Stroke is a leading cause of long-term disability in the United States and determining the diagnosis and treatment best suited to a patient often relies on subtle clinical judgments. Reviews of assessment practices indicate that clinicians often base evaluation and treatment recommendations for stroke survivors on non-standard speech samples and cursory subjective impressions. Approximately one million Americans have acquired a speech or language disorder as a result of stroke, providing the opportunity for using speech patterns from stroke to develop an objective, easy-to-use measurement tool for clinicians. The researchers have developed a prototype software system that has identified objective speech measures that are sensitive to variations in stroke. Quantitative perceptual and acoustic measures have been identified that are relevant to both differential diagnosis and severity estimation. This proposal will combine this research with the power of Internet delivery to create a product called ClinicalMeasures. ClinicalMeasures will support analyses that can be conducted locally or remotely in time and space, allowing secure transmission of audio and video samples to external sites for quantification by trained personnel or review by expert clinicians. While a patient's clinician will have the tools to perform the assessment at his or her clinic, the company will also provide expert assessment analysis upon request. Using simple menu activation choices, a clinician can capture patient data for analysis or transmission via secure Internet services to the company server for remote analysis by experts, with the final assessment returned to the clinician for patient evaluation. Equipped with this tool, clinicians will be able to obtain objective and unbiased measures for use in differential diagnosis, severity estimation, and treatment planning. Considerable impact is expected on routine stroke rehabilitation, tele-rehabilitation, and clinical research. The researchers will conduct clinical investigations to establish efficiency and validity of central target measures. Due to the efficiency of the envisioned product, its affordability, and the present inaccessibility of objective clinical measures, substantial impact is expected on both clinical practice and clinical research worldwide. PUBLIC HEALTH RELEVANCE: This proposal is relevant to the public health by providing an easy-to-use and widely available tool for clinicians to obtain objective and unbiased assessments of stoke survivors.