Cantor Cutiva Lady Catherine, Fajardo Adriana, Burdorf Alex
a Department of Public Health, Erasmus MC , University Medical Center , Rotterdam , the Netherlands and.
b Programa de Fonoaudiología , Universidad del Rosario , Bogotá D.C. , Colombia.
Int J Speech Lang Pathol. 2016 Dec;18(6):550-559. doi: 10.3109/17549507.2016.1143969. Epub 2016 Mar 24.
The three aims of this study were to assess agreement between self-perceived voice disorders, perceptual and instrumental assessment; to determine factors associated with perceptual voice assessment; and to determine which associated factors would serve as an initial screening tool for ascertainment of the presence or absence of voice disorders among teachers.
A cross-sectional study was conducted among 574 Colombian teachers. Participants filled in a questionnaire and recorded a voice sample. The voice samples were perceptually evaluated by a speech-language pathologist with the Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale and objectively with an automated voice analysis for fundamental frequency, jitter, shimmer and maximum phonation time. Agreements between GRBAS scale, self-reported voice disorders and instrumental analysis were determined by unweighted Coheńs Kappa coefficients and receiver operating characteristic curves. Multivariate logistic regression analysis was used to identify variables associated with the perceptual assessment. Diagnostic performance of these variables was assessed by the area under the curve.
There was no agreement between self-reported voice disorders and GRBAS assessments. Maximum phonation time showed a slight agreement with perceptual assessment of voice disorders.
Since these three methods offer different information, it is advisable to include all methods in ascertainment of voice disorders among teachers at work.
本研究的三个目的是评估自我感知的嗓音障碍、感知评估和仪器评估之间的一致性；确定与嗓音感知评估相关的因素；并确定哪些相关因素可作为初步筛查工具，用于确定教师中嗓音障碍的存在与否。
对574名哥伦比亚教师进行了一项横断面研究。参与者填写了一份问卷并录制了嗓音样本。言语病理学家使用等级、粗糙度、气息声、无力和紧张（GRBAS）量表对嗓音样本进行感知评估，并通过对基频、抖动、闪烁和最大发声时间的自动嗓音分析进行客观评估。通过未加权的科恩卡方系数和受试者工作特征曲线确定GRBAS量表、自我报告的嗓音障碍和仪器分析之间的一致性。使用多变量逻辑回归分析来识别与感知评估相关的变量。通过曲线下面积评估这些变量的诊断性能。
自我报告的嗓音障碍与GRBAS评估之间不存在一致性。最大发声时间与嗓音障碍的感知评估略有一致性。
由于这三种方法提供了不同的信息，因此在确定在职教师的嗓音障碍时，建议采用所有方法。
