Moving Toward Non-transcription based Discourse Analysis in Stable and Progressive Aphasia.

The treatment analysis was preliminary and included only 15 participants, and enrollment was still ongoing. The primary outcome of the treatment study was naming of trained items, not discourse, so the discourse changes are secondary findings. Participants received SFA/PCA therapy together with active or sham brain stimulation, and the stimulation groups were combined, so the contribution of any single component cannot be separated. The PPA sample was small, with only one person with the semantic variant, and that variant was not analysed separately. Multiple comparison corrections were not used in the PPA analysis because it was exploratory. The authors say direct comparisons of accuracy and reliability for scoring from formal transcripts, orthographic transcripts, and video or audio are still needed. The stable aphasia group included 25 participants who were not aphasic by WAB but reported communication difficulties or identified as having aphasia. The paper reports secondary database analyses and preliminary treatment data, not a trial designed to establish that these measures are ready for routine clinical use.

Do not conclude that non-transcription scoring is already validated or that therapy caused the discourse changes. The treatment analysis was preliminary, used discourse as a secondary outcome, and combined active and sham stimulation groups, so the effects of therapy and stimulation cannot be separated.