Evaluation of Three Proposed Markers for Language Impairment in English: A Meta-Analysis of Diagnostic Accuracy Studies

2014 ◽  
Vol 57 (6) ◽  
pp. 2261-2273 ◽  
Author(s):  
Monika Pawłowska
Keyword(s):  
Diagnostic Accuracy ◽  
Language Impairment ◽  
Meta Analysis ◽  
Nonword Repetition ◽  
Future Research ◽  
Likelihood Ratios ◽  
Sentence Repetition ◽  
Study Heterogeneity ◽  
English Speaking ◽  
Verb Tense

Purpose The goal of the study was to determine to what extent 3 proposed markers of language impairment (LI) in English (verb tense, nonword repetition, and sentence repetition) accurately distinguish affected and unaffected English-speaking individuals. Method Electronic databases were searched for diagnostic accuracy studies involving the 3 markers. Quality of relevant studies was described. Numbers of true and false positives and negatives were extracted and used to calculate likelihood ratios (LRs). Results Thirteen studies met the selection criteria. The majority were based on clinically ascertained samples. Pooled LRs and 95% confidence intervals (CIs) for tense (LR+) and sentence repetition (LR+ and LR−) were suggestive of presence (LR+) or absence (LR−) of LI. Wide CIs around the value of inconsistency I 2 index reduced reliability of pooled values for sentence repetition. High between-study heterogeneity precluded pooling of LR values for tense (LR−) and nonword repetition (LR+ and LR−). Conclusion The limited evidence available suggests that the proposed markers may be at best suggestive of LI in English. Future research may refine existing marker tasks to increase their accuracy and test the most promising tasks in unselected samples of participants with and without LI.

Using Nonword Repetition to Identify Language Impairment in Bilingual Children: A Meta-Analysis of Diagnostic Accuracy

2021 ◽  
pp. 1-21
Author(s):  
José A. Ortiz
Keyword(s):  
Diagnostic Accuracy ◽  
Language Impairment ◽  
Meta Analysis ◽  
Nonword Repetition ◽  
Bilingual Children ◽  
Eligibility Criteria ◽  
Study Results ◽  
Meta Regression Analysis ◽  
Word Search ◽  
Meta Analyses

Purpose Nonword repetition has been endorsed as a less biased method of assessment for children from culturally and linguistically diverse backgrounds, but there are currently no systematic reviews or meta-analyses on its use with bilingual children. The purpose of this study was to evaluate diagnostic accuracy of nonword repetition in the identification of language impairment (LI) in bilingual children. Method Using a key word search of peer-reviewed literature from several large electronic databases, as well as ancestral and forward searches, 13 studies were identified that met the eligibility criteria. Studies were evaluated on the basis of quality of evidence, design characteristics, and reported diagnostic accuracy. A meta-regression analysis, based on study results, was conducted to identify task characteristics that may be associated with better classification accuracy. Results Diagnostic accuracy across studies ranged from poor to good. Bilingual children with LI performed with more difficulty on nonword repetition tasks than those with typical language. Quasi-universal tasks, which account for the phonotactic constraints of multiple languages, exhibited better diagnostic accuracy and resulted in less misidentification of children with typical language than language-specific tasks. Conclusions Evidence suggests that nonword repetition may be a useful tool in the assessment and screening of LI in bilingual children, though it should be used in conjunction with other measures. Quasi-universal tasks demonstrate the potential to further reduce assessment bias, but extant research is limited.

Sentence Repetition: A Clinical Marker for Developmental Language Disorder in Danish

2019 ◽  
Vol 62 (12) ◽  
pp. 4450-4463
Author(s):  
Rikke Vang Christensen
Keyword(s):  
Language Disorder ◽  
Future Research ◽  
Typically Developing ◽  
Developmental Language Disorder ◽  
Older Children ◽  
Likelihood Ratios ◽  
Clinical Marker ◽  
Sentence Repetition ◽  
Good Identification ◽  
Syntactic Properties

