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Validation of the Brazilian Portuguese CAPE-V Instrument—Br CAPE-V for Auditory-Perceptual Analysis

  • Mara Behlau
    Correspondence
    Address correspondence and reprint requests to Mara Behlau, Department of Communication Disorders, Unifesp Universidade Federal de São Paulo, CENTRO DE ESTUDOS DA VOZ (CEV) Rua Machado Bittencourt 361. São Paulo, SP. 04044-001. Brazil.
    Affiliations
    Department of Communication Disorders, Unifesp Universidade Federal de São Paulo, São Paulo 04023-062, Brazil

    CEV, Centro de Estudos da Voz, São Paulo, Brazil
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  • Bruna Rocha
    Affiliations
    Department of Communication Disorders, Unifesp Universidade Federal de São Paulo, São Paulo 04023-062, Brazil

    CEV, Centro de Estudos da Voz, São Paulo, Brazil
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  • Marina Englert
    Affiliations
    Department of Communication Disorders, Unifesp Universidade Federal de São Paulo, São Paulo 04023-062, Brazil

    CEV, Centro de Estudos da Voz, São Paulo, Brazil
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  • Glaucya Madazio
    Affiliations
    CEV, Centro de Estudos da Voz, São Paulo, Brazil
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      Summary

      Introduction

      The Consensus Auditory Perceptual Evaluation of Voice (CAPE-V) scale is a modern, clinical-scientific approach to voice analysis. It has been translated and culturally adapted to Brazilian Portuguese, but it still lacks validation.

      Objective

      To validate the Brazilian Portuguese version of the CAPE-V scale using the previously translated and culturally adapted version.

      Method

      Forty voice samples were selected (30 dysphonic, 10 nondysphonic), and the degree of vocal deviation was evaluated by a committee of three voice specialists. Nine voice specialists judged the 40 voice samples plus 20% repetition (total of 48 samples) using the CAPE-V. To ensure construct validity of the CAPE-V, its analysis was compared to the Grade-Roughness-Breathiness-Asthenia-Strain (GRBAS) scale that was performed 48-72 hours later. Finally, the intra- and inter-rater reliability values were verified and the correlation between the nine judges and the previously defined evaluation was analyzed.

      Results

      The Brazilian CAPE-V presented significant intra (0.860-0.997) and inter-rater reliability values (0.707-0.964) for the overall degree and strong correlation with GRBAS (above 0.828). Deviant voice quality had greater consensus among raters than normal voices. A strong correlation was observed between the analysis of the nine raters and that of the committee.

      Conclusion

      CAPE-V is an important diagnostic instrument that contributes to the standardization of vocal quality evaluation in several languages, including Brazilian Portuguese. Thus, its usefulness is neither related to a single language nor to a single set of raters.

