Interne Validität des Acoustic Voice Quality Index Version 03.01 und des Acoustic Breathiness Index

Zusammenfassung

Hintergrund Akustische Messverfahren haben das Potential Heiserkeit und Behauchtheit objektiv zu messen und der Acoustic Voice Quality Index (AVQI) und der Acoustic Breathiness Index (ABI) zeigen gute Ergebnisse hinsichtlich Validität und Reliabilität. Das Ziel dieser Studie war die Überprüfung der internen Validität der aktuellen Version des AVQI 03.01 und des ABI im Deutschen. Hierzu wurde die Sensitivität gegenüber Stimmveränderungen im Heiserkeits- und Behauchtheitsgrad durch logopädische Stimmtherapie untersucht.

Material und Methoden Insgesamt wurden 84 Stimmaufzeichnungen von fortlaufender Sprache und dem Vokal [a:] vor und nach einer Stimmtherapie verwendet. Alle Aufnahmen der 42 Probanden stammten von Stimmpatienten mit unterschiedlichen Schweregraden einer Dysphonie vor und nach einer konservativen Therapie. Alle Stimmen wurden von drei Stimmexperten nach dem RBH-System beurteilt.

Ergebnisse Die Intra- Beurteiler Reliabilität ergab insgesamt eine hohe Reliabilität für Heiserkeit (Kappa Mittelwert = 0,76) und Behauchtheit (Kappa Mittelwert = 0,69). Die Inter- Beurteiler Reliabilität erreichte hingegen eine niedrigere Reliabilität für beide Stimmqualitätsaspekte, die zwischen Kappa = 0,27 und 0,29 lag. Für beide Messverfahren, AVQI und ABI, zeigte sich ein deutlicher Zusammenhang zwischen der Perzeption von Veränderungen der Stimmqualität vor und nach der Therapie und dem Messergebnis (Heiserkeit vs. AVQI: r = 0,715, p < 0,01 und Behauchtheit vs. ABI: r = 0,712, p < 0,01). Die Unterschiede waren auch nicht signifikant.

Schlussfolgerung Die Resultate zeigten, dass AVQI Version 03.01 und ABI eine hohe interne Validität haben, um Stimmveränderungen nach Intervention zu erfassen. AVQI und ABI sind zwei valide und robuste Messinstrumente, die Heiserkeit und Behauchtheit objektiv messen können.

Abstract

Objective Acoustics might have the potential to objectify voice quality (eg, hoarseness and breathiness). The Acoustic Voice Quality Index (AVQI) and the Acoustic Breathiness Index (ABI) revealed sufficient valid and reliable results in the evaluation of voice quality. The aim of the present study is to validate the recent version of AVQI 03.01 and ABI in their internal validation. The responsiveness of change is evaluated on the hoarseness and breathiness severity after voice therapy.

Materials and Methods In total, 84 voice samples of continuous speech and sustained vowel [a:] before and after a voice therapy were used. All 42 subjects presented organic and nonorganic voice disorders and various degrees of dysphonia severity before and after behavioral voice therapy. The voice samples were judged by three voice experts using the RBH-scale, which is based on the GRBAS-scale.

Results The intra-rater reliability was high for hoarseness (mean kappa = 0.76) and breathiness (mean kappa = 0.69).The inter-rater reliability was lower for both voice quality characteristics and ranged between kappa = 0.27 to 0.29. A strong correlation was identified between the perceived rating of hoarseness and breathiness and AVQI and ABI before and after voice therapy (r = 0.715, p < 0.01, and r = 0.712, p < 0.01, respectively). Additionally, no significant differences were revealed.

Conclusion The present results showed that AVQI version 03.01 und ABI had a high internal validity to assess voice changes after voice therapy. AVQI and ABI are two valid and robust voice measures to objectify hoarseness and breathiness.

Schlüsselwörter

auditiv-perzeptive Beurteilung - Stimmqualität - Stimmdiagnostik - Acoustic Voice Quality Index - Acoustic Breathiness Index

Key words

auditory-perceptual judgment - voice quality - voice diagnostic - Acoustic Voice Quality Index - Acoustic Breathiness Index

