Maryn Youri, De Bodt Marc, Roy Nelson
Department of Speech-Language Pathology and Audiology, Sint-Jan General Hospital, Ruddershove 10, Bruges, Belgium.
J Commun Disord. 2010 May-Jun;43(3):161-74. doi: 10.1016/j.jcomdis.2009.12.004. Epub 2009 Dec 23.
Voice practitioners require an objective index of dysphonia severity as a means to reliably track treatment outcomes. To ensure ecological validity however, such a measure should survey both sustained vowels and continuous speech. In an earlier study, a multivariate acoustic model referred to as the Acoustic Voice Quality Index (AVQI), consisting of a weighted combination of 6 time-, frequency- and quefrency-domain metrics, was developed to measure dysphonia severity in both speaking tasks. In the current investigation, the generalizability and clinical utility of the AVQI are evaluated by first assessing its external cross-validity and then determining its sensitivity to change in dysphonia severity following surgical and/or behavioral voice treatment. The results, based upon a new set of normal and disordered voices compared favorably with outcomes reported earlier, indicating acceptable external validity. Furthermore, the AVQI was sensitive to treatment-related changes, validating its role as a potentially robust and objective voice treatment outcomes measure.
Readers will be able to: (1) explain methodological issues surrounding the development of voice treatment outcomes measures (such as external cross-validity and responsiveness to change), (2) appreciate the relevance of measuring dysphonia severity in both sustained vowels and connected speech, (3) describe the method of obtaining the Acoustic Voice Quality Index (AVQI), (4) appreciate differences among a variety of estimates of diagnostic accuracy, and (5) discuss the AVQI as a clinically valid treatment outcomes measure.
嗓音治疗从业者需要一种客观的嗓音障碍严重程度指标，作为可靠跟踪治疗效果的手段。然而，为确保生态效度，这样一种测量方法应同时考察持续元音和连续语音。在一项早期研究中，开发了一种多变量声学模型，称为声学嗓音质量指数（AVQI），它由6个时域、频域和倒频域指标的加权组合构成，用于测量两种言语任务中的嗓音障碍严重程度。在当前的研究中，通过首先评估AVQI的外部交叉效度，然后确定其对手术和/或行为嗓音治疗后嗓音障碍严重程度变化的敏感性，来评估AVQI的可推广性和临床实用性。基于一组新的正常和异常嗓音得出的结果与早期报告的结果相比更有利，表明具有可接受的外部效度。此外，AVQI对与治疗相关的变化敏感，证实了其作为一种潜在强大且客观的嗓音治疗效果测量方法的作用。
读者将能够：（1）解释围绕嗓音治疗效果测量方法发展的方法学问题（如外部交叉效度和对变化的反应性），（2）认识到在持续元音和连贯语音中测量嗓音障碍严重程度的相关性，（3）描述获得声学嗓音质量指数（AVQI）的方法，（4）认识到各种诊断准确性估计之间的差异，以及（5）将AVQI作为一种临床有效的治疗效果测量方法进行讨论。
