Looking at the differences between tests made for people with aphasia and tests used for all health problems: Which test is best when comparing the cost and benefits of aphasia treatments?
What did the researchers aim to find out?
We compared two tests that measure health-related quality of life.
One test, the EQ-5D-3L has a scoring system used by policy makers. This test is used for all health conditions and does not measure communication.
The second test, the SAQOL-39g, does not have the same type of scoring system, but was made to measure elements of quality of life relevant to people with aphasia.
We aimed to find out which test is best to use when comparing the costs and benefits of aphasia treatments.
What type of research was done?
We used data collected during the Constraint Induced or Multi-Modal Personalised Aphasia Rehabilitation (COMPARE) trial.
Results of the research
We found that the two tests measure different parts of quality of life.
- The EQ-5D-3L alone measures pain/discomfort.
- The SAQOL-39g alone measures communication.
- Both tests measure mobility and emotional well-being.
This is important, because it tells us we need a new way of comparing costs and benefits of aphasia treatments.
A test is needed that:
1) measures communication as an important part of quality of life.
2) has a scoring system used by policy makers.
Why was the research done?
The EQ-5D-3L is used in some aphasia trials to measure costs and benefits of treatment. We wanted to understand if this test produces trustworthy results.
What does the research mean for me and others?
This research supports the use of tests that:
- Measure the parts of quality of life that impact people with aphasia the most, such as communication.
- Are designed in a way that is easy for people with aphasia to answer.
What research methods were used?
We looked back at information from the COMPARE trial, that did not include personal information like people's names.
We looked for patterns between the test results that could help us understand the differences between the two tests.
How to obtain the treatment detailed in the research?
People in this study were part of the COMPARE trial.
Different people had different treatments. People had either:
- Multi-modal aphasia treatment (M-MAT), or
- Constraint-induced aphasia therapy plus (CIAT-Plus), or
- The treatment offered by their hospital.
More information can be found on this website: COMPARE Aphasia Therapy Research Trial, Research, La Trobe University
Background information on the research topic
- Up to 40% of patients with stroke experience aphasia.
- Aphasia is a communication disorder and has large impacts on health-related quality of life.
- Economic evaluations are important. Policy makers use this information to make decisions about resources.
- More resources are given to treatments that show the greatest health benefits to patients and value to society.
- We wanted to understand which tests are best to show the health benefits for people with aphasia.
Risks related to the research
n/a
Who was allowed to take part in the research?
People could take part in the study if:
- They had aphasia after a stroke at least six (6) months before the trial.
- They were medically well.
- They spoke English before their stroke.
- They did not need help for personal care, like going to the toilet.
Information about the people who took part
201 people took part in this study. They were all people with aphasia after stroke.
- The average age was 63.9 years old.
- 69% of people were male.
- The average time since stroke was 2 and a half years.
Why was the research done this way?
We used information from the COMPARE trial because it is faster than collecting new data.
This saves people with aphasia from doing more tests, and it saves money.
When was the research done?
The COMPARE trial was done between 2016 and 2021.
This study was completed in 2024.
Where was the research done?
The COMPARE trial was done in Australia and New Zealand.
Where did the money come from?
- National Health and Medical Research Council (Investigator Grants 1175821 & 2032983)
- National Health and Medical Research Council Fellowship (1554273).
- National Health and Medical Research Council Centre of Research Excellence in Aphasia Recovery and Rehabilitation (Aphasia CRE; APP 1553236, 2019-2024)
- An Australian Government Research Training Program scholarship.
Problems with the research
We could only use the information collected as part of the COMPARE trial.
If information was not collected, we could not know about it.
Is the research trustworthy?
Yes. The information used in this study came from a large randomised control trial of aphasia treatments.
The information came from a large number of people (201).
Data was carefully collected following guidelines.
Next steps
There is a need make a change to the tests used.
- There are more tests that have the scoring system used by policy makers. These tests have not yet been looked into for people with aphasia.
- More questions could be added to the EQ-5D-3L about commmunication.
- Or, a new scoring system could be added to the SAQOL-39g.
Any of these may help measure the health benefits for people with aphasia in treatment research in a more trustworthy way.
