Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Telehealth services for children with neuro-developmental disabilities in the Asia-Pacific region: A systematic review(Oxford, 2024) Devagiri, B.; Ariyasena, A.D.K.; Siriwardhana, D.D.; Sumanasena, S.BACKGROUND: In recent years telehealth became a popular and a rational health service delivery approach, especially amidst multiple challenges posed while providing health care interventions during the COVID-19 pandemic. AIM: We synthesized available evidence on telehealth for managing children with NDDs in the Asia-Pacific region with the aim of identifying successful methods. METHODOLOGY: We systematically reviewed six electronic databases: MEDLINE, AMED, EMBASE, PsychInfo, Web of Science, and (CINAHL plus) using the keywords and database-specific subject headings from their inception to 25th August 2021. Review findings were synthesized narratively, and harvest plots were used to demonstrate the effect of interventions. The protocol and reporting the findings of this review adhered to PRISMA 2020 guidelines. PROSPERO registration: CRD 340690. RESULTS: We harvested 30,823 records; 17,563 duplicates were removed, and 196 full-text articles were assessed for eligibility. 16 studies with multiple research designs were included in the review. Eight were from the Pacific region and eight represented Asia. The interventions targeted families and children with a variety of NDDs (autism spectrum disorder, Down syndrome, cleft lip and palate, hearing impairment, cerebral palsy etc.) via telehealth. Telehealth packages consisted of direct and indirect methods of synchronous, asynchronous, and hybrid approaches. All studies used parent-led intervention strategies. Telehealth reported a positive effect in 7/16 studies while five showed a neutral effect. CONCLUSIONS: According to published evidence telehealth for children with NDDs is an evolving, evidence-based service facilitation modality in the Asia-Pacific region, with only a few published randomized controlled trials. The systematic review shows promising telehealth practices emerging across the region despite the diversity in NDDs studied.Item Measurement properties of frenchay aphasia screening test across different languages: A COSMIN systematic review.(University of Kelaniya, Sri Lanka, 2023) Jayasingha, J.A.P.P.; Ariyasena, A.D.K.; Siriwardhana, D.D.BACKGROUND: Aphasia is a language disorder that occurs due to damage to the brain; the left side of the brain contributes more towards language. Aphasia may cause problems in understanding, speaking, reading, or writing (American Speech-Language-Hearing Association, 2022a). The main goals of speech therapy treatments are to enhance communication, restore speech and language ability as much as possible, and teach different communication strategies (Schulman, 2020). Frenchay Aphasia Screening test (FAST) is used to identify aphasia (Enderby et al., 1987). The best-evaluated and most widely used aphasia assessment is the Frenchy aphasia screening test (Salter et al., 2006). No matter how valid this original tool is, a systematic review is yet to be conducted collating the psychometric properties of the FAST test across different languages. It is therefore important to summarize the measurement properties in those studies to analyzed the methodological quality of those validation studies. It will aid in identifying research gaps and inform future research. The study describes the measurement properties of Frenchay Aphasia Screening Test across different languages. OBJECTIVE/S: This systematic review aimed to appraise and summarize the psychometric properties of the Frenchay Aphasia Screening Test across different languages. METHODS: This study was conducted as a systematic review and followed the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) 2020 guideline. The study was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD - 383989). Research studies were searched using the following electronic databases: MEDLINE, EMBASE, PsychInfo, AMED, CINAHL Plus, and Web of Science. Reference lists of selected articles were also searched, and a forward citation search was done through Google Scholar. Studies were included if they presented at least one psychometric measurement property described in the consensus-based standards for the selection of health states measurement instrument (COSMIN) risk of bias checklist. Study selection involved two stages: 1) title and abstract screening and 2) full-text review. Disagreements between the two reviewers were discussed in both stages until a consensus was researched. The inter-rater reliability between the two raters was good (kappa=0.76) during the full-text review. The methodological quality of studies on measurement properties was assessed using the COSMIN risk of bias checklist. Data were synthesized according to the COSMIN guidelines. RESULTS: One hundred fifty-two articles were screened; 143 articles were excluded, and nine articles were selected for full-text review; four articles were included from full-text review. Overall, seven articles were included. This review included the original English version and six translations/adaptations of FAST. Two independent reviewers were involved in the article selection to avoid bias. According to the results, the PROM development studies on FAST were low. When considering the methodological quality of 16 measurement properties, hypothesis testing was rated as high as it was analyzed in four studies, and in each of those studies, it was rated as sufficient. The results were inconsistent and insufficient for other measurement properties to make conclusions. CONCLUSION/S: Based on the overall findings, only hypothesis testing demonstrated high-quality evidence for Frenchay Aphasia Screening Test. Furthermore, due to insufficient results, it was not possible to come to a conclusion about the measurement properties of content validity, internal consistency, cross-cultural validity, reliability, and criterion validity of the Frenchay aphasia screening test.Item Availability of rehabilitation services for communication disorders in Sri Lanka: a cross-sectional survey(BMJ Publishing Group Ltd, 2023) Caldera, A.V.; Wickremasinghe, R.; Munasinghe, T.U.; Perera, K.M.N.; Muttiah, N.; Tilakarathne, D.; Peiris, M.K.R.R.; Thamilchelvan, E.; Sooriyaarachchi, C.; Nasma, M.N.; Manamperige, R.M.; Ariyasena, A.D.K.; Sumanasena, S.P.OBJECTIVES: To describe the rehabilitation services available for communication disorders in Sri Lanka and to estimate the adequacy of the services in provinces and districts of the country. SETTING: The study considered government and private institutions, which provide rehabilitation services for communication disorders in Sri Lanka. PARTICIPANTS: Institutions providing services of speech-language pathologists, audiologists and audiology technicians in Sri Lanka. PRIMARY AND SECONDARY OUTCOME MEASURES: We investigated the number of government hospitals and private institutions, which provide speech-language pathology and audiology services in Sri Lanka as the primary outcome measure. A number of speech-language pathologists, audiologists and audiology technicians working in the institutions were obtained from records and institution-based inquiries to identify the adequacy of the services in the country as the secondary outcome measure. RESULTS: Of the 647 government hospitals that provide free healthcare services in the country, 45 and 33 hospitals had speech and language therapy and audiology units, respectively. Government hospitals do not have audiologists but only have audiology technicians. The number of speech and language therapists and audiology technicians in the government sector per 100 000 population in the country was 0.44 and 0.18, respectively. There were wide variations in specialist to population ratio between districts. 77 private centres provide speech therapy services in 15 out of the 25 districts; 36 private centres provide audiological evaluations in 9 districts. CONCLUSIONS: The number of specialist speech and language therapists and audiologists is not sufficient to provide adequate rehabilitation services for communications disorder for the Sri Lankan population. Not recruiting audiologists to the government sector affects the management of hearing impairment in the affected.