Purpose The aim of the study was to explore the potential of performance on a Danish sentence repetition (SR) task—including specific morphological and syntactic properties—to identify difficulties in children with developmental language disorder (DLD) relative to typically developing (TD) children. Furthermore, the potential of the task as a clinical marker for Danish DLD was explored. Method SR performance of children with DLD aged 5;10–14;1 (years;months; n = 27) and TD children aged 5;3–13;4 ( n = 87) was investigated. Results Compared to TD same-age peers, children with DLD were less likely to repeat the sentences accurately but more likely to make ungrammatical errors with respect to verb inflection and use of determiners and personal pronouns. Younger children with DLD also produced more word order errors that their TD peers. Furthermore, older children with DLD performed less accurately than younger TD peers, indicating that the SR task taps into morphosyntactic areas of particular difficulty for Danish children with DLD. The classification accuracy associated with SR performance showed high levels of sensitivity and specificity (> 90%) and likelihood ratios indicating good identification potential for clinical and future research purposes. Conclusion SR performance has a strong potential for identifying children with DLD, also in Danish, and with a carefully designed SR task, performance has potential for revealing morphosyntactic difficulties. Supplemental Material https://doi.org/10.23641/asha.10314437

Clausal Density Between Ages 4 and 9 Years for the Edmonton Narrative Norms Instrument: Reference Data and Psychometric Properties

2020 ◽  
pp. 1-15
Author(s):  
Ling-Yu Guo ◽  
Phyllis Schneider ◽  
William Harrison
Keyword(s):  
Diagnostic Accuracy ◽  
Psychometric Properties ◽  
Language Impairment ◽  
Reference Data ◽  
Reliability And Validity ◽  
Correlation Coefficients ◽  
Criterion Validity ◽  
Likelihood Ratios ◽  
Generation Task ◽  
Sensitivity Specificity

Purpose This study provided reference data and examined psychometric properties for clausal density (CD; i.e., number of clauses per utterance) in children between ages 4 and 9 years from the database of the Edmonton Narrative Norms Instrument (ENNI). Method Participants in the ENNI database included 300 children with typical language (TL) and 77 children with language impairment (LI) between the ages of 4;0 (years;months) and 9;11. Narrative samples were collected using a story generation task, in which children were asked to tell stories based on six picture sequences. CD was computed from the narrative samples. The split-half reliability, concurrent criterion validity, and diagnostic accuracy were evaluated for CD by age. Results CD scores increased significantly between ages 4 and 9 years in children with TL and those with LI. Children with TL produced higher CD scores than those with LI at each age level. In addition, the correlation coefficients for the split-half reliability and concurrent criterion validity of CD scores were all significant at each age level, with the magnitude ranging from small to large. The diagnostic accuracy of CD scores, as revealed by sensitivity, specificity, and likelihood ratios, was poor. Conclusions The finding on diagnostic accuracy did not support the use of CD for identifying children with LI between ages 4 and 9 years. However, given the attested reliability and validity for CD, reference data of CD from the ENNI database can be used for evaluating children's difficulties with complex syntax and monitoring their change over time. Supplemental Material https://doi.org/10.23641/asha.13172129

Children's Nonword Repetition Tasks and English Language Learners

2010 ◽  
Vol 11 (3) ◽  
pp. 73-79
Author(s):  
Sara C. Steele ◽  
Deborah A. Hwa-Froelich
Keyword(s):  
English Language Learners ◽  
Language Learners ◽  
Language Impairment ◽  
English Language ◽  
Nonword Repetition ◽  
Adopted Children ◽  
Typically Developing ◽  
Bilingual Speakers ◽  
Internationally Adopted Children ◽  
English Speaking

Nonword repetition performance has been shown to differentiate monolingual English-speaking children with language impairment (LI) from typically developing children. These tasks have been administered to monolingual speakers of different languages and to simultaneous and sequential bilingual English Language Learners (ELLs) with mixed results. This article includes a review of the nonword repetition performance of monolingual and bilingual speakers and of internationally adopted children. Clinical implications for administration and interpretation of nonword repetition task outcomes are included.

