Department of Speech & Hearing Sciences, University of Washington, Seattle.
Department of Speech, Language & Hearing Sciences, Boston University, MA.
J Speech Lang Hear Res. 2021 May 11;64(5):1571-1580. doi: 10.1044/2021_JSLHR-20-00623. Epub 2021 Apr 28.
Purpose The reliability of auditory-perceptual judgments between listeners is a long-standing problem in the assessment of voice disorders. The purpose of this study was to determine whether a relatively novel experimental scaling method, called visual sort and rate (VSR), yielded stronger reliability than the more frequently used method of visual analog scales (VAS) for ratings of overall severity (OS) and breathiness (BR) in speakers with voicedisorders. Method Fifty speech samples were selected from a database of speakers with voice disorders. Twenty-two inexperienced listeners provided ratings of OS or BR in four rating blocks: VSR-OS, VSR-BR, VAS-OS, and VSR-BR. For the VAS task, listeners rated each speaker for BR or OS using a vertically oriented 100-mm VAS. For the VSR task, stimuli were distributed into sets of samples with a range of speaker severities in each set. Listeners sorted and ranked samples for OS or BR within each set, and final ratings were captured on a vertically oriented 100-mm VAS. Interrater variability, defined as the mean of the squared differences between a listener's ratings and group mean ratings, and intrarater reliability (Pearson ) were compared across rating tasks for OS and BR using paired tests. Results Results showed that listeners had significantly less interrater variability (better reliability) when using VSR methods compared to VAS for judgments of both OS and BR. Intrarater reliability was high across rating tasks and dimensions; however, ratings of BR were significantly more consistent within individual listeners when using VAS than when using VSR. Conclusions VSR is an experimental method that decreases variability of auditory-perceptual judgments between inexperienced listeners when rating speakers with a range of dysphonic severities and disorders. Future research should determine whether a clinically viable tool may be developed based on VSR principles and whether such benefits extend to experienced listeners.
目的 听众之间听觉感知判断的可靠性是评估嗓音障碍的一个长期存在的问题。本研究的目的是确定一种相对新颖的实验标度方法，称为视觉分类和评分（VSR），在评估嗓音障碍患者的总体严重度（OS）和气息声（BR）时，与更常用的视觉模拟量表（VAS）相比，是否具有更强的可靠性。
方法 从嗓音障碍患者数据库中选择了 50 个语音样本。22 名无经验的听众在四个评分块中提供了 OS 或 BR 的评分：VSR-OS、VSR-BR、VAS-OS 和 VSR-BR。对于 VAS 任务，听众使用垂直定向的 100mm VAS 为 BR 或 OS 对每个说话者进行评分。对于 VSR 任务，刺激被分配到一组具有每个集合中说话者严重程度范围的样本中。听众在每个集合中对 OS 或 BR 进行排序和排名，最终评分记录在垂直定向的 100mm VAS 上。使用配对 t 检验比较 OS 和 BR 的评分任务的组内评分差异的平均值（定义为组内评分差异的平方平均值）和内部分辨率（Pearson ）。
结果 结果表明，与 VAS 相比，听众在使用 VSR 方法评估 OS 和 BR 时，组内评分差异更小（可靠性更高）。各评分任务和维度的内部分辨率均较高；然而，当使用 VAS 时，BR 的评分在单个听众内更一致，而当使用 VSR 时则不一致。
结论 VSR 是一种实验方法，可降低在评估具有不同程度和类型的发音障碍的患者时，无经验听众之间听觉感知判断的变异性。未来的研究应该确定是否可以基于 VSR 原理开发出一种可行的临床工具，以及这些益处是否扩展到有经验的听众。
