Quantifying Dosage in Self-Managed Speech-Language Therapy: Exploring Components of Cumulative Intervention Intensity in a Real-World Mobile Health Data Set
Q&A with Claire Cordella
What is the purpose of your research?
Cumulative Intervention Intensity (CII; Baker 2012) is a proposed framework for conceptualizing and calculating dose which has been used to quantify intensity of speech-language therapy (SLT) in highly controlled laboratory studies and clinical trials. However, it is unknown whether CII can be applied to characterize the practice patterns of patients undertaking at-home, self-managed SLT. The current study leverages real-world mobile health (mHealth) data to investigate the applicability of CII parameters to self-managed SLT, including the interrelationships between individual CII parameters and their utility for identifying naturally occurring subgroups of patient users.
What were your methods for this study?
Our team used anonymized data from 2,223 post-stroke survivors who used the Constant Therapy application. Four quantitative CII parameters – dose, session frequency, session duration, and total intervention duration – were calculated per user over a three-month analysis period using raw session-level data. We conducted correlation analyses at the level of the individual and group to examine the degree of relatedness between each of the CII parameters. CII parameter measures were additionally used as inputs to a k-mean clustering analysis to identify practice pattern subgroups.
How do your findings relate to the brain and recovery?
Results demonstrate the feasibility of calculating components of CII based on available usage statistics from a commercial app for self-managed SLT. The calculation of CII in this way may provide both users and clinicians with a fuller picture of at-home, self-managed practice habits than looking at any one dosage component alone. The study represents a first step toward more comprehensive and theoretically-grounded dose reporting for self-managed SLT. It was concluded that the calculation of CII may provide both users and clinicians with a fuller picture of at-home, self-managed practice habits than looking at any one dosage component alone. The study represents a first step toward more comprehensive and theoretically-grounded dose reporting for self-managed SLT.
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Cordella, C. & Kiran, S. 2024. Quantifying Dosage in Self-Managed Speech-Language Therapy: Exploring Components of Cumulative Intervention Intensity in a Real-World Mobile Health Data Set. American Journal of Speech-Language Pathology. doi: 10.1044/2024_AJSLP-23-00285