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Jie Li ◽  
Lei Feng ◽  
Jiangbo Li ◽  
Jian Tang
Keyword(s):  
Pulmonary Embolism ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Diagnostic Accuracy ◽  
Acute Pulmonary Embolism ◽  
Meta Analysis ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Acute Pe ◽  
Limited Sensitivity

Abstract. Background: The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonary embolism (PE). Methods: A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve, sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) as well as the 95 % confidence intervals (CIs) were calculated to evaluate the diagnostic accuracy of MRA for acute PE. Meta-disc software version 1.4 was used to analyze the data. Results: Five studies were included in this meta-analysis. The pooled sensitivity (86 %, 95 % CI: 81 % to 90 %) and specificity (99 %, 95 % CI: 98 % to 100 %) demonstrated that MRA diagnosis had limited sensitivity and high specificity in the detection of acute PE. The pooled estimate of PLR (41.64, 95 % CI: 17.97 to 96.48) and NLR (0.17, 95 % CI: 0.11 to 0.27) provided evidence for the low missed diagnosis and misdiagnosis rates of MRA for acute PE. The high diagnostic accuracy of MRA for acute PE was demonstrated by the overall DOR (456.51, 95 % CI: 178.38 - 1168.31) and SROC curves (AUC = 0.9902 ± 0.0061). Conclusions: MRA can be used for the diagnosis of acute PE. However, due to limited sensitivity, MRA cannot be used as a stand-alone test to exclude acute PE.

Differentiating School-Aged Children With and Without Language Impairment Using Tense and Grammaticality Measures From a Narrative Task

2016 ◽  
Vol 59 (2) ◽  
pp. 317-329 ◽  
Author(s):  
Ling-Yu Guo ◽  
Phyllis Schneider
Keyword(s):  
Language Development ◽  
Diagnostic Accuracy ◽  
Language Impairment ◽  
Likelihood Ratios ◽  
Verb Morphology ◽  
Story Generation ◽  
School Aged Children ◽  
Sensitive Tool ◽  
Good Diagnostic Accuracy ◽  
Sensitivity Specificity

Purpose To determine the diagnostic accuracy of the finite verb morphology composite (FVMC), number of errors per C-unit (Errors/CU), and percent grammatical C-units (PGCUs) in differentiating school-aged children with language impairment (LI) and those with typical language development (TL). Method Participants were 61 six-year-olds (50 TL, 11 LI) and 67 eight-year-olds (50 TL, 17 LI). Narrative samples were collected using a story-generation format. FVMC, Errors/CU, and PGCUs were computed from the samples. Results All of the three measures showed acceptable to good diagnostic accuracy at age 6, but only PGCUs showed acceptable diagnostic accuracy at age 8 when sensitivity, specificity, and likelihood ratios were considered. Conclusion FVMC, Errors/CU, and PGCUs can all be used in combination with other tools to identify school-aged children with LI. However, FVMC and Errors/CU may be an appropriate diagnostic tool up to age 6. PGCUs, in contrast, may be a sensitive tool for identifying children with LI at least up to age 8 years.

Nonword Repetition and Child Language Impairment

1998 ◽  
Vol 41 (5) ◽  
pp. 1136-1146 ◽  
Author(s):  
Chris Dollaghan ◽  
Thomas F. Campbell
Keyword(s):  
Language Impairment ◽  
Language Intervention ◽  
Nonword Repetition ◽  
School Age Children ◽  
Language Test ◽  
Likelihood Ratios ◽  
Language Tests ◽  
Traditional Language ◽  
High Degree ◽  
Repetition Task

A brief, processing-dependent, nonword repetition task, designed to minimize biases associated with traditional language tests, was investigated. In Study 1, no overlap in nonword repetition performance was found between a group of 20 school-age children enrolled in language intervention (LI) and a group of 20 age-matched peers developing language normally (LN). In Study 2, a comparison of likelihood ratios for the nonword repetition task and for a traditional language test revealed that nonword repetition distinguished between children independently identified as LI and LN with a high degree of accuracy, by contrast with the traditional language test. Nonword repetition may have considerable clinical utility as a screening measure for language impairment in children. Information on the likelihood ratios associated with all diagnostic tests of language is badly needed.

