Verst-Maldaun Language Assessment (VMLA) Validation Process Database

This paper drives the process of creating VMLA, a language test meant to be used during awake craniotomies. It focuses on step by step process and aims to help other developers to build their own assessment. This project was designed as a prospective study and registered in the Ethic Committee of Educational and Research Institute of Sirio Libanês Hospital. Ethics committee approval number: HSL 2018-37 / CAEE 90603318.9.0000.5461. Images were bought by Shutterstock.com and generated the following receipts: SSTK-0CA8F-1358 and SSTK-0235F-6FC2 VMLA is a neuropsychological assessment of language function, comprising object naming (ON) and semantic. Originally composed by 420 slides, validation among Brazilian native speakers left 368 figures plus fifteen other elements, like numbers, sentences and count. Validation was focused on educational level (EL), gender and age. Volunteers were tested in fourteen different states of Brazil. Cultural differences resulted in improvements to final Answer Template. EL and age were identified as factors that influenced VLMA assessment results. Highly educated volunteers performed better for both ON and semantic. People over 50 and 35 years old had better performance for ON and semantic, respectively. Further validation in unevaluated regions of Brazil, including more balanced number of males and females and more even distribution of age and EL, could confirm our statistical analysis. After validation, ON-VMLA was framed in batteries of 100 slides each, mixing images of six different complexity categories. Semantic-VMLA kept all the original seventy verbal and non-verbal combinations. The validation process resulted in increased confidence during intraoperative test application. We are now able to score and evaluate patient´s language deficits. Currently, VLMA fits its purpose of dynamical application and accuracy during language areas mapping. It is the first test targeted to Brazilians, representing much of our culture and collective imagery. Our experience may be of value to clinicians and researchers working with awake craniotomy who seek to develop their own language test. The test is available for free use at www.vemotests.com (beginning in February, 2021)