[Study on the concordance of objective multi-parameters analysis and perceptual evaluation]

Through exploring the concordance of objective multi-parameters analysis and perceptual evaluation, to establish an objective multi-parameters evaluation protocol of voice disorder and to make the evaluation of voice objectification and quantification.

Voice samples from 271 patients (124 female and 147 male)with dysphonia and 69 control subjects with normal voice (37 female and 32 male)were recorded and assessed by a jury composed of 5 experts in phoniatrics from different hospitals. The jury was instructed to classify voice samples according to the G (grade) component of the GRBAS scale on a visual analogue scale secondarily transformed in a 4-point scale ranging from 0 for normal to 3 for severe dysphonia. The voice samples were unified sentences and ordered randomly 3 times, the mean of 3 evaluation scores were the final results. The objective parameters, including fundamental frequency (F0), jitter, shimmer, fundamental frequency standard deviation (F0SD), normalized noise energy (NNE), harmonic-to-noise ratio (HNR) and maximal phonatory time (MPT), were measured on a 2-second sustained vowel/a/including its initial segment, using the software Dr. Speech for Windows. The data were analyzed using SPSS11.0.

All objective parameters except for F0 had high correlation with G and the variance tendency of these parameters values was coherent with the extent of voice disorder. And there were statistical differences between adjacent voice disorder groups. Male and female objective multi-parameters protocols were established respectively consisting of jitter, shimmer, F0SD, NNE, HNR and MPT using discriminant analysis (P < 0.05). The concordance between perceptual evaluation and objective multi-parameters evaluation was 81.6% in male and 83.2% in female. The concordance of evaluation of normal voice and severe voice disorder groups were better than that of mild and moderate voice disorder groups. All mis-grading voices were judged in the adjacent voice group.

The objective parameters of voice are able to reflect the characteristic of its perceptual evaluation and the concordance between perceptual evaluation and objective multi-parameters evaluation is good. The objective multi-parameters evaluation protocol we established could provide an objective and quantitative evaluation method for voice disorders.