hce_cmu
112年
英文
第 46 題
📖 題組：
The news that one of the Hollywood superstars was diagnosed the aphasia drew everyone’s attention on the causes and effects of such disease. According to the medical statistics in the USA, approximately one-third of stroke survivors suffer from impaired communication abilities, and 30%–42% of these patients have longstanding symptoms of aphasia, and the most common, Broca’s aphasia, is caused by lesions on anterior brain regions, which often require long-term care, leading to substantial economic and mental health burdens on the family and society. Community medical resources have confirmed that promoting full engagement with rehabilitation treatment for post-stroke patients has reduced the disability rate below 40% and increased activities of daily living by 35%. In addition, intensive speech and language therapy (SLT) improves the functional reorganization of the central nervous system; however, high-intensity and high-dose interventions may not be acceptable to all patients. Therefore, other treatments adjunct to SLT might be useful. More specifically, while intensive SLT is effective, recent evidence suggests that scalp acupuncture therapy (SAT) may have beneficial effects on comprehension, oral expression, repetition, denomination, reading and writing in postapoplectic aphasia (Tang, Tang, & Yang, 2019). One research group from Taiwan (Liu, Huang, Xu, Wu, Tao, & Chen, 2021) tried to appraise the cost-effectiveness of combining SAT with SLT community patients with Broca’s aphasia after stroke, compared to SLT alone. They found that combination therapy was cost-effective and reduced the use of non-standard treatments and medications, leading to lower direct non-medical costs and self-paid expenses. In Liu et al.’s (2021) research, a within-trial cost-effectiveness analysis was applied among 203 participants with Broca’s aphasia after stroke who had been randomly assigned to receive scalp acupuncture with SLT (intervention) or SLT alone (control). Both groups underwent SLT, which roughly last 30 minutes each day, 5 days a week for 4 weeks; while the intervention group simultaneously received scalp acupuncture. Moreover, outcomes were measured using informal assessments and self-report questionnaires and the incremental cost-effectiveness ratios (ICERs) were calculated as a measure of the additional costs necessary to achieve greater treatment outcomes. The results of this economic analysis revealed that patients receiving combination therapy reduced their use of non-standard treatment interventions and medications, reflected in reduced direct non-medical costs and self-paid expenses. Combination therapy was less costly than SLT alone calculated according to the modified intention-to-treat principle. In other words, SAT is a cost-effective treatment option for patients with Broca’s aphasia after stroke, compared to SLT alone. In short, the study, which included the first economic evaluation of acupuncture treatment in patients with Broca’s aphasia after stroke, had valuable findings and methodological limitations. There are only a few studies on acupuncture treatment in patients with Broca’s aphasia after stroke, Liu et al. (2021) concluded that acupuncture seems to be effective in improving post-stroke aphasia, functional communication and language function, and the best curative effect was achieved with the combination of acupuncture with speech and language training. Potential limitations included lack of blinding, variability of treatment regimens, and a heterogeneous patient sample. While SAT appears to be an effective treatment for post-stroke aphasia, the real-world implementation of SAT in low-income and middle-income countries and regions may be restricted by poor acupuncture services, inefficient systems, and a deficiency of therapists. Standardized education and training for the public, community physicians, and government agencies are needed to improve awareness of the benefits and cost-effectiveness of SAT. Still, although the effects of acupuncture appear to be persistent as the differences between the groups were slightly larger after 12 weeks follow-up investigation than those who received immediately post-treatment, long-lasting health economic effects require further study.
