The Aphasia Rapid Test: an NIHSS-like aphasia test

Area of Science:

• Neurology
• Speech-Language Pathology
• Clinical Assessment

Background:

• Aphasia is a common communication disorder following stroke.
• Accurate and rapid assessment of aphasia severity is crucial for patient management.
• Existing bedside assessments may lack speed or comprehensive predictive value.

Purpose of the Study:

• To evaluate the Aphasia Rapid Test (ART) for inter-rater reproducibility.
• To assess the ART's sensitivity in detecting changes in aphasia severity from Day 1 to Day 8 post-stroke.
• To determine the predictive value of Day 8 ART scores for 3-month aphasia outcomes using the Aphasia Handicap Score (AHS).

Main Methods:

• The Aphasia Rapid Test (ART), a 26-point scale, was administered to acute stroke patients.
• Inter-rater reproducibility was assessed in 91 patients within one week of stroke onset.
• Sensitivity to change and predictive value for 3-month outcomes were evaluated in 70 patients.

Main Results:

• The ART demonstrated excellent inter-rater reproducibility (concordance coefficient=0.99, weighted Kappa=0.93).
• The ART detected significant changes in aphasia severity between Day 1 and Day 8 in 66% of patients.
• Day 8 ART scores were highly predictive of 3-month aphasia outcomes (AUC > 0.9), with specific cut-off values identified for good and poor prognoses.

Conclusions:

• The Aphasia Rapid Test is a simple, rapid, and reproducible bedside tool for assessing aphasia in acute stroke.
• The ART effectively monitors early changes in aphasia severity.
• ART scores are strong predictors of long-term verbal communication outcomes, aiding clinical decision-making.