Lechien Jérôme R
Department of Surgery, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), B7000 Mons, Belgium.
Department of Otolaryngology Head Neck Surgery, CHU Saint-Pierre, B1000 Brussels, Belgium.
J Pers Med. 2025 Aug 2;15(8):348. doi: 10.3390/jpm15080348.
: To investigate the reliability and validity of the Singer Reflux Symptom Score (sRSS), a new patient-reported outcome questionnaire documenting the severity of reflux symptoms in singing voice is proposed. : Amateur and professional singers consulting the European Reflux Clinic for laryngopharyngeal reflux disease (LPRD) symptoms and findings were prospectively recruited from January 2022 to February 2023. The diagnosis was based on a Reflux Symptom Score (RSS) > 13 and Reflux Sign Assessment (RSA) > 14. A control group of asymptomatic singer subjects was recruited from the University of Mons. The sRSS was rated within a 7-day period to assess test-retest reliability. Internal consistency was measured using Cronbach's α in patients and controls. A correlation analysis was performed between sRSS and Singing Voice Handicap Index (sVHI) to evaluate convergent validity. Responsiveness to change was evaluated through pre- to post-treatment sRSS changes. The sRSS threshold for suggesting a significant impact of LPRD on singing voice was determined by receiver operating characteristic (ROC) analysis. : Thirty-three singers with suspected LPRD (51.5% female; mean age: 51.8 ± 17.2 years) were consecutively recruited. Difficulty reaching high notes and vocal fatigue were the most prevalent LPRD-related singing complaints. The sRSS demonstrated high internal consistency (Cronbach-α = 0.832), test-retest reliability, and external validity (correlation with sVHI: r = 0.654; = 0.015). Singers with suspected LPRD reported a significant higher sRSS compared to 68 controls. sRSS item and total scores significantly reduced from pre-treatment to 3 months post-treatment except for the abnormal voice breathiness item. ROC analysis revealed superior diagnostic accuracy for sRSS (AUC = 0.971) compared to sRSS-quality of life (AUC = 0.926), with an optimal cutoff at sRSS > 38.5 (sensitivity: 90.3%; specificity: 85.0%). : The sRSS is a reliable and valid singer-reported outcome questionnaire for documenting singing symptoms associated with LPRD leading to personalized management of Singers. Future large-cohort studies are needed to evaluate its specificity for LPRD compared to other vocal fold disorders in singers.
为了研究辛格反流症状评分（sRSS）的可靠性和有效性，我们提出了一种新的患者报告结局问卷，用于记录歌唱嗓音中反流症状的严重程度。从2022年1月至2023年2月，前瞻性招募了因喉咽反流病（LPRD）症状和检查结果而咨询欧洲反流诊所的业余和专业歌手。诊断基于反流症状评分（RSS）>13和反流体征评估（RSA）>14。从蒙斯大学招募了一组无症状歌手作为对照组。在7天内对sRSS进行评分以评估重测可靠性。使用克朗巴赫α系数测量患者和对照组的内部一致性。对sRSS和歌唱嗓音障碍指数（sVHI）进行相关性分析以评估收敛效度。通过治疗前至治疗后的sRSS变化评估对变化的反应性。通过受试者工作特征（ROC）分析确定提示LPRD对歌唱嗓音有显著影响的sRSS阈值。连续招募了33名疑似LPRD的歌手（女性占51.5%；平均年龄：51.8±17.2岁）。难以唱高音和嗓音疲劳是与LPRD相关的最常见歌唱主诉。sRSS显示出高内部一致性（克朗巴赫α=0.832）、重测可靠性和外部效度（与sVHI的相关性：r=0.654；P=0.015）。与68名对照组相比，疑似LPRD的歌手报告的sRSS显著更高。除嗓音异常呼吸音项目外，sRSS项目和总分从治疗前到治疗后3个月显著降低。ROC分析显示，与sRSS-生活质量（AUC=0.926）相比，sRSS具有更高的诊断准确性（AUC=0.971），最佳截断值为sRSS > 38.5（敏感性：90.3%；特异性：85.0%）。sRSS是一种可靠且有效的歌手报告结局问卷，用于记录与LPRD相关的歌唱症状，从而实现对歌手的个性化管理。未来需要进行大规模队列研究，以评估其与歌手其他声带疾病相比对LPRD的特异性。
