| BackgroundLanguage, the most important function of the brain, is the nature of the human brain evolved to a highly complex substance products. Many studies suggest that the basal ganglia is connected with advanced neural function, such as emotion, learning, memory, thinking, language,et al. The patients with left basal ganglia hemorrhage, while the majority of people’s language center is in the left cerebral hemisphere, could have a variety of types of language dysfunction, such as the trans-cortical motor aphasia, the trans-cortical sensory aphasia, the cortical mixed aphasia,et al, the majority characteristic of which is the more serious problem of the hearing and writing ability, but the relatively better repeating ability. The deficiency of the language function includes the spoken fluency, the understanding ability of language, the ability of repeating, naming or not, reading and writing ability, dysarthria, and the language rhythmic disorder.There are many methods to estimate the language function in home, such as China Rehabilitation Research Center Aphasia Examination(CRRCAE), Aphasia Battery of Chinese, et al. CRRCAE, which was draw up in1990, had draw on the design theories and framework experience of the Standard Language Test of Aphasia(SLTA), which could diagnosis and estimate the aphasia after some treating, combining with the characteristics of Chinese language and language habits, rules and language environments. It has been widely applied in the assessment of aphasia due to a variety of causes on the brain in domestic hospitals and rehabilitation centers, when its reliability, validity and sensitivity had been verified. Completing the scale, with closely linked to clinical diagnosis and treatment, can be personalized language rehabilitation training plan, more conducive to the recovery of patients with language. But the scale had the relatively cumbersome and arduous assessment method, while it was inconvenient for the statistics and analysis data to storage, the workman was easily to get wrong, had low efficiency.Along with the popularization of information technology and computer in the field of medicine, to convert some test scale and tools for computer test evaluation system has become a trend. Therefore, we, conceiving of cooperation with software engineering, will convert the paper test tool CRRCAE to the Chinese computer software testing system, which was applied to the Chinese aphasia patients to accept test, reliability and validity, to explore the possible better advantages than the paper test tool. we expect that the evaluation can provide the new method and thought for estimating the clinical language features.Objective1. We will convert the paper test tool CRRCAE to the Chinese computer software testing system. Research on the reliability and validity of the CRRCAE computer application software and its potential advantages compare to the paper test tool, for supplying the theories to expand its utilization in clinic.2. To explore the applicability of the format of Chinese software system about CRRCAE in evaluating language function and observing the curative effect of the left basal ganglia hemorrhage treatment.MethodsAccording to the basic ideas, about the operation and score, of CRRCAE scale, we convert the manual operation and score into the Chinese computer application software installed, which was applied to the clinical estimation. Meanwhile, we collected the participants’feedback to modify and debug the software, making it more optimized.When the software was set, there are37testees who got the brain disease(patient group) and41testees (control group) to be researched first by CRRCAE computer software testing system, have be produced. These groups followed the method of the first test to do computer and the paper version test randomly. After each test, they would answer the questionnaire. The patient group would be accepted the computer version test again after2weeks. by contraries, the control group would be tested with the computer version firstly and be tested with the paper version test after2weeks. After getting the result of test, the work group will compare the scores of all entries between computer and the paper version test to analyze the criteria validity of computer version,compare the test time and choose ratio by the testee between computer version and the paper version test in2groups to analysis for the advantages of the computer version.Later, the minimally invasive surgical method on the left basal ganglia hemorrhage with24cases was performed, with the language rehabilitation training after the operation, we evaluated the language function with CRRCAE before the surgery,4weeks and8weeks after the surgery in order to summarize the characteristics of the left basal ganglia hemorrhage with aphasia.Results In this study, the total of84testees were divided equally into patient group and control group, with6participants lost to follow-up and unfinished test, in which case group5cases, control group1case. The rest of the participants are required to complete the paper version test and computer version test. This study questionnaires out of84, a total of78effective questionnaires were taken back (questionnaire recovery rate92.68%).when the CRRCAE preliminary computer software version was modified after debugging, case group testees respectively accepted the paper version and the computer version of the test. The overall average respectively(93.69±18.26,94.15±18.12,r=0.996,P<0.01), had the higher correlation. Spearman’s correlation coefficient of each Sub-test scores between computer version and paper version CRRCAE n patient group showed good correlation(0.782-0.992,P<0.01). It showed that the CRRCAE version had a good standard of validity.The37patients in patient group had received another test with the CRRCAE computer version after2weeks since the first test.the two computer version test overall average score had better correlation respectively(94.15±18.12,96.43±16.01, r=0.684,P<0.01). And each sub-test scores had good correlation(r=0.792-0.964,P<0.01), It showed that the software system had reliable retest reliability.There are totally78testees to complete the test in the patient group and control group. The average test time respectively was3602.69±421.38s and4251.24±475.86s in the computer software version and the paper version of the patient group, while the average test time respectively was1917.30±236.74s and2313.25±312.98s in the computer software version and the paper version of the control group. The paired T test showed that the time in the computer version were significantly lower than that of the paper version.In the questionnaire feedback information, when asked if it was necessary to take the CRRCAE test again, which version would more likely to be accepted, there were73to78(93.59%,73/78) testees showed a tendency to choose the computer version of the test, which there were35(94.59%,35/37) testees in the patients,41(92.68%,38/41) testees in the control group. The chi square test showed that the computer version selection rate in the control group and patients group had significant difference (χ2=55.86, P<0.01).When using the format of Chinese software system about the CRRCAE to evaluate the language function of24patients, who had be operated and with medical treatment, with left basal ganglia intracerebral hemorrhage, we found that the total scores and the average scores on the format of Chinese software system about the CRRCAE were all significantly raised, the patients’ language function were remarkably increased, as the time went by. ConclusionsIn this study we found that the format CRRCAE computer software evaluation system had better standard reliability to evaluate the patients language function, who had the aphasia with the brain disorder in stroke. It could obviously shorten the evaluation time, reduced the workload of raters, which could make the testing process more fluent, convenient, improving the work efficiency; increasing the management and preservation of the database, more convenient for clinical and scientific research. The software was portability and random installation, which was convenient for clinical promotion, which could assess the characteristics of the patients with aphasia caused by the cerebral hemorrhage and the degree of its language recovery after treatment, had good clinical application value. |
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