• Literatur

• 1 Barsties B, De Bodt M. Assessment of voice quality: current state-of-the-art. Auris Nasus Larynx 2015; 42: 183-188
• 2 Nawka T, Anders LC, Wendler J. Die auditive Beurteilung heiserer Stimmen nach dem RBH-System. Sprache-Stimme-Gehör 1994; 18: 130-133
• 3 Kempster GB, Gerratt BR, Verdolini Abbott K. et al. Consensus auditoryperceptual evaluation of voice: development of a standardized clinical protocol. Am J Speech Lang Pathol 2009; 18: 124-132
• 4 Oates J. Auditory-perceptual evaluation of disordered voice quality: pros, cons and future directions. Folia Phoniatr Logop 2009; 61: 49-56
• 5 Barsties B, Maryn Y. The influence of voice sample length in the auditory-perceptual judgment of overall voice quality. J Voice 2016; 31: 202-210
• 6 Maryn Y, Corthals P, Van Cauwenberge P. et al. Toward improved ecological validity in the acoustic measurement of overall voice quality: combining continuous speech and sustained vowels. J Voice 2010; 24: 540-555
• 7 Maryn Y, Roy N. Sustained vowels and continuous speech in the auditory-perceptual evaluation of dysphonia severity. J Soc Bras Fonoaudiol 2012; 24: 107-112
• 8 Boersma P, Weenink D. [computer program]. Amsterdam: Praat: Doing phonetics by computer, Version 5.3.57. Available from: http://www.praat.org
• 9 Maryn Y, De Bodt M, Roy N. The Acoustic Voice Quality Index: toward improved treatment outcomes assessment in voice disorders. J Commun Disord 2010; 43: 161-174 30
• 10 Barsties B, Maryn Y. Der Acoustic Voice Quality Index in Deutsch: Ein Messverfahren zur allgemeinen Stimmqualität. HNO 2012; 60: 715-720
• 11 Reynolds V, Buckland A, Bailey J. et al. Objective assessment of pediatric voice disorders with the acoustic voice quality index. J Voice 2012; 26: 672.e1-7
• 12 Maryn Y, De Bodt M, Barsties B. et al. The value of the Acoustic Voice Quality Index as a measure of dysphonia severity in subjects speaking different languages. Eur Arch Otorhinolaryngol 2014; 271: 1609-1619
• 13 Maryn Y, Kim HT, Kim J. Auditory-perceptual and acoustic methods in measuring dysphonia severity of Korean speech. J Voice 2016; 30: 587-594
• 14 Hosokawa K, Barsties B, Iwahashi T. et al. Validation of the Acoustic Voice Quality Index in the Japanese Language. J Voice 2017; 31: 260.e1-260.e9
• 15 Uloza V, Petrauskas T, Padervinskis E. et al. Validation of the Acoustic Voice Quality Index in the Lithuanian Language. J Voice 2017; 31: 257.e1-257.e11
• 16 Kankare E, Barsties v. Latoszek B, Maryn Y. et al. The Acoustic Voice Quality Index Version 02.02 in Finnish Speaking Population. In submission.
• 17 Barsties B, Maryn Y. The improvement of internal consistency of the Acoustic Voice Quality Index Am. J Otolaryngol 2015; 36: 647-656
• 18 Barsties B, Maryn Y. External validation of the Acoustic Voice Quality Index version 03.01 with extended representativity. Ann Otol Rhinol Laryngol 2016; 125: 571-83
• 19 Hosokawa K, Barsties v. Latoszek B, Iwahashi T. et al. The Acoustic Voice Quality Index Version 03.01 for the Japanese-speaking Population J Voice, In Press.
• 20 Delgado J, León NM, Jiménez A. et al. Validation of the Acoustic Voice Quality Index version 03.01 and the Acoustic Breathiness Index in the Spanish language. Ann Otol Rhinol Laryngol. In Press
• 21 Barsties v. Latoszek B, Lehnert B, Janotte B. Validation of the Acoustic Voice Quality Index v03.01 and Acoustic Breathiness Index in German. In submission.
• 22 Maryn Y, Weenink D. Objective dysphonia measures in the program Praat: smoothed cepstral peak prominence and acoustic voice quality index. J Voice 2015; 29: 35-43
• 23 Barsties B, Maryn Y. Test-Retest-Variabilität und interne Konsistenz des Acoustic Voice Quality Index. HNO 2013; 61: 399-403
• 24 Barsties v. Latoszek B, Ulozaitė-Stanienė N, Petrauskas T. et al. The influence of gender and age on the Acoustic Voice Quality Index and Dysphonia Severity Index: A normative study J Voice, In Press.
• 25 Barsties v. Latoszek B, Maryn Y, Gerrit E. et al. The Acoustic Breathiness Index (ABI): A Multivariate Acoustic Model for Breathiness. J Voice 2017; 31: 511e11-511e27
• 26 Barsties v. Latoszek B, Maryn Y, Gerrit E. et al. A meta-analysis: acoustic measurement of roughness and breathiness JSLHR, In Press.
• 27 Barsties v. Latoszek B, De Bodt M, Gerrit E. et al. The exploration of an objective model for roughness with several acoustic markers Journal of Voice, In Press.
• 28 Roy N. Assessment and treatment of musculoskeletal tension in hyperfunctional voice disorders. Int J Speech Lang Pathol 2008; 10: 195-209
• 29 Andrade PA, Wood G, Ratcliffe P. et al. Electroglottographic study of seven semi-occluded exercises: Lax Vox, straw, lip-trill, tongue-trill, humming, hand-over-mouth, and tongue-trill combined with hand-over-mouth. J Voice 2014; 28: 589-95
• 30 Guzman M, Calvache C, Romero L. et al. Do Different Semi-Occluded Voice Exercises Affect Vocal Fold Adduction Differently in Subjects Diagnosed with Hyperfunctional Dysphonia?. Folia Phoniatr Logop 2015; 67: 68-75
• 31 Maryn Y, De Bodt M, Van Cauwenberge P. Effects of biofeedback in phonatory disorders and phonatory performance: a systematic literature review. Appl Psychophysiol Biofeedback 2006; 31: 65-83
• 32 Barsties v. Latoszek B. Preliminary study of Novafon local vibration voice therapy for dysphonia treatment. Logoped Phoniatr Vocol. In Press
• 33 Deliyski DD, Shaw HS, Evans MK. Adverse effects of environmental noise on acoustic voice quality measurements. J Voice 2005; 19: 15-28
• 34 Deliyski DD, Shaw HS, Evans MK. et al. Regression tree approach to studying factors influencing acoustic voice analysis. Folia Phoniatr Logop 2006; 58: 274-88
• 35 Kreiman J, Gerratt BR, Kempster GB. et al. Perceptual evaluation of voice quality: review, tutorial, and a framework for future research. J Speech Hear Res 1993; 36: 21-40
• 36 Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-174
• 37 Portney LG, Watkins MP. Foundations of Clinical Research: Applications to Practice (3rd Edition). Prentice Hall; 2008
• 38 Frey LR, Botan CH, Friedman PGKG. Investigating Communication: An Introduction to Research Methods. Englewood Cliffs, NJ: Prentice-Hall; 1991