Dejonckere P H, Remacle M, Fresnel-Elbaz E, Woisard V, Crevier-Buchman L, Millet B
Institute of Phoniatrics, Utrecht University, The Netherlands.
Rev Laryngol Otol Rhinol (Bord). 1996;117(3):219-24.
The perceptual GRBAS scale for deviant voice quality (completed with a "I" parameter: Instability = fluctuation of voice quality over time) was tested in 5 different institutes on 943 voice patients. Each voice was evaluated separately by 2 professionals. The interrater correlation reaches 0.87 for G (grade), 0.70 for R (roughness), 0.69 for B (breathiness) and 0.65 for A/S (asthenicity/strain). Experience with the scale significantly improves the interrater agreement. The intrarater correlation (80 voices; time interval 2-6 months) is systematically slightly stronger than the interrater correlation. Further, GIRBAS/acoustical correlations were investigated on 80 pathological voices, by using the Multidimensional Voice Program (MDVP) of Kay. Principal component analysis allows reduction of 21 MDVP parameters to 5 clinically relevant aspects, with a typical acoustical measurement for each of them. The strongest correlations are found between G and Shimmer/Noise to harmonics ratio, R and Jitter, and B and Shimmer. As tremor and diplophonia are easily identified perceptually and acoustically, it seems useful to add this information respectively to AS and R. The GIRBAS scale seems to be a valuable instrument for clinical practice.
针对异常嗓音质量的感知GRBAS量表（补充了一个“I”参数：不稳定性 = 嗓音质量随时间的波动）在5个不同机构对943名嗓音患者进行了测试。每个嗓音由2名专业人员分别进行评估。评估者间的相关性在G（等级）方面达到0.87，在R（粗糙性）方面达到0.70，在B（呼吸声）方面达到0.69，在A/S（无力/紧张）方面达到0.65。使用该量表的经验显著提高了评估者间的一致性。评估者内的相关性（80个嗓音；时间间隔2 - 6个月）在系统上略强于评估者间的相关性。此外，通过使用Kay的多维嗓音程序（MDVP），对80个病理性嗓音的GIRBAS/声学相关性进行了研究。主成分分析可将21个MDVP参数减少到5个临床相关方面，每个方面都有一个典型的声学测量指标。在G与闪烁/噪声谐波比、R与抖动以及B与闪烁之间发现了最强的相关性。由于震颤和复音在感知和声学上很容易识别，因此分别将此信息添加到A/S和R中似乎很有用。GIRBAS量表似乎是临床实践中的一种有价值的工具。