Sensitivity and Specificity of Dickkopf-1 Protein in Serum for Diagnosing Hepatocellular Carcinoma: A Meta-Analysis

2014 ◽  
Vol 29 (4) ◽  
pp. 403-410 ◽  
Author(s):  
Jie Zhang ◽  
Ying Zhao ◽  
Qin Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Test Performance ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Knowledge Infrastructure ◽  
Combined Test ◽  
Dickkopf 1

Objective This meta-analysis evaluated the diagnostic accuracy of positive serum Dickkopf-1 (DKK1) for diagnosing hepatocellular carcinoma (HCC). Material and methods Articles listed on Embase, PubMed, Wanfang, Weipu Periodical Database or the Chinese National Knowledge Infrastructure (CNKI) and published up to July 10, 2013, were searched in either English or Chinese. The pooled sensitivity (SEN), specificity (SPE), positive and negative likelihood ratios (PLR and NLR), diagnostic odds ratio (DOR) and summary receiver operating characteristic (sROC) curve were calculated to summarize the overall test performance. Results Four articles (6 studies) provided DKK1 diagnostic data. The pooled SEN, SPE, PLR, NLR, DOR and area under the sROC curve of DKK1 for the diagnosis of HCC were 0.65 (95% confidence interval [95% CI], 0.52-0.76), 0.94 (95% CI, 0.82-0.98), 10.1 (95% CI, 3.68-27.74), 0.38 (95% CI, 0.28-0.51), 26.90 (95% CI, 10.45-69.19) and 0.84 (95% CI, 0.81-0.87), respectively. Three articles (5 studies) provided DKK1 and α-fetoprotein (AFP) combined test data. The pooled SEN, SPE, PLR, NLR, DOR and area under the sROC curve of combined detection for the diagnosis of HCC were 0.81 (95% CI, 0.76-0.85), 0.85 (95% CI, 0.78-0.91), 5.52 (95% CI, 3.76-8.10), 0.22 (95% CI, 0.19-0.27), 24.60 (95% CI, 17.69-34.19) and 0.88 (95% CI, 0.85-0.91), respectively. Conclusion Both DKK1 and DKK1 plus AFP had high diagnostic accuracy for diagnosis of HCC.

scholarly journals Diagnostic Accuracy of Confocal Laser Endomicroscopy for the Diagnosis of Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (23) ◽  
pp. 12390
Author(s):  
Sneha Sethi ◽  
Xiangqun Ju ◽  
Richard M. Logan ◽  
Paul Sambrook ◽  
Robert A. McLaughlin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
High Sensitivity ◽  
Risk Of Bias ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Likelihood Ratios

Background: Advances in treatment approaches for patients with oral squamous cell carcinoma (OSCC) have been unsuccessful in preventing frequent recurrences and distant metastases, leading to a poor prognosis. Early detection and prevention enable an improved 5-year survival and better prognosis. Confocal Laser Endomicroscopy (CLE) is a non-invasive imaging instrument that could enable an earlier diagnosis and possibly help in reducing unnecessary invasive surgical procedures. Objective: To present an up to date systematic review and meta-analysis assessing the diagnostic accuracy of CLE in diagnosing OSCC. Materials and Methods. PubMed, Scopus, and Web of Science databases were explored up to 30 June 2021, to collect articles concerning the diagnosis of OSCC through CLE. Screening: data extraction and appraisal was done by two reviewers. The quality of the methodology followed by the studies included in this review was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A random effects model was used for the meta-analysis. Results: Six studies were included, leading to a total number of 361 lesions in 213 patients. The pooled sensitivity and specificity were 95% (95% CI, 92–97%; I2 = 77.5%) and 93% (95% CI, 90–95%; I2 = 68.6%); the pooled positive likelihood ratios and negative likelihood ratios were 10.85 (95% CI, 5.4–21.7; I2 = 55.9%) and 0.08 (95% CI, 0.03–0.2; I2 = 83.5%); and the pooled diagnostic odds ratio was 174.45 (95% CI, 34.51–881.69; I2 = 73.6%). Although risk of bias and heterogeneity is observed, this study validates that CLE may have a noteworthy clinical influence on the diagnosis of OSCC, through its high sensitivity and specificity. Conclusions: This review indicates an exceptionally high sensitivity and specificity of CLE for diagnosing OSCC. Whilst it is a promising diagnostic instrument, the limited number of existing studies and potential risk of bias of included studies does not allow us to draw firm conclusions. A conclusive inference can be drawn when more studies, possibly with homogeneous methodological approach, are performed.

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