Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-17T17:30:04.024Z Has data issue: false hasContentIssue false

Measuring voice outcomes: state of the science review

Published online by Cambridge University Press:  08 March 2017

P N Carding*
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, England
J A Wilson
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Freeman Hospital, Newcastle upon Tyne, England
K MacKenzie
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Royal Infirmary, Glasgow, UK
I J Deary
Affiliation:
Medical Research Council Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Scotland, UK
*
Address for correspondence: Prof Paul Carding, Professor of Speech/Voice Pathology, Dept of Speech, Voice and Swallowing, Otolaryngology, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK. E-mail: paul.carding@nuth.nhs.uk

Abstract

Researchers evaluating voice disorder interventions currently have a plethora of voice outcome measurement tools from which to choose. Faced with such a wide choice, it would be beneficial to establish a clear rationale to guide selection. This article reviews the published literature on the three main areas of voice outcome assessment: (1) perceptual rating of voice quality, (2) acoustic measurement of the speech signal and (3) patient self-reporting of voice problems. We analysed the published reliability, validity, sensitivity to change and utility of the common outcome measurement tools in each area. From the data, we suggest that routine voice outcome measurement should include (1) an expert rating of voice quality (using the Grade-Roughness-Breathiness-Asthenia-Strain rating scale) and (2) a short self-reporting tool (either the Vocal Performance Questionnaire or the Vocal Handicap Index 10). These measures have high validity, the best reported reliability to date, good sensitivity to change data and excellent utility ratings. However, their application and administration require attention to detail. Acoustic measurement has arguable validity and poor reliability data at the present time. Other areas of voice outcome measurement (e.g. stroboscopy and aerodynamic phonatory measurements) require similarly detailed research and analysis.

