Reliability and Accuracy of Expert Auditory-Perceptual Evaluation of Voice via Telepractice Platforms

Purpose This study assessed the reliability and accuracy of auditory-perceptual voice evaluations by experienced clinicians via telepractice platforms. Method Voice samples from 20 individuals were recorded after transmission via telepractice platforms. Twenty experienced clinicians (10 speech-language pathologists, 10 laryngologists) evaluated the samples for dysphonia percepts (overall severity, roughness, breathiness, and strain) using a modified Consensus Auditory-Perceptual Evaluation of Voice. Reliability was calculated as the mean of squared differences between repeated ratings (intrarater agreement), and between individual and group mean ratings (interrater agreement). Repeated measures analyses of variance were constructed to measure effects of transmission condition (e.g., original recording, WebEx, Zoom), dysphonia percept, and their interaction on intrarater agreement, interrater agreement, and average ratings. Significant effects were evaluated with post hoc Tukey's tests. Results There were significant effects of transmission condition, percept, and their interaction on average ratings, and a significant effect of percept on interrater agreement. Post hoc testing revealed statistically, but not clinically, significant differences in average roughness ratings across transmission conditions, and significant differences in interrater agreement for several percepts. Overall severity had the highest agreement and strain had the lowest. Conclusion Telepractice transmission does not substantially reduce reliability or accuracy of auditory-perceptual voice evaluations by experienced clinicians.