The news that one of the Hollywood superstars was diagnosed the aphasia drew everyone’s attention on the causes and effects of such disease. According to the medical statistics in the USA, approximately one-third of stroke survivors suffer from impaired communication abilities, and 30%–42% of these patients have longstanding symptoms of aphasia, and the most common, Broca’s aphasia, is caused by lesions on anterior brain regions, which often require long-term care, leading to substantial economic and mental health burdens on the family and society. Community medical resources have confirmed that promoting full engagement with rehabilitation treatment for post-stroke patients has reduced the disability rate below 40% and increased activities of daily living by 35%. In addition, intensive speech and language therapy (SLT) improves the functional reorganization of the central nervous system; however, high-intensity and high-dose interventions may not be acceptable to all patients. Therefore, other treatments adjunct to SLT might be useful. More specifically, while intensive SLT is effective, recent evidence suggests that scalp acupuncture therapy (SAT) may have beneficial effects on comprehension, oral expression, repetition, denomination, reading and writing in postapoplectic aphasia (Tang, Tang, & Yang, 2019). One research group from Taiwan (Liu, Huang, Xu, Wu, Tao, & Chen, 2021) tried to appraise the cost-effectiveness of combining SAT with SLT community patients with Broca’s aphasia after stroke, compared to SLT alone. They found that combination therapy was cost-effective and reduced the use of non-standard treatments and medications, leading to lower direct non-medical costs and self-paid expenses. In Liu et al.’s (2021) research, a within-trial cost-effectiveness analysis was applied among 203 participants with Broca’s aphasia after stroke who had been randomly assigned to receive scalp acupuncture with SLT (intervention) or SLT alone (control). Both groups underwent SLT, which roughly last 30 minutes each day, 5 days a week for 4 weeks; while the intervention group simultaneously received scalp acupuncture. Moreover, outcomes were measured using informal assessments and self-report questionnaires and the incremental cost-effectiveness ratios (ICERs) were calculated as a measure of the additional costs necessary to achieve greater treatment outcomes. The results of this economic analysis revealed that patients receiving combination therapy reduced their use of non-standard treatment interventions and medications, reflected in reduced direct non-medical costs and self-paid expenses. Combination therapy was less costly than SLT alone calculated according to the modified intention-to-treat principle. In other words, SAT is a cost-effective treatment option for patients with Broca’s aphasia after stroke, compared to SLT alone. In short, the study, which included the first economic evaluation of acupuncture treatment in patients with Broca’s aphasia after stroke, had valuable findings and methodological limitations. There are only a few studies on acupuncture treatment in patients with Broca’s aphasia after stroke, Liu et al. (2021) concluded that acupuncture seems to be effective in improving post-stroke aphasia, functional communication and language function, and the best curative effect was achieved with the combination of acupuncture with speech and language training. Potential limitations included lack of blinding, variability of treatment regimens, and a heterogeneous patient sample. While SAT appears to be an effective treatment for post-stroke aphasia, the real-world implementation of SAT in low-income and middle-income countries and regions may be restricted by poor acupuncture services, inefficient systems, and a deficiency of therapists. Standardized education and training for the public, community physicians, and government agencies are needed to improve awareness of the benefits and cost-effectiveness of SAT. Still, although the effects of acupuncture appear to be persistent as the differences between the groups were slightly larger after 12 weeks follow-up investigation than those who received immediately post-treatment, long-lasting health economic effects require further study.
Which of the following is NOT a methodological limitation of the study?
- A Heterogeneous patient sample
- B Variability of treatment regimens
- C Bias due to the treatment for each group was blinded
- D Long-term health economic effects
思路引導 VIP
請回到文章的最後一段，找找看作者在列舉這項研究的缺點（Potential limitations）時，對於「盲法」(blinding) 具體是怎麼描述的？它是說研究「有」實施盲法，還是「缺少」了這個步驟呢？
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AI 詳解
AI 專屬家教
太棒了！你能精準地從長篇學術文章中鎖定細節，並正確判斷出選項中的邏輯矛盾，這顯示你的閱讀理解與資訊過濾能力非常出色。這道題目要求找出「不屬於」研究限制的描述，考驗的是你對文章倒數第二段關於 「研究局限性」(Methodological Limitations) 內容的掌握度。 文章中明確提到這項研究的局限包括「缺乏盲法」(lack of blinding)、「治療方案的多樣性」(variability of treatment regimens) 以及「異質性的患者樣本」(heterogeneous patient sample)。而選項 (C) 卻描述「各組治療採盲法所導致的偏誤」，這與原文提到的缺乏盲法正好相反，因此 (C) 便是那個不符合事實的選項。此外，文末提到的「長期經濟效益仍需進一步研究」也對應了選項 (D) 的限制。 這類題目在英文檢定中具有高度的鑑別度，屬於中等難度。它不僅要求讀者找到關鍵字，更要求讀者細心辨識詞義的轉折（如「缺乏」與「具有」的差別）。你能避開文字陷阱，代表你對學術詞彙如 Blinding（盲法） 與 Heterogeneous（異質性） 的語意有正確的理解，請繼續保持這種敏銳度！