Many ways of measuring: a scoping review of measurement instruments for use with people with aphasia

Background

In clinical practice and in research, aphasia measurement instruments are used for many reasons: to screen and diagnose, to identify deficits and strengths, and to measure outcomes. A proliferation in available measurement instruments presents challenges to both the aphasia clinician and researcher and forms a barrier to optimal practice. There is a need for a comprehensive review of measurement instruments to identify the diversity of constructs measured by available tools and their cultural and linguistic applicability to the international aphasia community.

Aims

(1) To identify all available standardised measurement instruments which have been developed or tested with people with aphasia; and (2) To describe the construct/s measured, method of report, structure (components and scoring system), and availability of cultural/linguistic adaptations, of identified instruments.

Methods and Procedures

This scoping review is reported in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Studies were identified through searches of PUBMED, EMBASE, and CINAHL databases. Secondary searches of individual measurement instruments and hand searching were also undertaken. Two reviewers independently assessed titles, abstracts, and full-text articles. Inclusion criteria: studies reporting psychometric properties of measurement instruments, participants with aphasia (or their proxies), English language full-text journal articles. Data extracted: purpose, structure, and method of report of each instrument. The construct(s) reported to be measured by each instrument was classified according to the International Classification of Functioning, Disability and Health (ICF).

Outcomes and Results

A total of 3642 articles were identified through database searches. Following the removal of duplicates, 2879 articles were screened by title and abstract; with 334 articles undergoing full-text review. Secondary searches of individual measurement instruments and hand searching identified a further 99 publications. In total, 284 references for 143 measurement instruments were included in this review. Measurement instruments were classified by ICF component; the majority were reported to be measures of Body Functions (n = 94); followed by Activity/Participation (n = 23); Environmental Factors (n = 5); and quality of life/other constructs not within the ICF (n = 16). Five measured multiple ICF components.

Conclusions and Implications

This review identified 143 measurement instruments, developed or tested with people with aphasia. Classified according to the ICF, these instruments primarily measure Body Functions (n = 94). Some measurement instruments have undergone extensive cultural and linguistic translation/adaptation, however most have not. The resulting corpus of instruments provides a basis for the selection of measurement instruments in clinical and research settings.