title: Auditory-perceptual Evaluation of Normal and Dysphonic Voices Using the Voice Deviation Scale.
abstract: OBJECTIVE
  This study aims to (1) determine the cutoff values of the overall severity (OS) of vocal deviation on the visual analog scale (VAS) based on the ratings of the numerical scale (NS); and (2) verify the power of discrimination of these cutoff values according to different degrees of vocal deviation.
  
  
  METHODS
  This is a prospective study.
  
  
  METHODS
  The auditory-perceptual evaluation was performed by four speech-language pathologists who used two protocols with different scalar properties: the VAS and the 4-point NS. Vocal samples from142 women and 69 men, plus 10% of repetition, with and without vocal complaints, ranging from 19 to 60 years were included. The analyzed speaking task was the counting from 1 to 10. For both protocols, the judges rated the OS.
  
  
  RESULTS
  Based on the correspondence between the two scales, the cutoff values of the OS on the VAS obtained were 35.5, 50.5, and 90.5 points. The 35.5 value corresponds to the cutoff point between normal variability and mild/moderate vocal deviations; the 50.5 value corresponds to the cutoff point between mild/moderate and moderate vocal deviations; the 90.5 value corresponds to the cutoff point between moderate and severe deviations. Areas under the receiver operating characteristic curve for the three cutoff values were 0.918, 0.948, and 0.970, respectively.
  
  
  CONCLUSIONS
  The cutoff values of the OS on the VAS were obtained, and the areas under the ROC curve showed that all the three cutoff points had excellent accuracy that represents a higher power of discrimination of different degrees of vocal deviations.
authors.affiliation: Centro de Estudos da Voz (CEV), Department of Otolaryngology, School of Medicine, Universidade de São Paulo (USP), São Paulo, Brazil. Electronic address: r.yamasaki@uol.com.br.
authors.forename: Rosiane
authors.initials: R
authors.lastname: Yamasaki
authors.affiliation: Centro de Estudos da Voz (CEV), São Paulo, Brazil.
authors.forename: Glaucya
authors.initials: G
authors.lastname: Madazio
authors.affiliation: Speech Science, School of Psychology and Centre for Brain Research, The University of Auckland, Auckland.
authors.forename: Sylvia H S
authors.initials: SHS
authors.lastname: Leão
authors.affiliation: Centro de Estudos da Voz (CEV), Instructor Professor of Speech Language Pathology and Audiology Course of Faculdade de Ciências Médicas da Santa Casa de São Paulo, Assistant Professor of Speech Language Pathology and Audiology Course of UniFMU Rede Laureate.
authors.forename: Marina
authors.initials: M
authors.lastname: Padovani
authors.affiliation: Department of Speech-language Pathology and Audiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.
authors.forename: Renata
authors.initials: R
authors.lastname: Azevedo
authors.affiliation: Centro de Estudos da Voz (CEV), Department of Speech-language Pathology and Audiology, Universidade Federal de São Paulo (UNIFESF), São Paulo, Brazil.
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
mesh_terms: D000328:Adult; D019540:Area Under Curve; D016022:Case-Control Studies; D055154:Dysphonia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013061:Speech Acoustics; D013067:Speech Perception; D013066:Speech-Language Pathology / Q000379:methods*; D014833:Voice Quality; D055815:Young Adult
keywords: Auditory-perceptual evaluation; Dysphonia; Rating scales; Vocal screening; Voice assessment