Human Communication Disorders, Universidade Federal de São Paulo UNIFESP, São Paulo, Brazil,
Centro de Estudos da Voz CEV, São Paulo, Brazil,
Folia Phoniatr Logop. 2020;72(5):402-410. doi: 10.1159/000502772. Epub 2019 Oct 1.
To propose a single qualifier scale for voice problems based on the International Classification of Functioning, Disability, and Health (ICF) that classifies a voice problem considering its multidimensionality.
A multicultural database was analyzed (280 subjects). The analyzed information was: the perceptual judgment of the overall voice quality (G); the acoustic analysis (A) with the Acoustic Voice Quality Index; the laryngeal diagnosis (L) and the patient self-assessment (P) using the Voice Handicap Index. The variables were categorized. A 2-step cluster analysis was performed to define groups with common characteristics.
A 7-point qualifier scale, the GALP, was defined to generally classify levels of voice problems considering 4 dimensions of the voice evaluation. Each level of voice problem, that is, no problem, mild, moderate, severe, or complete voice problem, has its own possible outcome for G, A, L, and P that will change, or not, the overall level of voice problem. The extremes of the scale represent "no problem" at all when all parameters are normal, and "complete problem" when all parameters are altered. The 3 levels in between were defined by the cluster analysis (mild, moderate, and severe problem) and change according to the outcome of each evaluation (G, A, L, and P). Thus, changes in one parameter alone may or not contribute to the change of the level of voice problem. Also, there are 2 categories for cases that do not fit the classification (not specified) and for which some of the variables are missing (not applicable).
The GALP scale was proposed to classify the level of voice problem. This approach considers important dimensions of voice evaluation according to the ICF. It is a potential tool to be used by different professionals, with different assessment procedures, and among different populations, clinicians, and study centers.
根据国际功能、残疾和健康分类（ICF）提出一种基于单一质量因素的嗓音问题分级量表，该量表考虑嗓音问题的多维性对其进行分类。
对多文化数据库（280 例）进行分析。分析信息包括：整体嗓音质量的听觉判断（G）；声学分析（A），采用声学嗓音质量指数；喉部诊断（L）和患者自我评估（P），采用嗓音障碍指数。对变量进行分类。采用两步聚类分析定义具有共同特征的组。
定义了一个 7 分制的质量因素分级量表，即 GALP，用于综合考虑嗓音评估的 4 个维度对嗓音问题的严重程度进行分级。每个嗓音问题的严重程度，即无问题、轻度、中度、重度或完全嗓音问题，都有其自身可能的 G、A、L 和 P 结果，这些结果将改变或不改变嗓音问题的整体严重程度。该量表的极端情况表示在所有参数正常时“无问题”，而在所有参数都改变时表示“完全问题”。中间的 3 个级别由聚类分析定义（轻度、中度和重度问题），并根据每个评估（G、A、L 和 P）的结果而改变。因此，单独一个参数的变化可能导致或不导致嗓音问题严重程度的变化。此外，还有 2 种情况不属于分类（不明确）和部分变量缺失（不适用）。
提出了 GALP 量表来对嗓音问题的严重程度进行分类。这种方法根据 ICF 考虑了嗓音评估的重要维度。它是一种潜在的工具，可以供不同专业人员、不同评估程序以及不同人群、临床医生和研究中心使用。