Type
Review Articles
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Carding, PN. Evaluating Voice Therapy: Evaluating the Effectiveness of Treatment. London: Whurr, 2000Google Scholar
2 Anthony, DM. Understanding Advanced Statistics; a Guide for Nurses and Healthcare Researchers. London: Churchill Livingstone, 1999Google Scholar
3 Armitage, P, Berry, G. Statistical Methods in Medical Research. Oxford: Blackwell Scientific Publications, 1994Google Scholar
4 Cronbach, L. Essentials of Psychological Testing. London: Harper & Row, 1970Google Scholar
5 Schuavetti, N, Metz, D. Evaluating Research in Communicative Disorders. Boston: Allyn and Bacon, 1997Google Scholar
6 Fayers, P, Machin, D. Quality of Life Assessment, Analysis and Interpretation. Chichester: John Wiley & Sons, 2000CrossRefGoogle Scholar
7 Carding, PN, Carlson, E, Epstein, R, Mathieson, I, Shewell, C. Formal perceptual evaluation of voice quality in the United Kingdom. Log Phon Vocol 2000;25:133–8CrossRefGoogle ScholarPubMed
8 Wilson, D. Voice Problems of Children, 3rd edn. Baltimore: Williams and Wilkins, 1987Google Scholar
9 Laver, J. The Phonetic Description of Voice Quality. Cambridge: Cambridge University Press, 1980Google Scholar
10 Hirano, M. Clinical Examination of Voice. New York: Springer-Verlag, 1981Google Scholar
11 Consensus of Auditory Perceptual Evaluation Voice 2001. In: http://www.asha.org [07 02 2002]Google Scholar
12 Dejonckere, PH, Obbens, C, Leeper, HA, Hawkins, S, Heeneman, H, Doyle, PC. Perceptual evaluation of dysphonia: reliability and relevance. Folia Phoniat Logop 1993;45:7683CrossRefGoogle ScholarPubMed
13 De Bodt, M, Wuyts, FL, Van de Heyning, PH, Croux, C. Test-retest of the GRBAS Scale: influence of experience and professional background on perceptual ratings of voice quality. J Voice 1997;11:7480CrossRefGoogle ScholarPubMed
14 Wuyts, FL, De Bodt, MS, Van de Heyning, PH. Is the reliability of a visual analog scale higher than an ordinal scale? An experiment with the GRBAS Scale for the perceptual evaluation of dysphonia. J Voice 1999;13:508–17CrossRefGoogle ScholarPubMed
15 Webb, A, Carding, P, Deary, IJ, MacKenzie, K, Steen, IN, Wilson, JA. A study of the reliability of three auditory perceptual scales for dysphonia. Eur Arch Otorhinolaryngol 2004;261:429–34CrossRefGoogle ScholarPubMed
16 Webb, AL, Carding, PN, Deary, IJ, MacKenzie, K, Steen, IN, Wilson, JA. Optimising outcome assessment of voice interventions, I: reliability and validity of three self-reported scales. J Laryng Otol 2007;121:763–7CrossRefGoogle ScholarPubMed
17 Steen, IN, Webb, Al, Deary, IJ, MacKenzie, K, Carding, PN, Wilson, JA. Optimising outcome assessment of voice interventions II: the sensitivity to change of self-report and observer rated measures. J Laryng Otol 2008;122:4551CrossRefGoogle Scholar
18 Gonzalez, J, Cervera, T, Miralles, JL. Acoustic voice analysis; reliability of a set of multidimensional parameters [in Spanish]. Acto Otorhino Espan 2002;53:256–68Google ScholarPubMed
19 Bough, D, Heur, RJ, Sataloff, RT, Hills, JR, Carter, JR. Intra-subject variability of objective voice measures. J Voice 1996;10:166–74CrossRefGoogle Scholar
20 Rabinov, RC, Kreiman, J, Gerrart, BR, Bielamonwicz, S. Comparing reliability of perceptual ratings of roughness and acoustic measures of jitter. J Speech Hear Res 1995;38:2632CrossRefGoogle ScholarPubMed
21 Carding, PN, Steen, IN, Webb, A, MacKenzie, K, Deary, IJ, Wilson, JA. The reliability and sensitivity to change of acoustic measures of voice quality. Clin Otol 2004;29:538–44CrossRefGoogle Scholar
22 Titze, I. Workshop on Acoustic Voice Analysis: summary statement. Iowa, Iowa: The University of Iowa, 1995Google Scholar
23 Kania, RE, Hartl, DM, Hans, S, Maeda, S, Vaissiere, J, Brasnu, DF. Fundamental frequency histograms measured by electroglottography during speech: a pilot study for standardization. J Voice 2006;20:1824CrossRefGoogle ScholarPubMed
24 Jacobson, BH, Johnson, A, Grywalski, C. The Voice Handicap Inventory (VHI): development and validation. Am J Speech Lang Path 1997;6:6670CrossRefGoogle Scholar
25 Carding, PN, Horsley, IA. An evaluation study of voice therapy in non-organic dysphonia. Eur J Disord Commun 1992;27:137–58CrossRefGoogle ScholarPubMed
26 Deary, IJ, Wilson, JA, Carding, PN, MacKenzie, K. VoiSS: a patient derived voice symptom scale. J Psychosom Res 2003;54:483–9CrossRefGoogle ScholarPubMed
27 Jones, SM, Carding, PN, Drinnan, MJ. Exploring the relationship between severity of dysphonia and voice-related quality of life. Clinical Otolaryngology;31:411–17CrossRefGoogle Scholar
28 Wilson, JA, Webb, AL, Carding, PN, Steen, N, MacKenzie, K, Deary, IJ. Comparing the Voice Symptom Scale (VoiSS) and the Voice Handicap Index: structure and content. Otol Clin 2004;29:169–74CrossRefGoogle ScholarPubMed
29 Rosen, CA, Lees, AS, Osborne, J, Zullo, T, Murray, T. Development and validation of the Voice Handicap Index-10. Laryngoscope 2004;9:1549–6CrossRefGoogle Scholar
30 Deary, IJ, Webb, A, MacKenzie, K, Wilson, JA, Carding, PN. Short, self-report voice symptom scales: psychometric characteristics of the Voice Handicap Index-10 and the Vocal Performance Questionnaire. Head Neck Surg 2004;131:232–5CrossRefGoogle ScholarPubMed
31 Olswang, L. Treatment Efficacy Research; Measuring Outcomes in Speech Language Pathology. New York: Thieme, 1998Google Scholar
32 Lee, M, Drinnan, M, Carding, PN. The reliability and validity of patient self-rating of their own voice quality. Clin Otol 2005;30:357–61CrossRefGoogle ScholarPubMed
33 Brockmann, M, Storck, C, Carding, PN, Drinnan, MJ. Voice loudness and gender effects on jitter and shimmer in healthy adults. J Speech Hear Res 2008;51:1152–60CrossRefGoogle ScholarPubMed