Uloza Virgilijus, Latoszek Ben Barsties V, Ulozaite-Staniene Nora, Petrauskas Tadas, Maryn Youri
Department of Otolaryngology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Eur Arch Otorhinolaryngol. 2018 Apr;275(4):949-958. doi: 10.1007/s00405-018-4903-x. Epub 2018 Feb 13.
The aim of the study was to investigate and compare the feasibility and robustness of the Acoustic Voice Quality Index (AVQI) and the Dysphonia Severity Index (DSI) in diagnostic accuracy, differentiating normal and dysphonic voices.
A group of 264 subjects with normal voices (n = 105) and with various voice disorders (n = 159) were asked to read aloud a text and to sustain the vowel /a/. Both speech tasks were concatenated, and perceptually rated for dysphonia severity by five voice clinicians. They rated the Grade (G) and the overall dysphonia severity with a visual analog scale (VAS). All concatenated voice samples were acoustically analyzed to receive an AVQI score. For DSI analysis, the required voice parameters were obtained from the sustained phonation of the vowel /a/.
The results achieved significant and marked concurrent validity between both auditory-perceptual judgment procedures and both acoustic voice measures. The DSI threshold (i.e., DSI = 3.30) pertaining to G obtained reasonable sensitivity of 85.8% and specificity of 83.4%. For VAS, the DSI threshold of 3.30 was determined also with reasonable sensitivity of 70.3% and excellent specificity of 93.9%. Also, the AVQI threshold (i.e., AVQI = 3.31) pertaining to G demonstrated reasonable sensitivity of 78.1% and excellent specificity of 92.0%. For VAS, an AVQI threshold of 3.33 was determined with excellent sensitivity of 97.0% and reasonable specificity of 81.8%.
The outcomes of the present study indicate comparable results between DSI and AVQI with a high level of validity to discriminate between normal and dysphonic voices. However, a higher level of accuracy was yielded for AVQI as a correlate of auditory perceptual judgment suggesting a reliable voice screening potential of AVQI.
本研究旨在调查和比较声学嗓音质量指数（AVQI）和嗓音障碍严重程度指数（DSI）在诊断准确性方面区分正常嗓音和嗓音障碍的可行性及稳健性。
一组264名受试者，其中嗓音正常者（n = 105）和患有各种嗓音疾病者（n = 159），被要求大声朗读一段文本并持续发元音/a/。两项语音任务被拼接在一起，由五名嗓音临床医生对嗓音障碍严重程度进行感知评分。他们用视觉模拟量表（VAS）对等级（G）和整体嗓音障碍严重程度进行评分。对所有拼接的嗓音样本进行声学分析以获得AVQI分数。对于DSI分析，从元音/a/的持续发声中获取所需的嗓音参数。
两项听觉感知判断程序与两项声学嗓音测量结果之间均取得了显著且明显的同时效度。与等级G相关的DSI阈值（即DSI = 3.30）获得了合理的85.8%的敏感性和83.4%的特异性。对于VAS，DSI阈值3.30的敏感性为70.3%，特异性极佳，为93.9%。此外，与等级G相关的AVQI阈值（即AVQI = 3.31）显示出合理的78.1%的敏感性和92.0%的极佳特异性。对于VAS，确定AVQI阈值为3.33时，敏感性极佳，为97.0%，特异性合理，为81.8%。
本研究结果表明，DSI和AVQI之间的结果具有可比性，在区分正常嗓音和嗓音障碍方面具有较高的效度。然而，作为听觉感知判断的一个关联指标，AVQI产生了更高的准确性水平，表明AVQI具有可靠的嗓音筛查潜力。
