Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Speech-Language Pathology

Background:

• Aphasia is a common and disabling consequence of stroke, impacting communication and quality of life.
• There is a need for standardized, evidence-based guidelines to optimize aphasia rehabilitation.
• Existing rehabilitation practices may lack consistency and uniform application of best practices.

Purpose of the Study:

• To develop and validate a national set of best practice statements for post-stroke aphasia rehabilitation.
• To establish a framework for consistent and evidence-based aphasia rehabilitation.
• To create a foundational component for the Australian Aphasia Rehabilitation Pathway (AARP).

Main Methods:

• A comprehensive literature review identified initial best practice statements.
• The RAND/UCLA Appropriateness Method (RAM) was employed for validation.
• A national Community of Practice, including over 250 stakeholders, guided the framework development.
• Nine expert speech pathologists participated in two rounds of appropriateness ratings.

Main Results:

• An initial 74 best practice statements were reviewed across eight care areas.
• Following two rounds of expert rating, 82 statements achieved consensus.
• The validation process involved iterative refinement, including adding and deleting statements.

Conclusions:

• A national, expert-validated set of 82 best practice statements for aphasia rehabilitation has been established.
• These statements represent the first such validated set for aphasia rehabilitation in Australia.
• The statements provide a basis for consistent implementation of evidence-based practice in stroke rehabilitation and are integral to the AARP.