Measuring communication as a core outcome in aphasia trials: Results of the ROMA-2 international core outcome set development meeting.
Sarah J Wallace, Linda Worrall, Tanya A Rose and 37 others
PMID 36583427WHAT IT FOUND
Experts agreed that the Scenario Test (TST) is the best measure of everyday communication for aphasia trials.
It uses role-play to score how much information a person conveys and how much help they need. This standardizes how communication outcomes are reported across studies.
Key findings
01The Scenario Test (TST) received consensus (72.41% yes votes) as the preferred measure of communication for inclusion in the ROMA core outcome set.
02TST was selected because it measures multimodal communication in interactive, everyday scenarios, aligning with the definition of situated language use.
03Ease of translation into other languages was the only feasibility criterion that reached consensus, reflecting the need for international data pooling.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The panel did not include representatives from every country where aphasia research occurs. Only one person with aphasia (consumer) participated in the meeting, limiting the patient perspective on the choice of measure. The TST may impose cognitive demands through role-play that differ from real-life interaction. The TST does not differentiate between verbal and non-verbal communication performance. There is a known ceiling effect for people with mild aphasia who communicate primarily through speech.
Declared interests
Several authors declared conflicts of interest because they authored or adapted the outcome measures considered. These authors did not vote on measures they authored. The study was funded by the National Health and Medical Research Council.
The easy way to misread this
Do not assume the Scenario Test (TST) is appropriate for all people with aphasia. It was designed for moderate to severe aphasia and has a reported ceiling effect for those with mild aphasia who rely primarily on speech. For mild cases, it may not capture subtle changes, and other measures like the WAB-R may be needed to differentiate linguistic competence from communicative performance.