Department of Otolaryngology, Hannover Medical School, Germany.
ENT, Phoniatrics and Pedaudiology-Klosterstern Hamburg, Germany.
J Speech Lang Hear Res. 2021 Jun 4;64(6):1855-1868. doi: 10.1044/2021_JSLHR-20-00462. Epub 2021 May 26.
Purpose The Vocal Tract Discomfort Scale (VTD Scale) is a self-rating questionnaire investigating physical symptoms in the larynx associated with vocal pathology. The aim of this work was to investigate the reliability, validity, sensitivity, and specificity of the first German version and to provide normative data with thresholds for pathology and a scaling scheme. Study Design A retrospective multicenter study was performed. Method A total of 571 participants (409 female and 162 male), with a mean age of 47.2 years, were recruited at three German centers; of these, there were 447 participants with voice disorder and 124 vocally healthy participants. The clinical examination consisted of patient history, visual laryngeal examination, acoustic and aerodynamic assessment, perceptual analysis by the Grading-Roughness-Breathiness-Asthenia-Strain Scale, and subjective evaluation using the VTD Scale and the Voice Handicap Index (VHI). Statistics included group comparisons ( test and analysis of variance), Pearson correlation coefficient (between VTD Scale and VHI), and Cronbach's alpha to assess validity and reliability. Analysis of receiver operating characteristics was performed to examine VTD Scale's discriminatory ability and provide a cutoff score. Additionally, percentiles were applied to provide VTD Scale ranges. Results There were highly significant differences between healthy participants and participants with voice disorder regarding the total score and both subscales of the VTD Scale. Internal consistency was excellent (α = .928). We found moderate, positive correlation between the VTD Scale and VHI (ρ = .596, < .001). Receiver operating characteristics analysis showed an area under the curve of 0.876 ( < .001, 95% confidence interval [0.846, 0.906]). VTD Scale ranges were no (score: 0-13), mild (score: 14-26), moderate (score: 27-40), and severe (score: 41-96) disorder. Conclusions Results confirm an excellent reliability and validity of the German VTD Scale. It provides additional and independent diagnostic information and is a useful instrument to complement voice assessment. The scaling into four severity subgroups allows the tool to be used for screening patients and considers a transferral to a voice specialist.
嗓音障碍严重度评估量表（VTD 量表）是一种自评问卷，用于调查与嗓音病理学相关的喉部物理症状。本研究旨在调查首个德语版本的可靠性、有效性、敏感性和特异性，并提供具有病理阈值和分级方案的规范数据。
回顾性多中心研究。
共招募了三个德国中心的 571 名参与者（409 名女性，162 名男性），平均年龄为 47.2 岁；其中 447 名参与者患有嗓音障碍，124 名参与者为嗓音健康。临床检查包括病史、喉镜检查、声学和空气动力学评估、Grading-Roughness-Breathiness-Asthenia-Strain 量表的感知分析以及嗓音障碍严重度评估量表（VTD 量表）和嗓音障碍指数（VHI）的主观评估。统计分析包括组间比较（ t 检验和方差分析）、Pearson 相关系数（VTD 量表与 VHI 之间）和 Cronbach's alpha 以评估有效性和可靠性。进行Receiver Operating Characteristics 分析以检查 VTD 量表的区分能力并提供截断分数。此外，还应用了百分位数来提供 VTD 量表的范围。
嗓音健康参与者和嗓音障碍参与者在 VTD 量表总分和两个分量表上均存在显著差异。内部一致性非常好（α =.928）。我们发现 VTD 量表与 VHI 之间存在中度、正相关（ρ =.596， <.001）。Receiver Operating Characteristics 分析显示曲线下面积为 0.876（ <.001，95%置信区间 [0.846, 0.906]）。VTD 量表的范围为无（得分：0-13）、轻度（得分：14-26）、中度（得分：27-40）和重度（得分：41-96）障碍。
结果证实了德语版 VTD 量表具有极好的可靠性和有效性。它提供了额外的、独立的诊断信息，是一种有用的工具，可以补充嗓音评估。将其划分为四个严重程度亚组，使该工具可用于筛选患者，并考虑转诊给嗓音专家。
