Impact of Cultural-Linguistic Differences on Vocal Fatigue Perception: A Systematic Review and Meta-Analysis

Area of Science:

• Speech and Hearing Sciences
• Cross-cultural Communication
• Diagnostic Accuracy

Background:

• Perception of clinical conditions can differ across cultural-linguistic groups.
• Limited evidence exists on how cultural background impacts the perception of vocal fatigue (VF).
• The Vocal Fatigue Index (VFI) is a self-assessment tool for voice disorders.

Purpose of the Study:

• To systematically review and investigate differences in perceived vocal fatigue (VF) across cultural-linguistic contexts.
• To assess the diagnostic accuracy of the Vocal Fatigue Index (VFI) in various translated versions.
• To determine the VFI's reliability as a cross-linguistic diagnostic tool for vocal fatigue.

Main Methods:

• A systematic literature search was conducted in major databases (MEDLINE, CENTRAL, Web of Science, Google Scholar) up to March 2024.
• Cross-sectional studies on the VFI's accuracy in detecting perceived VF across languages were included.
• Meta-analysis of sensitivity and specificity for each of the VFI's three factors was performed using summary receiver operating characteristic curves.

Main Results:

• Eight studies examining the VFI in English, Malayalam, Turkish, German, Mandarin Chinese, Polish, Cantonese, and Finnish were included.
• Pooled sensitivity and specificity for VFI factors were: Factor 1 (0.91/0.88), Factor 2 (0.83/0.84), and Factor 3 (0.75/0.77).
• Results indicated medium to high, yet heterogeneous, diagnostic accuracy of the VFI across cultural-linguistic settings.

Conclusions:

• The Vocal Fatigue Index (VFI) demonstrates promising, though heterogeneous, accuracy in assessing vocal fatigue (VF) across diverse cultural and linguistic backgrounds.
• Future research should explore the reasons for heterogeneity in diagnostic accuracy.
• Further adaptation and validation of the VFI in more languages are recommended to establish its global utility.