Psychometric properties of the German Stroke and Aphasia Quality of Life Scale 39 generic version

Background: The international expert consensus core outcome set for post-stroke aphasia recommends the Stroke and Aphasia Quality of Life Scale - 39/generic (SAQOL-39g) for assessing patient-reported health-related quality of life. Cultural adaptations of the SAQOL-39g are mandatory in stroke rehabilitation.Aim: We adapted the original English SAQOL-39g into German and evaluated its psychometric quality.Design: Evaluation of a self-report scale embedded in a prospective multicenter parallel group randomized waitlist-controlled trial on the effectiveness of intensive speech and language therapy.Setting: Nineteen in- and outpatient aphasia rehabilitation centers in Germany.Population: People with chronic post-stroke aphasia (N.=156) of all types and severity levels.Methods: We followed applicable guidelines for cross-cultural test adaptations and psychometric evaluations. Psychometric analyses are based on the assessment before three weeks of intensive speech and language therapy (acceptability, internal consistency, validity; N.=156), on the assessments before and after three weeks of waiting in the control group (test-retest reliability; N.=78), and on the assessments before and after three weeks of intensive speech and language therapy (responsiveness; N.=156).Results: The German SAQOL-39g was feasible across all aphasia severity grades (no missing data; no floor/ceiling effects). Internal consistency was excellent (Cronbach's α=0.90); test-retest reliability was moderate-to-good (intraclass-correlations: ICC=0.73 for single/0.85 for average measures). Both exploratory factor analyses and multidimensional scaling of proximity data/graphical network analysis supported the 3-dimensional structure (domains: physical, psychosocial, communication) of the English original version. Convergent (|r|=0.29 to 0.48) and discriminative (|r|=0.03 to 0.07) validities were acceptable. Responsiveness to intervention-induced change showed a small-to-medium treatment effect (group difference after intervention compared to waiting-list control: Cohen's d=0.34).Conclusions: The German SAQOL-39g is a reliable, valid and change-sensitive patient-reported outcome measure to assess the physical, communication and psychosocial quality of life in chronic post-stroke aphasia, with comparable psychometric properties and factorial structure to the original English version.Clinical rehabilitation impact: The German SAQOL-39g is an easy-to-administer and -score patient-reported scale that can be used in rehabilitation settings to measure health-related quality of life and support patient-centered goal setting in people with chronic post-stroke aphasia of different ages, stroke durations, severity and type of aphasia

P2x 3 receptor-expression in fetal and infant bladders: the basis for a new therapeutic concept for overactive bladders in children

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Re-evaluation of the penicillamine challenge test in the diagnosis of Wilson's disease in children

Backgrounds/Aims: A urinary copper (Cu) >25 mu mol/24 h following penicillamine had a reported specificity of 98.2% and sensitivity of 88.2% in diagnosing Wilson's disease (WD). We have re-evaluated this test. Ninety-eight subjects were studied at presentation. Methods: Thirty-eight (19 girls, 19 boys; median age 10.3 years; range 5-16 years) had an ultimate diagnosis of WD. Sixty (24 girls, 36 boys; median age 10.1, range 2.3-15 years) had other fiver disorders. Urinary Cu was estimated for 24 h before (basal Cu) and for 24 h whilst giving penicillamine 500 mg orally 12 hourly x2 (post-penicillamine Cu). Results: Both basal Cu and post-penicillamine Cu differed significantly between WD patients and controls (basal Cu: median 6.5 mu mol/24 h, range 0.9-109 mu mol/24 h, versus median: 0.8 mu mol/24 h, range 0.1-19.5, p <0.0001; post-penicillamine Cu: median 36.9 mu mol/24 h, range 1.98-219 mu mol/24 h, versus median 12.35 mu mol/24 h, range 0.5-49.8 mu mol/24 h, p <0.0001). A post-penicillamine Cu >25 mu mol/24 h was observed in 29/38 patients with WD and in 4/60 controls. 25/ 38 WD patients were symptomatic. Twenty-three of these and 6/13 asymptomatic siblings had a positive test. The test had a sensitivity of 76% (95% confidence interval 101, 59.8-88.6%) and a specificity of 93% (95% CI, 83.8-98.2%). Sensitivity was better in symptomatic patients (92%, [95% CI; 74-99%]) than asymptomatic (46%,195% CI; 19.2-74.9%]). Conclusions: This test is valuable in the diagnosis of WD with active liver disease, but is unreliable to exclude the diagnosis in asymptomatic siblings. (C) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserve