The Importance of Self-Reported Outcomes and Continued Quality Improvement : Aphasia and Communication Disabilities Program - a Program Evaluation.
Bibliographic record
Abstract
Background Currently there are 165,761 people in Canada living with aphasia today. The Aphasia and Communication Disabilities Program (ACDP) is a therapeutic and social group program for adults offered by March of Dimes Canada. Treating patients with communication challenges in a group setting has been in practice for many decades. Many experts argue it is as effective as individual speech therapy. Continued quality improvement in care is determined by the evaluation of community based interventions like ACDP. A comprehensive program evaluation of ACDP was undertaken from August 2017 to May 2018. Methods The areas targeted for evaluation were narrowed to five domains; pre-existing clinical evidence, program cost, functional improvement and well-being of patients, expectations and needs of patients/families and current staff/volunteer perspectives on program functions. A comprehensive literature review and two communicatively accessible questionnaires were developed based on the Life Participation Approach to Aphasia (LPAA)/Aphasia Framework for Outcomes Measurements (A-FORM) and the RYFF Scales of Psychological Well-Being. In addition, four focus groups and an online questionnaire were used to asses all four populations (patients, caregivers, volunteers and staff).ResultsPatients self-reported improvement in all four LPAA domains - language and related impairments (84%), personal identity/attitude/feelings (80%), communication and language environment (74%) and participation in life situations (70%). Areas identified for continued quality improvement were as followsu2013 administrative support, physical exercise, caregiver support, tools for staff and opportunities for peer support.Conclusions Understanding self-reported outcomes and consistently targeting quality improvement are essential in community interventions u2013 particularly ones with challenging populations that are under-researched.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.026 | 0.019 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.003 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".