title: Efficiency and cutoff values of the Voice Activity and Participation Profile for nonteachers and teachers.
abstract: OBJECTIVE
  To identify the efficiency characteristics and cutoff values of the dimensions of the Voice Activity and Participation Profile (VAPP) protocol, which discriminates the dysphonic and vocally healthy individuals; to verify if the cutoff values remain the same for a sample of teachers.
  
  
  METHODS
  Efficiency characteristics and cutoff values of VAPP data from 171 subjects were analyzed by receiver-operating characteristic (ROC) curve: 90 teachers (60 dysphonic and 30 vocally healthy individuals, with a similar mean age, p=0.418) and 81 nonteachers (48 dysphonic and 33 vocally healthy individuals, with a similar mean age, p=0.934).
  
  
  RESULTS
  The area under the ROC curve (AUC) and the cutoff values of the total score of VAPP for discriminating the individuals with and without dysphonia are different for the nonteachers and teachers. The nonteachers presented AUC=0.986 (p<0.001) and 4.5 points of cutoff of the total score of VAPP (sensitivity=95.8%; specificity=90.9%); the teachers presented AUC=0.872 (p<0.001) and 14.6 points of cutoff of the total score of VAPP (sensitivity=91.7%, specificity=75.9%).
  
  
  CONCLUSIONS
  The cutoff values of VAPP are different for the nonteachers and teachers, being higher for the teachers but with greater sensitivity and specificity for the nonteachers, and can be used to screen large populations with the risk of voice disorders.
authors.affiliation: Centro de Estudos da Voz, Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Zambon
authors.affiliation: Centro de Estudos da Voz, Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Moreti
authors.affiliation: Centro de Estudos da Voz, Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Aline Cristina Tafarelo
authors.initials: AC
authors.lastname: Vargas
authors.affiliation: Centro de Estudos da Voz, Departamento de Fonoaudiologia, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
mesh_terms: D016022:Case-Control Studies; D059026:Diagnostic Self Evaluation; D055154:Dysphonia / Q000503:physiopathology*; D005178:Faculty; D005260:Female; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000503:physiopathology; D011788:Quality of Life; D012372:ROC Curve; D012016:Reference Values; D015203:Reproducibility of Results; D057566:Self Report / Q000592:standards*; D064232:Visual Analog Scale; D014831:Voice / Q000502:physiology*