title: Reliability of the perceptual evaluation of adductor spasmodic dysphonia.
abstract: OBJECTIVE
  Although perceptual assessment by experienced voice clinicians remains the gold standard for the diagnosis and assessment of severity of adductor spasmodic dysphonia (ADSD), the interrater reliability of voice experts for this task has not been assessed. In addition, it is unknown whether telephone-recorded or -transmitted voice samples could be used for this task. The aims of this study were (1) to assess the reliability of perceptual analysis of ADSD severity by voice experts and (2) to compare the results between digitally recorded voice samples and those recorded over the telephone.
  
  
  METHODS
  Five laryngologists randomly selected voice samples from 46 ADSD patients and rated the severity of ADSD on a 5-point rating scale. A set of digital voice recordings and a set of telephone voice recordings made from filtering the digital set via the telephone were rated, and each voice set was rated twice. Measures of intrarater and interrater reliability, as well as a measure of the probability of agreement among the raters, were calculated.
  
  
  RESULTS
  There was a high level of agreement on ADSD severity, with excellent interrater and intrarater reliability (Cronbach's alpha, .93 to .96). The probabilities of rater agreement on the digitally recorded and telephone-filtered voice samples were similar (chi2, p = .07). The ratings of digital versus telephone voice samples were highly correlated (Pearson r, 0.99; p < .001).
  
  
  CONCLUSIONS
  These results demonstrate that voice experts are reliably able to judge and agree on the severity of ADSD. Telephone-filtered voices appear to convey adequate ADSD perceptual cues for expert listeners to judge the severity of spasmodic dysphonia.
authors.affiliation: Division of Head and Neck Surgery, University of California-Los Angeles School of Medicine, Los Angeles 90095, USA.
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Chhetri
authors.forename: Albert L
authors.initials: AL
authors.lastname: Merati
authors.forename: Joel H
authors.initials: JH
authors.lastname: Blumin
authors.forename: Lucian
authors.initials: L
authors.lastname: Sulica
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Damrose
authors.forename: Veling W
authors.initials: VW
authors.lastname: Tsai
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013689:Telephone; D014832:Voice Disorders; D014833:Voice Quality