title: Cross-cultural adaptation, validation, and cutoff point of the Italian version of the voice activity and participation profile: Profilo di Attività e Partecipazione Vocale.
abstract: OBJECTIVE
  The purpose of the study was to investigate the validity of the Profilo di Attività e Partecipazione Vocale (PAPV) and to identify the cutoff point of the total score that discriminates dysphonic from vocally healthy individuals.
  
  
  METHODS
  Cross-sectional, nonrandomized, prospective study with controls.
  
  
  METHODS
  The PAPV was administered to 239 individuals, 108 with vocal complaint, 131 without vocal complaint, 141 female, 98 male, mean age of 45.8 years. The instrument was submitted to validity, reliability, reproducibility, and responsiveness.
  
  
  RESULTS
  Construct-related validity was evaluated by comparing the scores of the groups with and without voice problem (Job: P < 0.001, self-perceived severity: P < 0.001, daily communication: P < 0.001, social communication: P < 0.001, emotion: P < 0.001, total: P < 0.001). The evaluation of criterion-related validity showed moderate-strong correlation coefficients between the PAPV, Voice Handicap Index, and vocal self-assessment. High alpha coefficients showed good internal consistency (job: 0.910, daily communication: 0.981, social communication: 0.981, emotion: 0.948, total: 0.989). High intraclass correlation coefficient showed good reproducibility (Job: 0.967, self-perceived severity: 0.979, daily communication: 0.990, social communication: 0.950, emotion: 0.976, total: 0.993). Changes after treatment were statistically significant for all PAPV scores (self-assessment P < 0.001, job P < 0.001, daily communication P < 0.001, social communication P = 0.005, emotion P < 0.001, total P < 0.001). The cutoff point with the highest sensitivity (84%) and specificity (100%) was 37.45 points.
  
  
  CONCLUSIONS
  The PAPV has undergone important steps required for cultural adaptation and validation process of outcome measures and it may be considered an important instrument to compose the assessment of Italian patients with dysphonia. The cutoff point that discriminates individuals with dysphonia from vocally healthy ones was 37.45 points for its total score.
authors.affiliation: New York Presbyterian Hospital-Columbia University, Speech and Hearing Department, New York, New York; Phelps Memorial Hospital Center, Institute for Voice and Swallowing, Sleepy Hollow, New York. Electronic address: atf9004@nyp.org.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Fava
authors.affiliation: Università degli Studi di Milano, Dipartimento di Scienze Cliniche e Biomediche "L. Sacco", Milano, Italy; Dipartimento di Otorinolaringoiatria dell'Ospedale S. Leopoldo Mandic of Merate, Lecce, Italy.
authors.forename: Nico Paolo
authors.initials: NP
authors.lastname: Paolillo
authors.affiliation: Touro College, Graduate Program in Speech-Language Pathology, Brooklyn, New York; CEV - Centro de Estudos da Voz, Sao Paulo, Brazil.
authors.forename: Gisele
authors.initials: G
authors.lastname: Oliveira
authors.affiliation: CEV - Centro de Estudos da Voz, Sao Paulo, Brazil; Universidade Federal de Sao Paulo, Department of Speech-Language Pathology, Sao Paulo, Brazil.
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014832:Voice Disorders / Q000175:diagnosis* / Q000523:psychology; D055815:Young Adult
keywords: Dysphonia; Quality of life; Translation; Validation; Voice