ABSTRACT
There are contradictory results or lack of validity studies concerning the naming function and brain laterality. Although anomia is a frequent symptom of memory impairment, and the most relevant symptom of aphasia, few studies have been conducted to evaluate its validity for detecting patients with left-hemisphere damage (LD), as per the MeSH definition. OBJECTIVE: To validate a paper-and-pencil confrontation naming test (CNT) according to side of brain injury; to select a valid and reliable abbreviated CNT wherein the effect of demographic variables is minimized; and to use the selected CNT to develop a computer-aided confrontation-naming evaluation (CACNE). METHODS: Control data were obtained from 213 healthy participants (HP) aged 15 to 89 years. A subsample of 106 HP was demographically matched to 39 patients with LD and 40 patients with right-hemisphere damage (RD). Anomia definition and CNT cues were considered for the CACNE. RESULTS: Test-retest and inter-rater reliability, internal consistency, and validity for detecting LD were demonstrated. A significant age effect was observed in HP. The CACNE was developed to detect anomia in interaction with environmental interventions. CONCLUSION: The inconsistencies observed in the CNT studies were probably due to the presence of anomia in almost 50% of the RD patients.
Existem resultados contraditórios ou falta de estudos de validade relativos à função de nomeação e lateralidade cerebral. Embora a anomia seja um sintoma frequente de comprometimento da memória e o sintoma mais relevante da afasia, poucos estudos foram realizados para avaliar sua validade na detecção de pacientes com lesão no hemisfério esquerdo (LHE) conforme definição do MeSH. OBJETIVO: Validar um teste de nomeação por confrontação (TNC) do tipo papel-e-lápis de acordo com o lado da lesão cerebral. Selecionar um TNC abreviada válida e confiável, na qual o efeito de variáveis ââdemográficas seja minimizado. Usar o TNC selecionado para desenvolver uma avaliação de nomeação por confrontação auxiliada por computador (CACNE). MÉTODOS: Os dados de controle foram obtidos de 213 participantes saudáveis ââ(PS) com idades entre 15 e 89 anos. Uma subamostra de 106 PS foi demograficamente pareada com 39 LHE e 40 pacientes com lesão no hemisfério direito (LHD). A definição de anomia e as pistas do TNC foram consideradas para a CACNE. RESULTADOS: A confiabilidade teste-reteste e interexaminador, consistência interna e validade para a detecção de LHE foram demonstradas. Um efeito significativo da idade foi observado na PS. CACNE foi desenvolvida para detectar anomia em interação com intervenções ambientais. CONCLUSÃO: As inconsistências observadas nos estudos do TNC devem-se provavelmente à presença de anomia em quase 50% dos pacientes com LHD.
ABSTRACT
ABSTRACT There are contradictory results or lack of validity studies concerning the naming function and brain laterality. Although anomia is a frequent symptom of memory impairment, and the most relevant symptom of aphasia, few studies have been conducted to evaluate its validity for detecting patients with left-hemisphere damage (LD), as per the MeSH definition. Objective: To validate a paper-and-pencil confrontation naming test (CNT) according to side of brain injury; to select a valid and reliable abbreviated CNT wherein the effect of demographic variables is minimized; and to use the selected CNT to develop a computer-aided confrontation-naming evaluation (CACNE). Methods: Control data were obtained from 213 healthy participants (HP) aged 15 to 89 years. A subsample of 106 HP was demographically matched to 39 patients with LD and 40 patients with right-hemisphere damage (RD). Anomia definition and CNT cues were considered for the CACNE. Results: Test-retest and inter-rater reliability, internal consistency, and validity for detecting LD were demonstrated. A significant age effect was observed in HP. The CACNE was developed to detect anomia in interaction with environmental interventions. Conclusion: The inconsistencies observed in the CNT studies were probably due to the presence of anomia in almost 50% of the RD patients.
RESUMO Existem resultados contraditórios ou falta de estudos de validade relativos à função de nomeação e lateralidade cerebral. Embora a anomia seja um sintoma frequente de comprometimento da memória e o sintoma mais relevante da afasia, poucos estudos foram realizados para avaliar sua validade na detecção de pacientes com lesão no hemisfério esquerdo (LHE) conforme definição do MeSH. Objetivo: Validar um teste de nomeação por confrontação (TNC) do tipo papel-e-lápis de acordo com o lado da lesão cerebral. Selecionar um TNC abreviada válida e confiável, na qual o efeito de variáveis ââdemográficas seja minimizado. Usar o TNC selecionado para desenvolver uma avaliação de nomeação por confrontação auxiliada por computador (CACNE). Métodos: Os dados de controle foram obtidos de 213 participantes saudáveis ââ(PS) com idades entre 15 e 89 anos. Uma subamostra de 106 PS foi demograficamente pareada com 39 LHE e 40 pacientes com lesão no hemisfério direito (LHD). A definição de anomia e as pistas do TNC foram consideradas para a CACNE. Resultados: A confiabilidade teste-reteste e interexaminador, consistência interna e validade para a detecção de LHE foram demonstradas. Um efeito significativo da idade foi observado na PS. CACNE foi desenvolvida para detectar anomia em interação com intervenções ambientais. Conclusão: As inconsistências observadas nos estudos do TNC devem-se provavelmente à presença de anomia em quase 50% dos pacientes com LHD.
