Adaptation of the Quick Aphasia Battery into Urdu and establishment of its psychometric properties

Quick Aphasia Battery provides a quick yet comprehensive evaluation of language performance in individuals with aphasia. While the tool was originally developed in English, no validated Urdu version existed for use in Pakistani clinical settings. This study aimed to translate and culturally adapt the Urdu version of the Quick Aphasia Battery and determine its psychometric properties, including reliability and preliminary diagnostic performance among stroke patients. The study was conducted in three phases. Phase 1 involved translation and adaptation, comprising forward-backward translation, expert review, cultural modification and pilot testing with 20 participants to assess clarity and feasibility. Phase 2 was validation including 44 participants (7 with aphasia and 37 without aphasia) to establish content validity, construct validity, and preliminary diagnostic performance. Phase 3 evaluated reliability, including internal consistency, inter-rater, test-retest and parallel forms reliability. Content validity indices were excellent (I-CVI = 0.75-1.00; S-CVI = 0.95-1.00). Mann-Whitney U test revealed significant group differences across all subtests (p < 0.001), supporting known group validity. The Preliminary Receiver Operating Characteristic analysis demonstrated an AUC of 0.96 (95% CI: 0.90-0.99), with a sensitivity of 86% and specificity of 92%. Reliability testing indicated inter-rater reliability with an Intraclass Correlation Coefficient value of 0.96, test-retest reliability with a value of 0.98 and internal consistency with a Cronbach's α value of 0.96; there was no significant difference across parallel forms (p = 0.526). The Urdu Quick Aphasia Battery exhibits promising preliminary validity and reliability for assessing language performance in Urdu-speaking stroke patients and shows consistency and agreement with the original version, despite the inclusion of culturally adapted modifications. However, given the limited number of aphasia cases, further validation with larger clinical samples is required before establishing its diagnostic utility.