Summary of findings for the main comparison. tDCS plus speech and language therapy (SLT) versus sham tDCS plus SLT for improving aphasia for improving aphasia in patients with aphasia after stroke.
| tDCS plus speech and language therapy (SLT) versus sham tDCS plus SLT for improving aphasia in patients with aphasia after stroke | ||||||
| Patient or population: patients with improving aphasia in patients with aphasia after stroke Settings: Intervention: tDCS plus speech and language therapy (SLT) versus sham tDCS plus SLT for improving aphasia | ||||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No. of Participants (studies) | Quality of the evidence (GRADE) | Comments | |
| Assumed risk | Corresponding risk | |||||
| Control | TDCS plus speech and language therapy (SLT) versus sham tDCS plus SLT for improving aphasia | |||||
| Functional communication post intervention Formal outcome measures of aphasia. Scale from: −infinity to +infinity | The mean functional communication post intervention in the control groups was NA1 | The mean functional communication post intervention in the intervention groups was 0.17 standard deviations higher (0.2 lower to 0.55 higher) | 112 (3 studies) | ⊕⊕⊝⊝ low2,3 | SMD 0.17 (−0.20 to 0.55) | |
| Functional communication at follow‐up formal measures of aphasia. Scale from: −infinity to +infinity Follow‐up: mean 6 months | The mean functional communication at follow‐up in the control groups was NA1 | The mean functional communication at follow‐up in the intervention groups was 0.14 standard deviations higher (0.31 lower to 0.58 higher) | 80 (2 studies) | ⊕⊕⊝⊝ very low2,3,4 | SMD 0.14 (−0.31 to 0.58) | |
| Language impairment: accuracy of naming nouns post intervention Accuracy in naming nouns. Scale from: −infinity to +infinity | The mean language impairment: accuracy of naming nouns post intervention in the control groups was NA1 | The mean language impairment: accuracy of naming nouns post intervention in the intervention groups was 0.42 standard deviations higher (0.19 to 0.66 higher) | 298 (11 studies) | ⊕⊕⊕⊝ moderate2 | SMD 0.42 (0.19 to 0.66) | |
| Language impairment: accuracy of naming nouns at follow‐up Accuracy in naming nouns. Scale from: −infinity to +infinity Follow‐up: mean 6 months | The mean language impairment: accuracy of naming nouns at follow‐up in the control groups was NA1 | The mean language impairment: accuracy of naming nouns at follow‐up in the intervention groups was 0.87 standard deviations higher (0.25 to 1.48 higher) | 80 (2 studies) | ⊕⊕⊝⊝ low2,4 | SMD 0.87 (0.25 to 1.48) | |
| Language impairment: accuracy of naming verbs post intervention Accuracy in verb naming. Scale from: −infinity to +infinity | The mean language impairment: accuracy of naming verbs post intervention in the control groups was NA1 | The mean language impairment: accuracy of naming verbs post intervention in the intervention groups was 0.19 standard deviations higher (0.68 lower to 1.06 higher) | 21 (3 studies) | ⊕⊕⊝⊝ very low2,3,4 | SMD 0.19 (−0.68 to 1.06) | |
| tDCS plus speech and language therapy (SLT) versus sham tDCS plus SLT for improving aphasia: dropouts post intervention Numbers of dropouts and adverse events | 87 per 1000 | 49 per 1000 (20 to 115) | See comment | 345 (15 studies) | ⊕⊕⊝⊝ low2,3 | Risks were calculated from odds ratio |
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; OR: Odds ratio; | ||||||
| GRADE Working Group grades of evidence High quality: further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: we are very uncertain about the estimate. | ||||||
1 No data can be provided due to the combination of different outcome measures for the same outcome in this analysis 2 Downgraded due to total sample size being < 400 as a rule of thumb 3 Downgraded due to the fact that the 95% CI around the pooled effect estimate includes both 1) no effect and 2) appreciable benefit or appreciable harm (an effect size of 0.5 serves as a surrogate for a minimal clinically important difference/appreciable benefit or harm) 4 Downgraded due to total sample size being < 100