Reliability and Validity of Speech Evaluation in Adductor Spasmodic Dysphonia: Common Mistake and Statistical Issues

  • Siamak Sabour
    Affiliations
    Department of Clinical Epidemiology, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
    Safety Promotions and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Published:November 02, 2017DOI:https://doi.org/10.1016/j.jvoice.2017.10.007
      I was interested to read the paper by Yanagida et al published in Journal of Voice on August 2017.
      • Yanagida S.
      • Nishizawa N.
      • Hashimoto R.
      • et al.
      Reliability and validity of speech evaluation in adductor spasmodic dysphonia.
      The purposes of the authors were to evaluate speech in patients with adductor spasmodic dysphonia (ADSD) by perceptual evaluations and acoustic measures, and to examine the reliability and validity of these measures.
      • Yanagida S.
      • Nishizawa N.
      • Hashimoto R.
      • et al.
      Reliability and validity of speech evaluation in adductor spasmodic dysphonia.
      Twenty-four patients with ADSD and 24 healthy volunteers were included in the study. Speech materials consisted of three sentences constructed from serial voiced syllables to elicit abductor voice breaks. Three otolaryngologists rated the degree of voice symptoms using a visual analog scale (VAS). VAS sheets with five 100-mm horizontal lines were given to each rater.
      • Yanagida S.
      • Nishizawa N.
      • Hashimoto R.
      • et al.
      Reliability and validity of speech evaluation in adductor spasmodic dysphonia.
      To evaluate the intra- and inter-rater and intermeasurer reliabilities of the VAS scores or acoustic measures, Pearson r correlations were calculated. To examine the validity of perceptual evaluations and acoustic measures, the sensitivity and the specificity were calculated.
      • Yanagida S.
      • Nishizawa N.
      • Hashimoto R.
      • et al.
      Reliability and validity of speech evaluation in adductor spasmodic dysphonia.
      Based on their results, Pearson r correlation coefficients for overall severity showed the highest intra- and inter-rater reliabilities. For acoustic events, the intermeasurer reliabilities were r = 0.64 (frequency shifts), r = 0.96 (aperiodic segments), and r = 1.0 (phonation breaks), and the intermeasurer reliability ranged from r = 0.10 to r = 1.0 Perceptual evaluation showed high sensitivity (91.7%) and specificity (100%), whereas acoustic analysis showed low sensitivity (70.8%) and high specificity (100%).
      • Yanagida S.
      • Nishizawa N.
      • Hashimoto R.
      • et al.
      Reliability and validity of speech evaluation in adductor spasmodic dysphonia.
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