title: Reliability of perceptions of voice quality: evidence from a problem asthma clinic population.
abstract: BACKGROUND
  Methods of perceptual voice evaluation have yet to achieve satisfactory consistency; complete acceptance of a recognised clinical protocol is still some way off.
  
  
  METHODS
  Three speech and language therapists rated the voices of 43 patients attending the problem asthma clinic of a teaching hospital, according to the grade-roughness-breathiness-asthenicity-strain (GRBAS) scale and other perceptual categories.
  
  
  RESULTS
  Use of the GRBAS scale achieved only a 64.7 per cent inter-rater reliability and a 69.6 per cent intra-rater reliability for the grade component. One rater achieved a higher degree of consistency. Improved concordance on the GRBAS scale was observed for subjects with laryngeal abnormalities. Raters failed to reach any useful level of agreement in the other categories employed, except for perceived gender.
  
  
  CONCLUSIONS
  These results should sound a note of caution regarding routine adoption of the GRBAS scale for characterising voice quality for clinical purposes. The importance of training and the use of perceptual anchors for reliable perceptual rating need to be further investigated.
authors.affiliation: Department of Speech and Language Therapy, Glasgow Royal Infirmary, Scotland, UK. Cameron.Sellars@ggc.scot.nhs.uk
authors.forename: C
authors.initials: C
authors.lastname: Sellars
authors.forename: A E
authors.initials: AE
authors.lastname: Stanton
authors.forename: A
authors.initials: A
authors.lastname: McConnachie
authors.forename: C P
authors.initials: CP
authors.lastname: Dunnet
authors.forename: L M
authors.initials: LM
authors.lastname: Chapman
authors.forename: C E
authors.initials: CE
authors.lastname: Bucknall
authors.forename: K
authors.initials: K
authors.lastname: MacKenzie
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D055154:Dysphonia / Q000139:chemically induced* / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D007830:Larynx / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D017410:Practice Guidelines as Topic; D015203:Reproducibility of Results; D013061:Speech Acoustics; D013067:Speech Perception / Q000502:physiology; D013066:Speech-Language Pathology; D014833:Voice Quality