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Updated: Jul 24, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
[On the auditory evaluation of voice quality]
1Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover. ptok.martin@mh-hannover.de
Background:
For routine clinical purposes, dysphonic voices are assessed perceptually using the GRBAS scale or analogues. For clinical application, the crucial question is the interrater reliability (IRR) of the auditory perceptual assessment of voice quality. Therefore, the IRR of the four point RBH (roughness, breathiness, hoarseness vs overall grade) scale was studied. Other parameters, e.g. validity and intrarater reliability were not considered.
Methods:
A total of 78 patients read a standard text "Der Nordwind und die Sonne". These samples were evaluated by 19 speech and voice therapy students according to the degree of roughness, breathiness and hoarseness. Data were subjected to reliability analysis.
Results:
Our data indicate a high IRR with a Cronbach's alpha of 0.94. No single rating of the 19 raters could be omitted without decreasing the IRR.
Discussion:
The data indicate that the perceptual assessment of hoarseness for running speech is highly reliable. The application of the RBH scale is suitable for clinical purposes. It should be considered as an outcome measure.
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