Behind the Headset: Predictive Accuracy of Patient-Reported Outcome Measures for Voice Symptoms in Call Centers

Objective: This study examines factors predicting self-reported voice symptoms in call center workers. Methods: Multivariate analysis and predictive modeling assess personal, work-related, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Receiver Operating Characteristic (ROC) curves are employed. Results: Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symptom complexity in call center professionals, necessitating comprehensive assessment. Limitations: This study recognizes its limitations, including a moderate-sized convenience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis. Value: This research provides novel insights into the interplay of personal, occupational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of individual susceptibility to voice disorders. Conclusion: Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behaviors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity.

Objetivo: Este estudio examina los factores que predicen los síntomas de voz en los trabajadores de call centers. Métodos: Se utilizan análisis multivariados y modelos predictivos para evaluar factores personales, laborales, acústicos y de comportamiento. Se emplean Modelos Lineales Generalizados (GLM) y curvas ROC. Resultados: La edad y los patrones de sueño afectaron la calidad vocal y el esfuerzo, mientras que los factores laborales influyeron en la percepción de síntomas. Los comportamientos vocales no saludables se relacionaron con voz tensa y mayor esfuerzo, mientras que la hidratación fue protectora. Los parámetros acústicos de voz mostraron potencial diagnóstico respaldado por datos de ROC. Los hallazgos subrayan complejidad de síntomas vocales en profesionales de centros de llamadas, requiriendo una evaluación integral. Limitaciones: Este estudio reconoce sus limitaciones, que incluyen una muestra de conveniencia de tamaño moderado y la dependencia de medidas PROMs. Futuras investigaciones deberían incorporar medidas objetivas, además de los autorreportes y análisis acústico. Importancia: Esta investigación aporta nuevos conocimientos sobre factores personales, laborales y síntomas de voz en trabajadores de call centers. El modelado predictivo mejora la evaluación de riesgos y la comprensión de la susceptibilidad individual a trastornos de la voz. Conclusión: Los resultados muestran asociaciones entre diversos factores y los síntomas vocales reportados. Los factores de protección incluyen dormir más de seis horas y una hidratación constante; los factores de riesgo incluyen las condiciones de trabajo, como la ubicación y comportamientos como fumar. Los modelos de diagnóstico indican una buena precisión para algunas PROMs de síntomas de la voz, lo que subraya la necesidad de modelos integrales que tengan en cuenta los factores laborales, los comportamientos vocales y los parámetros acústicos para comprender la complejidad de los problemas de la voz.

Autoavaliação de sintomas relacionados à voz em indivíduos com câncer de tireoide antes, imediatamente após e no pós-operatório tardio de tireoidectomia / Self-assessment of voice-related symptoms in individuals with thyroid cancer before, immediately after, and in the late postoperative period of thyroidectomy

RESUMO Objetivo Verificar autopercepção de sintomas vocais, de fadiga vocal e relacionados à tireoidectomia em indivíduos com câncer de tireoide, nos momentos pré-operatório, pós-operatório imediato e pós-operatório tardio, e analisar a influência do gênero. Métodos Trata-se de um estudo de intervenção antes e após com 20 indivíduos com câncer de tireoide, média de 46 anos de idade, avaliados em três momentos: pré-cirurgia (M1), imediatamente após cirurgia (M2) e no pós-operatório tardio (M3) da tireoidectomia. Os indivíduos responderam aos instrumentos Escala de Sintomas Vocais, Índice de Fadiga Vocal e Thyroidectomy-Related Voice and Symptom Questionnaire. Os dados foram analisados ​​de forma descritiva e inferencial. Resultados Na autoavaliação de sintomas vocais físicos e orofaringolaríngeos relacionados à tireoidectomia, o M3 apresentou valores estatisticamente menores que o M1 (p=0,006 e p=0,028, respectivamente) e o M2 (p<0,001 e p=0,004, respectivamente). Para os sintomas totais (p=0,001) e vocais (p=0,001) relacionados à tireoidectomia, os valores do M3 foram significativamente menores que os do M2. Na autoavaliação de sintomas vocais dos domínios total e limitação, o M1 (p<0,001; p<0,001) e o M3 (p=0,013; p=0,001) apresentaram valores significativamente menores que o M2. Indivíduos do gênero masculino apresentaram percepção de sintomas de fadiga no domínio fadiga e limitação vocal (p=0,035) e percepção de sintomas relacionados à tireoidectomia nos domínios total (p=0,044) e sintomas vocais (p=0,012) significativamente menores do que os do gênero feminino, independentemente do momento. Conclusão Sintomas vocais físicos e relacionados à tireoidectomia diminuem no pós-operatório tardio; sintomas vocais totais e limitação aumentam no pós-operatório imediato e diminuem no tardio. Mulheres têm maior percepção de fadiga e limitação vocal e de sintomas totais e vocais relacionados à tireoidectomia.

