title: Does the presence or location of graphic markers affect untrained listeners' ratings of severity of dysphonia?
abstract: OBJECTIVE
  To determine the effect of presence and location of severity labels for different types of visual analog scales (VAS) on overall severity (OS) ratings in dysphonic speech.
  
  
  METHODS
  Experimental, between group comparisons.
  
  
  METHODS
  Dysphonic and normal voice samples from male and female speakers were presented to inexperienced listeners for judgments of OS. To rate samples, listeners used an undifferentiated 100-mm VAS labeled at the extremes, a VAS with nonlinearly distributed labels as in the "beta" version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V), or a VAS with symmetrically distributed labels as in the "official" version of the CAPE-V.
  
  
  RESULTS
  Overall, mean OS ratings did not differ significantly across scale types, although ratings using the nonlinearly marked VAS were generally lower than those from other scales. This effect was significant for female speakers whose samples tended toward moderate OS. The ratings distribution, when compiled into 10-mm bins, differed significantly by scale type, with users of the nonlinearly marked scales skewing their ratings toward normal.
  
  
  CONCLUSIONS
  The presence and placement of labels on VAS did not significantly affect OS ratings overall, but values were significantly lower when rating female voices with the nonlinearly labeled VAS. Results indicate that professionals should specify the scale type used for rating OS and use scales consistently when comparing voices.
authors.affiliation: Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington. Electronic address: kfnagle@gmail.com.
authors.forename: Kathy F
authors.initials: KF
authors.lastname: Nagle
authors.affiliation: Department of Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Leah B
authors.initials: LB
authors.lastname: Helou
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland.
authors.forename: Nancy P
authors.initials: NP
authors.lastname: Solomon
authors.affiliation: Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington.
authors.forename: Tanya L
authors.initials: TL
authors.lastname: Eadie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D055154:Dysphonia / Q000175:diagnosis* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010699:Phonation / Q000502:physiology*; D011594:Psychometrics / Q000379:methods / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D012727:Sex Characteristics; D013061:Speech Acoustics; D013065:Speech Intelligibility / Q000502:physiology*; D013068:Speech Production Measurement; D064232:Visual Analog Scale; D014831:Voice / Q000502:physiology
keywords: Dysphonia; Perceptual rating; Severity; Visual analog scale