A Tablet-Based Aphasia Assessment System "STELA": Feasibility and Validation Study

Yoko Inamoto; Masahiko Mukaino; Sayuri Imaeda; Manami Sawada; Kumi Satoji; Ayako Nagai; Satoshi Hirano; Hideto Okazaki; Eiichi Saitoh; Shigeru Sonoda; Yohei Otaka

doi:10.2196/42219

A Tablet-Based Aphasia Assessment System "STELA": Feasibility and Validation Study

JMIR Form Res. 2023 Feb 8:7:e42219. doi: 10.2196/42219.

Authors

Yoko Inamoto¹, Masahiko Mukaino^{2

3}, Sayuri Imaeda⁴, Manami Sawada⁴, Kumi Satoji⁴, Ayako Nagai⁵, Satoshi Hirano³, Hideto Okazaki⁶, Eiichi Saitoh³, Shigeru Sonoda⁶, Yohei Otaka³

Affiliations

¹ Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan.
² Deparment of Rehabilitation Medicine, Hokkaido University Hospital, Sapporo, Japan.
³ Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan.
⁴ Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan.
⁵ Department of Rehabilitation, Fujita Health University Nanakuri Memorial Hospital, Tsu, Japan.
⁶ Department of Rehabilitation Medicine II, School of Medicine, Fujita Health University, Tsu, Japan.

PMID: 36753308
PMCID: PMC9947769
DOI: 10.2196/42219

Abstract

Background: There is an extensive library of language tests, each with excellent psychometric properties; however, many of the tests available take considerable administration time, possibly bearing psychological strain on patients. The Short and Tailored Evaluation of Language Ability (STELA) is a simplified, tablet-based language ability assessment system developed to address this issue, with a reduced number of items and automated testing process.

Objective: The aim of this paper is to assess the administration time, internal consistency, and validity of the STELA.

Methods: The STELA consists of a tablet app, a microphone, and an input keypad for clinician's use. The system is designed to assess language ability with 52 questions grouped into 2 comprehension modalities (auditory comprehension and reading comprehension) and 3 expression modalities (naming and sentence formation, repetition, and reading aloud). Performance in each modality was scored as the correct answer rate (0-100), and overall performance expressed as the sum of modality scores (out of 500 points).

Results: The time taken to complete the STELA was significantly less than the time for the WAB (mean 16.2, SD 9.4 vs mean 149.3, SD 64.1 minutes; P<.001). The STELA's total score was strongly correlated with the WAB Aphasia Quotient (r=0.93, P<.001), supporting the former's concurrent validity concerning the WAB, which is a gold-standard aphasia assessment. Strong correlations were also observed at the subscale level; STELA auditory comprehension versus WAB auditory comprehension (r=0.75, P<.001), STELA repetition versus WAB repetition (r=0.96, P<.001), STELA naming and sentence formation versus WAB naming and word finding (r=0.81, P<.001), and the sum of STELA reading comprehension or reading aloud versus WAB reading (r=0.82, P<.001). Cronbach α obtained for each modality was .862 for auditory comprehension, .872 for reading comprehension, .902 for naming and sentence formation, .787 for repetition, and .892 for reading aloud. Global Cronbach α was .961. The average of the values of item-total correlation to each subscale was 0.61 (SD 0.17).

Conclusions: Our study confirmed significant time reduction in the assessment of language ability and provided evidence for good internal consistency and validity of the STELA tablet-based aphasia assessment system.

Keywords: Cronbach α; aphasia; assessment; auditory comprehension; digital health intervention; digital mental health intervention; heuristic evaluation; internal consistency; naming and sentence formation; psychological health; psychometric; reading aloud; reading comprehension; repetition; speech; stress; system usability; tablet; validity.

©Yoko Inamoto, Masahiko Mukaino, Sayuri Imaeda, Manami Sawada, Kumi Satoji, Ayako Nagai, Satoshi Hirano, Hideto Okazaki, Eiichi Saitoh, Shigeru Sonoda, Yohei Otaka. Originally published in JMIR Formative Research (https://formative.jmir.org), 08.02.2023.