Subject(s)
Humans , Reproducibility of Results , Diagnosis , Alzheimer Disease , Cognitive Dysfunction , Anomia , Neuropsychological TestsABSTRACT
The Mini-Mental State Examination (MMSE) is recognized as a valid screening for dementia. It consists of 29 verbal items from a total of 30. The Brief Aphasia Evaluation (BAE) includes 10 aphasia and 12 orientation items, which are similar to most of the MMSE items. It was studied whether those BAE items (MMSE-like): (a) correlate with the rest of the BAE items (BAE-rest), and (b) differentiate patients with left cerebral lesions (LC) from both patients with right cerebral lesions (RC) and healthy participants (HP). A sample of 109 right-handed volunteers (38 HP, 37 LC, and 34 RC) was studied. The three groups were matched according to gender, age, and education. Patients were similar in multiple variables. The correlation between MMSE-like and BAE-rest was .90. MMSE-like showed a sensitivity and specificity of .81 or above to identify the LC from the other two groups. There is a risk for misdiagnosing aphasia as dementia with the MMSE.
Subject(s)
Aphasia/diagnosis , Neuropsychological Tests , Aphasia/psychology , Data Interpretation, Statistical , Dementia/diagnosis , Dementia/psychology , Diagnosis, Differential , Female , Functional Laterality/physiology , Humans , Male , Mental Processes/physiology , Middle Aged , Orientation/physiology , Psychomotor Performance/physiology , Reproducibility of ResultsABSTRACT
INTRODUCTION: Aphasia tests validated according to the brain injury side are necessary, especially for Spanish instruments. OBJECTIVES: To study the concurrent validity of this Brief Aphasia Evaluation (BAE) to differentiate patients with left cerebral lesions (LC) from patients with right cerebral lesions (RC) as well as LC from healthy participants (HP). To study, through an unrestricted-sub-test-factor analysis, the BAE conceptual and content validity to generate a verbal homogeneous construct. MATERIALS AND METHODS: Data were obtained from a sample of 109 right-handed volunteers: 37 LC, 34 RC and 38 HP. The three groups were matched according to gender, age and education. RESULTS: Both groups of patients were similar in type and site of lesion, time since onset of condition, risk factors, presence of hemianopsia and hemiparesis and number of hospital visits. The Cronbach's alpha coefficient indicated an internal consistency of 0.99 for the total score and 0.88 or above for any of the sub-tests. All sub-tests (with loadings of 0.65 or above) grouped in one factor which explained 78% of the variance. The BAE showed a sensitivity and specificity of 0.84 or above to identify the LC (median as cut-off point). CONCLUSIONS: This test of free distribution demonstrated a satisfactory validity.
Subject(s)
Brain Damage, Chronic/diagnosis , Dominance, Cerebral/physiology , Functional Laterality/physiology , Verbal Learning/physiology , Adult , Analysis of Variance , Brain Damage, Chronic/pathology , Brain Damage, Chronic/physiopathology , Brain Damage, Chronic/psychology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Reproducibility of Results , Severity of Illness Index , SpainABSTRACT
Due the availability of new data transmission technologies and new standards for medical studies development, e-health systems have had a sustained adoption in recent years. In this scenario, the health systems are incorporating and increasing the health services offering in response to their needs. This paper presents a system able to transmit medical studies using different communication channels providing an effective use of the medical equipment, the data transmission networks and the human resources availability. This system is based on service oriented architecture (SOA) to propose different alternatives in terms of which data needs to be transmitted for the acquired medical study, in order to attend different medical diagnosis providing an efficient use of the available communication channels. About the security implemented for the data transmission, there are different configurations available for encryption and signing at message level, to ensure that messages cannot be changed without detection during the transmission. For message definition, the HL7 V3 standard is implemented and the medical studies are stored in a centralized database located in a web server accessible via Internet to enable second medical opinion from other specialists.
