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Interobserver perceptual analysis of smokers voice
R A Dedivitis1, A P B Barros, D S Queija
1Faculdade de Ciências da Saúde, Universidade Metropolitana de Santos, Santos, Brazil. dedivitis.hns@uol.com.br
Clinical Otolaryngology and Allied Sciences
|April 29, 2004
Summary
Experienced speech therapists showed varied agreement when assessing voices of male and female smokers in recovery. Disagreement was higher for pathological voices, indicating challenges in voice quality perception.
Area of Science:
- Speech-Language Pathology
- Otolaryngology
- Addiction Medicine
Background:
- Voice disorders are common in individuals with a history of smoking and alcohol abuse.
- Assessing voice quality perceptually is crucial for diagnosis and treatment planning.
- Subjectivity in perceptual voice analysis can lead to inter-rater variability.
Purpose of the Study:
- To investigate inter-rater reliability among experienced speech-language therapists in assessing voice variations.
- To analyze perceptual voice quality in male and female smokers in recovery using the GRBAS scale.
- To identify potential discrepancies in voice assessment based on vocal parameters.
Main Methods:
- A perceptual voice analysis was conducted by three experienced speech-language therapists on 57 participants (48 males, 9 females) from Alcoholics Anonymous.
- Participants were long-term smokers who had ceased alcohol consumption.
- The Grade, Roughness, Breathiness, Asthenia, and Strain (GRBAS) scale was used to evaluate sustained /a/ vowel phonations, with kappa statistics applied to assess inter-rater agreement.
Main Results:
- Inter-rater agreement varied across different voice parameters, with the lowest concordance for roughness (kappa = 0.016-0.234) and breathiness (kappa = 0.147-0.191).
- High concordance was observed for asthenic voice quality (kappa not applicable to 0.156).
- Disagreement was more pronounced for pathological voice qualities compared to normal voices, with discrepancies typically limited to one scale point.
Conclusions:
- Perceptual voice assessment by experienced clinicians shows considerable variability, particularly for roughness and breathiness in smokers in recovery.
- The GRBAS scale demonstrates higher reliability for asthenic voice quality compared to roughness and breathiness.
- Further research and standardized training may be needed to improve consistency in the perceptual evaluation of voice disorders, especially in clinical populations with complex histories.