Behlau Mara, Madazio Glaucya, Moreti Felipe, Oliveira Gisele, Dos Santos Luciana de Moraes Alves, Paulinelli Bruna Rabelo, Couto Junior Euro de Barros
Centro de Estudos da Voz-CEV, São Paulo, São Paulo, Brazil; Department of Speech-Language Pathology and Audiology, Universidade Federal de São Paulo-UNIFESP, São Paulo, São Paulo, Brazil.
Centro de Estudos da Voz-CEV, São Paulo, São Paulo, Brazil.
J Voice. 2016 Jul;30(4):506.e9-506.e18. doi: 10.1016/j.jvoice.2015.05.022. Epub 2015 Jul 11.
To evaluate the efficiency of four self-assessment questionnaires that rate the impact of a voice problem on the individual's life: Voice-Related Quality of Life (V-RQOL), the original and reduced versions of the Voice Handicap Index (VHI) and VHI-10, Vocal Performance Questionnaire (VPQ), and Voice Symptom Scale (VoiSS).
Data from 975 subjects, 486 with a diagnosis of dysphonia and 489 vocally healthy individuals, were submitted to the receiver operating characteristic (ROC) curve analysis to obtain the cutoff values that determine the discriminating power of these instruments (presence of dysphonia vs healthy voice).
The ROC curve analysis showed that the most efficient questionnaires were the VoiSS and the VHI. Results showed that they presented as a perfect classification based on their efficiency, specificity, and sensitivity values (all three of them = 1). The VHI-10 and the V-RQOL showed excellent classification (VHI-10: efficiency = 0.991; specificity = 1; sensitivity = 0.981; V-RQOL: efficiency = 0.914; specificity = 0.860; sensitivity = 0.967). Finally, the VPQ showed a good level of classification (efficiency = 0.828; specificity = 0.824; sensitivity = 0.831). The cutoff values for the instruments are as follows: VoiSS = 16 points, VHI = 19 points, VHI-10 = 7.5 points, V-RQOL = 91.25, and VPQ = 20.5 points. These values are important for screening large populations as well as for helping in the decision-making process of clinical management. The cutoff values for maximum sensitivity and specificity of the instruments that did not produce perfect classification are as follows: VHI-10: sensitivity = 5; specificity = 7.5, V-RQOL: sensitivity = 86.25; specificity = 98.75, and VPQ: sensitivity = 15.5; specificity = 31.5.
Both the VoiSS and the VHI are perfect classifiers. The VHI-10 and the V-RQOL are excellent classifiers, and the VPQ is good at discriminating individuals with dysphonia from the ones without dysphonia.
评估四种自我评估问卷对嗓音问题对个体生活影响的评分效率，这四种问卷分别是：嗓音相关生活质量问卷（V-RQOL）、嗓音障碍指数（VHI）的原始版本和简化版本以及VHI-10、嗓音表现问卷（VPQ）和嗓音症状量表（VoiSS）。
对975名受试者的数据进行分析，其中486名被诊断为发声障碍，489名嗓音健康个体，将这些数据进行受试者工作特征（ROC）曲线分析，以获得确定这些工具区分能力的临界值（发声障碍与健康嗓音）。
ROC曲线分析表明，效率最高的问卷是VoiSS和VHI。结果显示，基于其效率、特异性和敏感性值，它们呈现出完美的分类（三者均为1）。VHI-10和V-RQOL显示出优秀的分类（VHI-10：效率=0.991；特异性=1；敏感性=0.981；V-RQOL：效率=0.914；特异性=0.860；敏感性=0.967）。最后，VPQ显示出良好的分类水平（效率=0.828；特异性=0.824；敏感性=0.831）。这些工具的临界值如下：VoiSS = 16分，VHI = 19分，VHI-10 = 7.5分，V-RQOL = 91.25分，VPQ = 20.5分。这些值对于筛查大量人群以及帮助临床管理决策过程很重要。未产生完美分类的工具的最大敏感性和特异性的临界值如下：VHI-10：敏感性=5；特异性=7.5，V-RQOL：敏感性=86.25；特异性=98.75，VPQ：敏感性=15.5；特异性=31.5。
VoiSS和VHI都是完美的分类工具。VHI-10和V-RQOL是优秀的分类工具，VPQ善于区分发声障碍个体和无发声障碍个体。
