Comments on “Comparison of Alternatives to Multidimensional Scoring in the Assessment of Language Comprehension in Aphasia” by Odekar and Hallowell (2005)

Abstract

These comments are written in response to an article by A. Odekar and B. Hallowell (2005) which argues that the use of plus-minus scoring may be faster and more efficient than "traditional multidimensional scoring" in current clinical contexts. As a long-time clinician and as the developer of binary choice multidimensional scoring as used in the Porch Index of Communicative Ability (PICA), I felt it necessary to correct some inaccuracies, to provide some clarifications and cautions, and to give the readers an alternative point of view regarding scoring issues. Four major issues are addressed. First, there is a growing trend to develop more, not fewer, multidimensional scoring systems because the older plus-minus method loses too much information about the patient. Second, although the Odekar and Hallowell article has an extensive discussion on the PICA, implying that this test battery is to be the focus of the study, the actual experiment employed the Revised Token Test and had little to do with the PICA. Third, the stated aim of the study, to demonstrate that plus-minus scoring is faster and less time consuming than multidimensional scoring, was not included in the experimental design. Finally, changes that replace established and effective clinical methods must not affect patient care negatively.