Apple, Cupertino, CA) application. To validate the MAST, we compared its performance with that of the Korean version of the Western Aphasia Battery (K-WAB) and conventional shortened FAST paper version (K-FAST). We analyzed interrater and internal reliability, using Cronbach's alpha coefficient, and assessed the diagnostic sensitivity, specificity, and power. RESULTS: There was significant correlation between K-FAST and MAST (intraclass correlation coefficient [ICC]=0.995, p<0.001). MAST also had a high correlation with K-WAB (ICC=0.752, p<0.001). Interrater reliability was very high (ICC=0.999, p<0.001). The test had high sensitivity (90.0%) and specificity (73.3%) with an accuracy of 0.930 (95% confidence interval=0.853-1.000). The MAST is a valid and reliable tool for detecting aphasia in patients with stroke. CONCLUSIONS: This telescreening test may overcome the limitations of test administration and may be a convenient and cost-effective alternative to the existing aphasia screening tests for patients with stroke.