The first aphasia screening test in Hungarian: A preliminary study on validity and diagnostic accuracy

The Hungarian Aphasia Screening Test (HAST) is a newly developed diagnostic tool for detecting post-stroke aphasia in clinical settings, and for differentiating between stroke patients with and without aphasia. The HAST was developed by our team and has not been published in English yet. In Hungarian, to date, there is no aphasia screening test with reported psychometric properties available. This study aims to present the main characteristics of the HAST and to evaluate its validity, internal consistency, and diagnostic accuracy. The HAST comprises five subtests (maximum score: 20) and takes 5-10 minutes to administer. We administered the HAST to 40 stroke patients with aphasia, 26 stroke patients without aphasia, and 51 healthy control participants to evaluate the test's construct validity, convergent validity, and internal consistency, as well as its sensitivity and specificity. We used the Western Aphasia Battery (WAB) as a reference test. With a cut-off score of 17, the HAST showed high diagnostic accuracy (sensitivity: 92.5%, specificity: 88.5%). Its construct validity was good; we identified one component in the test, and moderate-to-strong positive correlations across most of its subtests (mean Spearman r = 0.56). Convergent validity of the HAST was satisfying, reflected by the moderate-to-strong positive correlations between subtests of the HAST and subtests of the WAB (Spearman r = 0.50-0.86). The correlation between the HAST total score and the WAB aphasia quotient was high (Spearman r = 0.86). Despite the small number of items within tasks, all subtests showed acceptable internal consistency (mean Cronbach's α = 0.74). Our preliminary results suggest that the HAST is a valid, accurate, and clinically feasible test to detect post-stroke aphasia and to identify patients who require a more detailed assessment of their language skills. In addition, it reliably identifies not only the presence but also the severity of aphasia, thus, it might be a good candidate for monitoring patient progress.