Medicine and Health Sciences Commons^™

How A Power Differential Between Clinicians And Researchers Contributes To The Research-To-Practice Gap, Natalie Douglas, Jacqueline Hinckley, Kate Grandbois, Megan Schliep, Amy Wonkka, Jennifer Oshita, Julie Feuerstein

HPD Articles

PURPOSE: The purpose of this article is to contend that there is a power differential between researchers and clinicians where researchers are the primary creators of knowledge and clinicians are the primary consumers of knowledge. Rooted in a sociological model illustrating interacting levels of power at macro-, meso-, and microlevels, we argue that authentic research-practice partnerships and clinician-researcher collaborations can mitigate this power differential. CONCLUSIONS: Clinicians and researchers in our field have vastly different responsibilities and priorities that impact our ability to work collaboratively to solve the most pressing problems for the clients we serve. Although some current research practices …

Precision Rehabilitation For Aphasia By Patient Age, Sex, Aphasia Severity, And Time Since Stroke? A Prespecified, Systematic Review-Based, Individual Participant Data, Network, Subgroup Meta-Analysis, Release Collaborators, Jacqueline Hinckley

HPD Articles

BACKGROUND: Stroke rehabilitation interventions are routinely personalized to address individuals' needs, goals, and challenges based on evidence from aggregated randomized controlled trials (RCT) data and meta-syntheses. Individual participant data (IPD) meta-analyses may better inform the development of precision rehabilitation approaches, quantifying treatment responses while adjusting for confounders and reducing ecological bias. AIM: We explored associations between speech and language therapy (SLT) interventions frequency (days/week), intensity (h/week), and dosage (total SLT-hours) and language outcomes for different age, sex, aphasia severity, and chronicity subgroups by undertaking prespecified subgroup network meta-analyses of the RELEASE database. METHODS: MEDLINE, EMBASE, and trial registrations were systematically …

Building Research Initiatives By Developing Group Effort (Bridge): Patient-Partners In Aphasia Research, Alejandro Brice, Jacqueline Hinckley

HPD Articles

Researcher-initiated research often has little or no input from the groups who will be affected by the results of the research. The aim of this project was to describe practices of embracing patient-partners (i.e., individuals with aphasia and spouses/family members) in research. Six webinars were developed for both researchers and patient-partners that were required prior to participating in a joint conference that focused on collaborative research teams. The conference was designed based on an appreciative inquiry approach. Including patient-partners into research priorities and planning has been accomplished across various health domains in the United States, but this was the first …

Dosage, Intensity, And Frequency Of Language Therapy For Aphasia: A Systematic Review-Based, Individual Participant Data Network Meta-Analysis., Rehabilitation And Recovery Of People With Aphasia After Stroke (Release) Collaborators, Jackie Hinckley

HPD Articles

BACKGROUND AND PURPOSE: Optimizing speech and language therapy (SLT) regimens for maximal aphasia recovery is a clinical research priority. We examined associations between SLT intensity (hours/week), dosage (total hours), frequency (days/week), duration (weeks), delivery (face to face, computer supported, individual tailoring, and home practice), content, and language outcomes for people with aphasia.

METHODS: Databases including MEDLINE and Embase were searched (inception to September 2015). Published, unpublished, and emerging trials including SLT and ≥10 individual participant data on aphasia, language outcomes, and time post-onset were selected. Patient-level data on stroke, language, SLT, and trial risk of bias were independently extracted. Outcome …

Utilising A Systematic Review-Based Approach To Create A Database Of Individual Participant Data For Meta- And Network Meta-Analyses: The Release Database Of Aphasia After Stroke, Release Collaborators, Jackie Hinckley

HPD Articles

Background

Collation of aphasia research data across settings, countries and study designs using big data principles will support analyses across different language modalities, levels of impairment, and therapy interventions in this heterogeneous population. Big data approaches in aphasia research may support vital analyses, which are unachievable within individual trial datasets. However, we lack insight into the requirements for a systematically created database, the feasibility and challenges and potential utility of the type of data collated.