      Key Words

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      REFERENCES

        • Barsties B
        • De Bodt M
        Assessment of voice quality: current state-of-the-art.
        Auris Nasus Larynx. 2015; 42: 183-188
        • Shrivastav R
        • Sapienza CM
        • Nandur V
        Application of psychometric theory to the measurement of voice quality using rating scales.
        J Speech Lang Hear Res. 2005; 48: 323-335
        • Oates J
        Auditory-perceptual evaluation of disordered voice quality: pros, cons and future directions.
        Folia Phoniatr Logop. 2009; 61: 49-56
        • Englert M
        • Madazio G
        • Gielow I
        • et al.
        Learning factor influence on the perceptual-auditory analysis.
        CoDAS. 2018; 30e20170107
        • Carding PN
        • Wilson JA
        • MacKenzie K
        • et al.
        Measuring voice outcomes: state of the science review.
        J Laryngol Otol. 2009; 123: 823-829
        • Hirano M
        Clinical Examination of Voice.
        Springer-Verlag, New York1981
        • Kempster GB
        • Gerratt BR
        • Verdolini Abbott K
        • et al.
        Consensus auditory-perceptual evaluation of voice: development of a standardized clinical protocol.
        Am J Speech Lang Pathol. 2009; 18: 124-132
        • Johnson K
        • Brehm SB
        • Weinrich B
        • et al.
        Comparison of the pediatric Voice Handicap Index with perceptual voice analysis in pediatric patients with vocal fold lesions.
        Arch Otolaryngol Head Neck Surg. 2011; 137: 1258-1262
        • Kelchner LN
        • Brehm SB
        • Weinrich B
        • et al.
        Perceptual evaluation of severe pediatric voice disorders: rater reliability using the consensus auditory perceptual evaluation of voice.
        J Voice. 2010; 24: 441-449
        • Zraick RI
        • Kempster GB
        • Connor NP
        • et al.
        Establishing validity of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V).
        Am J Speech Lang Pathol. 2011; 20: 14-22
        • Mozzanica F
        • Ginocchio D
        • Borghi E
        • et al.
        Reliability and validity of the Italian version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V).
        Folia Phoniatr Logop. 2013; 65: 257-265
        • Gunjawate DR
        • Ravi R
        • Bhagavan S
        Reliability and validity of the Kannada version of the Consensus Auditory-Perceptual Evaluation of Voice.
        J Speech Lang Hear Res. 2020; 63: 385-392
        • Chen Z
        • Fang R
        • Zhang Y
        • et al.
        The Mandarin Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and its reliability.
        J Speech Lang Hear Res. 2018; 26: 2451-2457
        • Khoramshahi H
        • Khatoonabadi AR
        • Khoddami SM
        • et al.
        Responsiveness of Persian version of Consensus Auditory Perceptual Evaluation of Voice (CAPE-V), Persian version of Voice Handicap Index (VHI), and Praat in Vocal Mass Lesions with muscle tension dysphonia.
        J Voice. 2018; 32: 770.e21-770.e30
        • Ertan-Schlüter E
        • Demirhan E
        • Ünsal EM
        • et al.
        The Turkish version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V): a reliability and validity study.
        J Voice. 2019; S0892-1997 (Online ahead of print): 30096-7https://doi.org/10.1016/j.jvoice.2019.05.014
        • Özcebe E
        • Aydinli FE
        • Tiğrak TK
        • et al.
        Reliability and validity of the Turkish version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V).
        J Voice. 2019; 33: 382.e1-382.e10
        • Almeida SC
        • Mendes AP
        • Kempster GB
        The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) psychometric characteristics: II European Portuguese Version (II EP CAPE-V).
        J Voice. 2019; 33: 582.e5-582.e13
        • Behlau M
        • Oliveira G
        Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), ASHA 2003.
        Rev Soc Bras Fonoaudiol. 2004; 9: 187-189
        • Karnell M
        • Melton S
        • Childes J
        • et al.
        Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders.
        J Voice. 2007; 21: 576-590
        • Rossi M
        • Pavlovic C
        • Espesser R
        Reducing context effects in the subjective evaluation of speech [abstract].
        in: 120th Meeting Acoustical Society America; 1990. Inst de Phonétique, Univ de Provence, Provence; France1990: 12
        • Awan SN
        • Lawson LL
        The effect of anchor modality on the reliability of vocal severity ratings.
        J Voice. 2009; 23: 341-345https://doi.org/10.1016/j.jvoice.2007.10.006
        • Martins PC
        • Couto TE
        • Gama ACC
        Auditory-perceptual evaluation of the degree of vocal deviation: correlation between the Visual Analogue Scale and Numerical Scale.
        CoDAS. 2015; 27: 279-284
        • Nemr K
        • Simões-Zenari M
        • Cordeiro GF
        • et al.
        GRBAS and CAPE-V scales: high reliability and consensus when applied at different times.
        J Voice. 2012; 26: 812e17-812e22
        • De Bodt M
        Een onderzoeksmodel voor stemstoornissen: de relatie tussen subjectieve en objectieve parameters in de beoordeling van de normale en pathologische stemfunctie.
        Universiteit Antwerpen, Antwerpen1997
        • Lee YW
        • Kim GH
        • Bae IH
        • et al.
        The cut-off analysis using visual analogue scale and cepstral assessments on severity of voice disorder.
        Logoped Phoniatr Vocol. 2018; 19: 1-6
        • Simberg S
        • Laine A
        • Sala E
        • et al.
        Prevalence of voice disorders among future teachers.
        J Voice. 2000; 14: 231-235
        • Yamasaki R
        • Madazio G
        • Leão SHS
        • et al.
        Auditory-perceptual evaluation of normal and dysphonic voices using the voice deviation scale.
        J Voice. 2016; 31: 67-71https://doi.org/10.1016/j.jvoice.2016.01.004
        • Gerratt BR
        • Kreiman J
        • Antonanzas-Barroso N
        • et al.
        Comparing internal and external standards in voice quality judgments.
        J Speech Hear Res. 1993; 36: 14-20
        • Chan KM
        • Yiu EM
        The effect of anchors and training on the reliability of perceptual voice evaluation.
        J Speech Lang Hear Res. 2002; 45: 111-126
        • Yiu EM
        • Murdoch B
        • Hird K
        • et al.
        Perception of synthesized voice quality in connected speech by Cantonese speakers.
        J Acoust Soc Am. 2002; 112: 1091-1101
        • Sellars C
        • Stanton AC
        • Mcconnachie A
        • et al.
        Reliability of perceptions of voice quality: evidence from a problem asthma clinic population.
        J Laryngol Otol. 2009; 123: 755-763
        • Núñez-Batalla F
        • Morato-Galán M
        • García-López I
        • et al.
        Adaptación fonética y validación del método de valoración perceptual de la voz CAPE- V al español.
        Acta Otorrinolaringol Esp. 2015; 66: 249-257