Perceptual evaluation of severe pediatric voice disorders: rater reliability using the consensus auditory perceptual evaluation of voice.
The purpose of this nonrandomized prospective study was to quantify the inter- and intrarater reliability of experienced speech-language pathologist's perceptual ratings of voice in pediatric patients post-laryngotracheal reconstruction (LTR). Moderate to severe dysphonia is common in this population. Using the sentence portion of the Consensus Auditory Perceptual Evaluation-Voice (CAPE-V) rating scale, three experienced speech-language pathologists independently rated randomized voice samples of 50 participants ages 4-20 years, who had acquired or congenital airway conditions requiring at least one LTR on the six salient perceptual vocal attributes. Data collection and listening conditions were carefully controlled. Seventeen (34%) of the samples were randomly selected for rerating at a later time. Estimates of interrater reliability were strongest for perceptual ratings of breathiness (intraclass correlation coefficient [ICC]=71%), roughness (ICC=68%), pitch (ICC=68%), and overall severity (ICC=67%). Reliability was lower for ratings of loudness (ICC=57%) and strain (ICC=35%). For each rater, the intrarater reliability on all but one parameter (strain) was moderate to strong (ICC=63-93%). There was a strong interrater eliability for four of six vocal parameters rated using the CAPE-V in a population of children and adolescents with marked dysphonia. The parameter of strain, when rated by auditory sample alone and apart from the clinical context, was difficult to rate.
Kelchner
Lisa N
LN
University of Cincinnati, Communication Science and Disorders, 202 Goodman Avenue G-65, French East, Cincinnati, OH 45267-0379, USA. kelchnl@email.uc.edu
Brehm
Susan B
SB
Weinrich
Barbara
B
Middendorf
Janet
J
deAlarcon
Alessandro
A
Levin
Linda
L
Elluru
Ravi
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D032921:Consensus; D055154:Dysphonia / Q000175:diagnosis* / Q000601:surgery*; D005260:Female; D006801:Humans; D007830:Larynx / Q000601:surgery; D008144:Loudness Perception; D008297:Male; D015588:Observer Variation; D010898:Pitch Perception; D011183:Postoperative Complications / Q000175:diagnosis*; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D015656:Respiratory Mechanics; D012720:Severity of Illness Index; D013066:Speech-Language Pathology / Q000379:methods* / Q000592:standards*; D014132:Trachea / Q000601:surgery; D014833:Voice Quality; D055815:Young Adult