Research On The Standardization Of Language Screening Test(LAST) In Patients With Stroke

Background and objective Approximately21-38%of stroke patients suffer fromaphasia, this serious neurological disease affects individual’s ability to communicate,so that patients can not be properly integrated into the social life. Currently theclinical diagnosis of aphasia mainly depends on the clinical interview and scaleevaluation. The assessment results contribute to determine the type and severity ofaphasia which makes rehabilitation more targeted, rational and scientific. But theStandard aphasia rating scales are not suitable for assessment of acute stroke patientsbecause these scales take too long to complete and must be administered by speechand language therapists. Therefore Constance et al. developed a brief languagescreening scale,named the Language Screening Test (LAST), for the assessment ofpatients with acute stroke. In order to get early diagnosis,characteristics ofassessment of patients with aphasia, and help guide clinical rehabilitation.,werevised LAST into Chinese version and applied it on clinical research．Methods After getting the authorization from the original author,we translatedLAST into Chinese from translation—back—translation—Culture—debugging-preliminary—experiment—modify procedures．We take the patients who meet theinclusion criteria from Fujian union hospitals Neurology ward from January2014toApril2014．To validate the scale, we included both “acute” and “chronic”patients.We first prospectively enrolled “acute” patients,that is, admitted withsuspected acute stroke to our stroke unit. During the same period, we enrolledstabilized patients seen in our neurology or rehabilitation department, who were ableto complete the entire ABC comprehensive language evaluation.All patients wereasked to complete CLAST,,and“chronic”patients were asked to complete the ABClanguage evaluation at the same time. Epidata3.02is adopted to establish the database and SPSS16.0is used to complete statistical analysis of the data.Thereliability of scale was tested with the alternate-form reliability， the internalconsistency reliability and the scorer reliability；the validity was evaluated with thecontent validity，the structure validity and the discrimination validity.At the sametime，this study also test the cut-off of CLAST in China post-stroke patients by theapplication of ROC curve．Results1. This research formed Chinese version of LAST．2. The analysis of the alter-form reliability of the questionnaire showed the retestcoefficient correlation was0.945.The intemal consistency analysis showed that theCronbach’s alpha coefficients of the questionnaire was0.909，demonstrating highinternal reliability of the questionnaire.3. The validity of this questionnaire showed the construct validity was good asindicated by factor analysis.The average score of the non-aphasia group is high thanthe aphasia group， the difference was significant(p<0.01)， demonstrating highdiscrimination validity of the questionnaire．.4. We take ABC as diagnostic criteria to explore the cut-off of LAST by using them in“chronic” patients．The result is the Chinese vision LAST has a high sensitivity、specificity when the cutoff is13.5，so that13.5is the suitable cut-off to assess aphasiain post-stroke patients．There are73cases (35.3%) patient among207cases werediagnosed as aphasia which matches foreign studies of aphasia after stroke prevalence(21-38%).ConclusionThis research formed Chinese version of LAST (CLAST) which is suitable forChinese stroke patients.This scale has high reliability, validity, sensitivity andspecificity,so it is suitable for further clinical application.