Aim

To report the development, preparation and establishment of an internationally agreed aphasia after stroke research database of individual participant data (IPD) to facilitate planned …

Predictors Of Poststroke Aphasia Recovery: A Systematic Review-Informed Individual Participant Data Meta-Analysis, Marian C. Brady, Release Collaborators, Jackie Hinckley

HPD Articles

Background and Purpose:

The factors associated with recovery of language domains after stroke remain uncertain. We described recovery of overall-language-ability, auditory comprehension, naming, and functional-communication across participants’ age, sex, and aphasia chronicity in a large, multilingual, international aphasia dataset.

Methods:

Individual participant data meta-analysis of systematically sourced aphasia datasets described overall-language ability using the Western Aphasia Battery Aphasia-Quotient; auditory comprehension by Aachen Aphasia Test (AAT) Token Test; naming by Boston Naming Test and functional-communication by AAT Spontaneous-Speech Communication subscale. Multivariable analyses regressed absolute score-changes from baseline across language domains onto covariates identified a priori in randomized controlled trials and all …

Release: A Protocol For A Systematic Review Based, Individual Participant Data, Meta- And Network Meta-Analysis, Of Complex Speech-Language Therapy Interventions For Stroke-Related Aphasia, Marian C. Brady, Myzoon Ali, Kathryn Vandenberg, Linda J. Williams, Louise R. Williams, Masahiro Abo, Frank Becker, Audrey Bowen, Caitlin Brandenburg, Caterina Breitenstein, Stefanie Bruehl, David A. Copeland, Tamara B. Cranfill, Marie Di Pietro-Bachmann, Pamela Enderby, Joanne Fillingham, Federica Lucia Galli, Marialuisa Gandolfi, Bertrand Glize, Erin Godecke, Neil Hawkins, Katerina Hilari, Jackie Hinckley, Simon Horton, David Howard, Petra Jaecks, Elizabeth Jefferies, Luis M. T. Jesus, Maria Kambanaros, Eun Kyoung Kang, Eman M. Khedr, Anthony Pak Hin Kong, Tarja Kukkonen, Marina Laganaro, Matthew A. Lambon Ralph, Ann Charlotte Laska, Beatrice Leemann, Alexander P. Leff, Roxele R. Lima, Antje Lorenz, Brian Macwhinney, Rebecca Shisler Marshall, Flavia Mattioli, Ilknur Mavis, Marcus Meinzer, Reza Nilipour, Enrique Noe, Nam-Jong Paik, Rebecca Palmer, Ilias Papathanasiou, Brigida F. Patricio, Isabel Pavão Martins, Cathy Price, Tatjana Prizl Jakovac, Elizabeth Rochon, Miranda L. Rose, Charlotte Rosso, Ilona Rubi-Fessen, Marina B. Ruiter, Claerwen Snell, Benjamin Stahl, Jerzy P. Szaflarski, Shirley A. Thomas, Mieke Van De Sandt-Koenderman, Ineke Van Der Meulen, Evy Visch-Brink, Linda Worrall, Heather Harris Wright

HPD Articles

Background: Speech and language therapy (SLT) benefits people with aphasia following stroke. Group level summary statistics from randomised controlled trials hinder exploration of highly complex SLT interventions and a clinically relevant heterogeneous population. Creating a database of individual participant data (IPD) for people with aphasia aims to allow exploration of individual and therapy-related predictors of recovery and prognosis.

Aim: To explore the contribution that individual participant characteristics (including stroke and aphasia profiles) and SLT intervention components make to language recovery following stroke.

Methods and procedures: We will identify eligible IPD datasets (including randomised controlled trials, non-randomised comparison …

Narratives Of Expert Speech-Language Pathologists: Defining Clinical Expertise And Supporting Knowledge Transfer, Natalie F. Douglas, Katie Squires, Jacqueline Hinckley, Erline V. Nakano

HPD Articles

Clinical expertise is a component of evidence-based practice; however, relatively little attention has been paid to this phenomenon in the professional literature of speech-language pathology. This may have negative impacts on the training of pre-professional and novice speech-language pathologists. The purpose of this study was to examine professional narratives of expert Speech-Language Pathologists (SLPs) to consider applications for knowledge transfer between expert clinicians and novice clinicians. Collection of the professional narratives of 10 expert SLPs were obtained through in-depth interviews. Interviews were transcribed and coded for themes. Themes that impacted expertise in SLP included: training; work sites; individual and clinician …