ABSTRACT Purpose To verify the self-perception of symptoms and vocal fatigue related to thyroidectomy in individuals with thyroid cancer in the pre, immediate post and late post-operative moments, and to analyze the influence of gender. Methods Intervention study before and after with 20 individuals, mean age 46 years, evaluated before surgery (M1), immediately after surgery (M2) and in the late postoperative period (M3) of thyroidectomy. Individuals answered the instruments: Voice Symptoms Scale, Vocal Fatigue Index and Thyroidectomy-Related Voice and Symptom Questionnaire. Data were analyzed descriptively and inferentially. Results In self-assessment of vocal symptoms of the total domains and limitation, M1 (p<0.001; p<0.001, respectively) and M3 (p=0.013; p=0.001, respectively) had significantly lower values than the M2. For the physical domain of self-assessment of vocal symptoms, the M3 showed statistically lower values than the M1 (p=0.006) and the M2 (p<0.001) assessments. Depending on the moment, the oropharyngolaryngeal symptoms in M3 had significantly lower values ​​than M2 (p=0.004) and M1 (p=0.028). Male scores were significantly lower than female scores in the self-assessment of fatigue symptoms in the fatigue and vocal limitation domain (p=0.035), regardless of the time of assessment. Conclusion Physical vocal symptoms and thyroidectomy-related symptoms decrease in the late postoperative period; total vocal symptoms and limitation increasing in the immediate postoperative period and decrease in the late postoperative period. Women have a higher perception of vocal fatigue and limitation, and of total and vocal symptoms related to thyroidectomy.

Productivity costs associated to voice symptoms, low sleep quality, and stress among college professors during homeworking in times of COVID-19 Pandemic / Costos de productividad asociados a síntomas de voz, baja calidad del sueño y estrés en profesores universitarios durante el trabajo en casa en tiempos de COVID-19

Objective. To estimate the productivity reduction costs associated to self-reported voice symptoms, low sleep quality, and high stress levels among college professors during homeworking in times of COVID-19 pandemic. Methods. This cross-sectional study included fifty-eight college professors who re-ported their reduction in productivity at work due to self-perceived stress levels, sleep quality, and voice symptoms. Results. High stress levels were reported by 24% of the participants, whereas 19% reported voice symptoms, and 3% low sleep quality. Costs associated with the three conditions were calculated for twenty-nine subjects. Productivity costs associated with high stress levels were higher (COP$32.345.925) than those for voice symptoms (COP$1.872.703) and low sleep quality (COP$319.733). Conclusion: Productivity reduction costs were higher for professors who reported high levels of stress followed by participants with self-reported voice symptoms and low sleep quality, which highlight the importance of prioritizing activities to reduce stress levels and voice symptoms in workplace health promotion programs imple-mented in educational settings

Objetivo. Estimar los costos de reducción de productividad asociados con los sínto-mas de voz, la baja calidad del sueño y los altos niveles de estrés entre los profesores universitarios durante el trabajo en casa en tiempos de COVID-19.Métodos. Este estudio transversal incluyó la participación de 58 docentes uni-versitarios, los cuales reportaron la reducción de la productividad en el trabajo relacionada con sus percepciones de los niveles de estrés, la calidad del sueño y los síntomas de voz.Resultados. El 24% de los participantes informó altos niveles de estrés, mientras que el 19% informó síntomas de voz y el 3% mala calidad del sueño. Los costos asociados con las tres condiciones se calcularon para 29 sujetos. Los costos de pro-ductividad asociados a altos niveles de estrés fueron mayores (COP$32.345.925) en comparación con los síntomas de voz (COP$1.872.703) y la mala calidad del sueño (COP$319.733).Conclusiones: Los costos asociados a la reducción en la productividad fueron altos en docentes que reportaron altos niveles de estrés, seguidos de los que reportaron síntomas de voz y baja calidad del sueño. Lo anterior resalta la importancia de prio-rizar actividades dirigidas a reducir los niveles de estrés y los síntomas vocales en los programas de promoción de la salud en los lugares de trabajo que se implementan en las instituciones educativas

Specific characteristics of the medical history of swallowing before and after application of botulinum toxin in patients with cervical dystonia

OBJECTIVES: To compare signs and symptoms of dysphagia in individuals with cervical dystonia (CD) before and after application of botulinum toxin (BTX). METHODS: A prospective study was conducted with 20 patients diagnosed with CD with indications for BTX application. We selected 18 patients who met the study inclusion criteria. All individuals were patients from the Movement Disorders Unit, Department of Neurology, Federal University of São Paulo. BTX was applied in the cervical region at the necessary dose for each individual. To identify signs/complaints of changes in swallowing, we used a specific questionnaire that was completed by patients and/or their companions on the day of BTX injection and repeated 10 to 15 days after BTX injection. RESULTS: Among the 18 study subjects, 15 (83.3%) showed primary and three (16.7%) showed secondary cervical dystonia. The most frequent dystonic movements were rotation (18), tilt (5), forward shift (3), backward shift (7), shoulder elevation (12), shoulder depression (2), and cervical tremor (6). The main complaints reported before BTX application were voice changes in 10 (55.6%), need for adjustment of eating position in 10 (55.6%), coughing and/or choking while eating in nine (50%), and increased eating time in nine (50%) individuals. The main complaints reported after BTX application were coughing and/or choking while eating in 11 (61.1%), voice changes in nine (50%), sensation of food stuck in the throat in eight (44%), and increased eating time in eight (44%) individuals. CONCLUSION: The administration of a swallowing-specific questionnaire to individuals with CD before and after BTX application enabled the identification of possible dysphagia symptoms prior to drug treatment resulting from CD, which are often subsequently interpreted as side effects of the drug treatment. Thus, dysphagia can be managed, and aspiration symptoms can be prevented.