title: Voice Self-assessment Protocols: Different Trends Among Organic and Behavioral Dysphonias.
abstract: OBJECTIVE
  This study aimed to correlate the results of five self-assessment instruments for patients with behavioral or organic dysphonia (OD), and to analyze their relationship with listeners' judgments of degree of voice severity and predominant type of voice deviation.
  
  
  METHODS
  This is a cross-sectional prospective study.
  
  
  METHODS
  A total of 103 patients (77 with behavioral dysphonia, 26 with OD) completed the Brazilian validated versions of five instruments: Voice Handicap Index (VHI), Voice-Related Quality of Life, Vocal Performance Questionnaire, Voice Symptom Scale (VoiSS), and Vocal Tract Discomfort Scale. Voice samples were collected for auditory-perceptual analysis. Correlations were made among protocols, and between these instruments and the perceptual analysis.
  
  
  RESULTS
  None of the instruments correctly identified 100% of the dysphonic individuals. The VoiSS identified 100 of the 103 subjects. Numerous correlations were found with variable strength. The strongest correlation was between frequency and severity scales of the Vocal Tract Discomfort Scale (r = 0.946) and the total score of the VHI and VoiSS (r = 0.917). Correlations between the instruments and the perceptual analysis achieved only moderate strength; the VHI, the Voice-Related Quality of Life, and the VoiSS showed the highest correlations with counting numbers task, particularly for OD. The predominant type of voice deviation did not influence the score of the protocols.
  
  
  CONCLUSIONS
  None of the self-assessment instruments is capable of identifying all cases of dysphonia. However, they are important in assessing the impact of voice problem on quality of life. Patient self-assessment and clinician perceptual evaluation share only moderate correlations, with higher strength for counting numbers task in comparison with sustained vowel.
authors.affiliation: Speech-Language Pathology and Audiology Department, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil; Centro de Estudos da Voz-CEV, São Paulo, Brazil. Electronic address: mbehlau@cevfono.com.
authors.forename: Mara
authors.initials: M
authors.lastname: Behlau
authors.affiliation: Speech-Language Pathology and Audiology Department, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil; Centro de Estudos da Voz-CEV, São Paulo, Brazil; Sindicato dos Professores de São Paulo-SINPRO-SP, São Paulo, Brazil.
authors.forename: Fabiana
authors.initials: F
authors.lastname: Zambon
authors.affiliation: Speech-Language Pathology and Audiology Department, Universidade Federal de São Paulo-UNIFESP, São Paulo, Brazil; Centro de Estudos da Voz-CEV, São Paulo, Brazil.
authors.forename: Felipe
authors.initials: F
authors.lastname: Moreti
authors.affiliation: Centro de Estudos da Voz-CEV, São Paulo, Brazil.
authors.forename: Gisele
authors.initials: G
authors.lastname: Oliveira
authors.affiliation: Centro de Estudos da Voz-CEV, São Paulo, Brazil.
authors.forename: Euro
authors.initials: E
authors.lastname: de Barros Couto
mesh_terms: D000328:Adult; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D004644:Emotions; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D012649:Self Concept; D012720:Severity of Illness Index; D013061:Speech Acoustics; D013067:Speech Perception; D011795:Surveys and Questionnaires; D014833:Voice Quality; D055815:Young Adult
keywords: dysphonia; protocols; quality of life; self-assessment; voice