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ABSTRACT Purpose To assess the influence of the listener experience, measurement scales and the type of speech task on the auditory-perceptual evaluation of the overall severity (OS) of voice deviation and the predominant type of voice (rough, breathy or strain). Methods 22 listeners, divided into four groups participated in the study: speech-language pathologist specialized in voice (SLP-V), SLP non specialized in voice (SLP-NV), graduate students with auditory-perceptual analysis training (GS-T), and graduate students without auditory-perceptual analysis training (GS-U). The subjects rated the OS of voice deviation and the predominant type of voice of 44 voices by visual analog scale (VAS) and the numerical scale (score "G" from GRBAS), corresponding to six speech tasks such as sustained vowel /a/ and /ɛ/, sentences, number counting, running speech, and all five previous tasks together. Results Sentences obtained the best interrater reliability in each group, using both VAS and GRBAS. SLP-NV group demonstrated the best interrater reliability in OS judgment in different speech tasks using VAS or GRBAS. Sustained vowel (/a/ and /ɛ/) and running speech obtained the best interrater reliability among the groups of listeners in judging the predominant vocal quality. GS-T group got the best result of interrater reliability in judging the predominant vocal quality. Conclusion The time of experience in the auditory-perceptual judgment of the voice, the type of training to which they were submitted, and the type of speech task influence the reliability of the auditory-perceptual evaluation of vocal quality.
RESUMO
RESUMO Objetivo Investigar a acurácia das medidas acústicas, isoladas e combinadas, na discriminação da intensidade do desvio vocal (GG) e da qualidade vocal predominante (QVP) em pacientes disfônicos. Método Participaram 302 pacientes do gênero feminino, com queixa vocal. A partir da vogal /ɛ/ sustentada, foram extraídas as medidas acústicas de média e desvio padrão (DP) da frequência fundamental (F0), o jitter, o shimmer e o Glottal to noise excitation (GNE) e a média dos três primeiros formantes (F1, F2, F3). A avaliação perceptivo-auditiva do GG e QVP foi realizada por três fonoaudiólogos especialistas em voz. Resultados Isoladamente, apenas o GNE obteve desempenho satisfatório na discriminação do GG e da QVP. Houve uma melhora na classificação do GG e QVP com a combinação das medidas acústicas. A média de F0, F2 e GNE (saudável × desvio leve a moderado), DP de F0, F1 e F3 (leve a moderado × desvio moderado), Jitter e GNE (moderado × desvio intenso) foram as melhores combinações para discriminar o GG. As melhores combinações para discriminação da QVP foram média de F0, Shimmer e GNE (saudável × rugosa), F3 e GNE (saudável × soprosa), média de F0, F3 e GNE (rugosa × tensa), média de F0, F1 e GNE (soprosa × tensa). Conclusão De forma isolada, o GNE mostrou-se o único parâmetro acústico capaz de discriminar o GG e a QVP. Houve um ganho no desempenho da classificação com a combinação das medidas acústicas tradicionais e formânticas, tanto para a discriminação do GG como da QVP.
ABSTRACT Purpose Investigate the accuracy of isolated and combined acoustic measurements in the discrimination of voice deviation intensity (GD) and predominant voice quality (PVQ) in patients with dysphonia. Methods A total of 302 female patients with voice complaints participated in the study. The sustained /ɛ/ vowel was used to extract the following acoustic measures: mean and standard deviation (SD) of fundamental frequency (F0), jitter, shimmer, glottal to noise excitation (GNE) ratio and the mean of the first three formants (F1, F2, and F3). Auditory-perceptual evaluation of GD and PVQ was conducted by three speech-language pathologists who were voice specialists. Results In isolation, only GNE provided satisfactory performance when discriminating between GD and PVQ. Improvement in the classification of GD and PVQ was observed when the acoustic measures were combined. Mean F0, F2, and GNE (healthy × mild-to-moderate deviation), the SDs of F0, F1, and F3 (mild-to-moderate × moderate deviation), and mean jitter and GNE (moderate × intense deviation) were the best combinations for discriminating GD. The best combinations for discriminating PVQ were mean F0, shimmer, and GNE (healthy × rough), F3 and GNE (healthy × breathy), mean F 0, F3, and GNE (rough × tense), and mean F0 , F1, and GNE (breathy × tense). Conclusion In isolation, GNE proved to be the only acoustic parameter capable of discriminating between GG and PVQ. There was a gain in classification performance for discrimination of both GD and PVQ when traditional and formant acoustic measurements were combined.