title: Evidence-based clinical voice assessment: a systematic review.
abstract: OBJECTIVE
  To determine what research evidence exists to support the use of voice measures in the clinical assessment of patients with voice disorders.
  
  
  METHODS
  The American Speech-Language-Hearing Association (ASHA) National Center for Evidence-Based Practice in Communication Disorders staff searched 29 databases for peer-reviewed English-language articles between January 1930 and April 2009 that included key words pertaining to objective and subjective voice measures, voice disorders, and diagnostic accuracy. The identified articles were systematically assessed by an ASHA-appointed committee employing a modification of the critical appraisal of diagnostic evidence rating system.
  
  
  RESULTS
  One hundred articles met the search criteria. The majority of studies investigated acoustic measures (60%) and focused on how well a test method identified the presence or absence of a voice disorder (78%). Only 17 of the 100 articles were judged to contain adequate evidence for the measures studied to be formally considered for inclusion in clinical voice assessment.
  
  
  CONCLUSIONS
  Results provide evidence for selected acoustic, laryngeal imaging-based, auditory-perceptual, functional, and aerodynamic measures to be used as effective components in a clinical voice evaluation. However, there is clearly a pressing need for further high-quality research to produce sufficient evidence on which to recommend a comprehensive set of methods for a standard clinical voice evaluation.
authors.affiliation: University of Utah, Salt Lake City, UT, USA. daryush.mehta@alum.mit.edu
authors.forename: Nelson
authors.initials: N
authors.lastname: Roy
authors.forename: Julie
authors.initials: J
authors.lastname: Barkmeier-Kraemer
authors.forename: Tanya
authors.initials: T
authors.lastname: Eadie
authors.forename: M Preeti
authors.initials: MP
authors.lastname: Sivasankar
authors.forename: Daryush
authors.initials: D
authors.lastname: Mehta
authors.forename: Diane
authors.initials: D
authors.lastname: Paul
authors.forename: Robert
authors.initials: R
authors.lastname: Hillman
mesh_terms: D016235:American Speech-Language-Hearing Association; D055317:Evidence-Based Practice; D006801:Humans; D013061:Speech Acoustics; D013066:Speech-Language Pathology / Q000379:methods*; D014481:United States; D014832:Voice Disorders / Q000175:diagnosis*