Validation of the Acoustic Voice Quality Index in the Japanese Language.
OBJECTIVE
The Acoustic Voice Quality Index (AVQI) is a multivariate construct for quantification of overall voice quality based on the analysis of continuous speech and sustained vowel. The stability and validity of the AVQI is well established in several language families. However, the Japanese language has distinct characteristics with respect to several parameters of articulatory and phonatory physiology. The aim of the study was to confirm the criterion-related concurrent validity of AVQI, as well as its responsiveness to change and diagnostic accuracy for voice assessment in the Japanese-speaking population.


METHODS
This is a retrospective study.


METHODS
A total of 336 voice recordings, which included 69 pairs of voice recordings (before and after therapeutic interventions), were eligible for the study. The auditory-perceptual judgment of overall voice quality was evaluated by five experienced raters. The concurrent validity, responsiveness to change, and diagnostic accuracy of the AVQI were estimated.


RESULTS
The concurrent validity and responsiveness to change based on the overall voice quality was indicated by high correlation coefficients 0.828 and 0.767, respectively. Receiver operating characteristic analysis revealed an excellent diagnostic accuracy for discrimination between dysphonic and normophonic voices (area under the curve: 0.905). The best threshold level for the AVQI of 3.15 corresponded with a sensitivity of 72.5% and specificity of 95.2%, with the positive and negative likelihood ratios of 15.1 and 0.29, respectively.


CONCLUSIONS
We demonstrated the validity of the AVQI as a tool for assessment of overall voice quality and that of voice therapy outcomes in the Japanese-speaking population.
Department of Otorhinolaryngology, Osaka Police Hospital, Osaka, Japan; Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: khosokawa@wg8.so-net.ne.jp.
Kiyohito
K
Hosokawa
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Medical School, Hochschule Fresenius University of Applied Sciences, Hamburg, Germany.
Ben
B
Barsties
Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Toshihiko
T
Iwahashi
Nimura ENT Voice Clinic, Osaka, Japan.
Mio
M
Iwahashi
Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Chieri
C
Kato
Department of Otorhinolaryngology and Head & Neck Surgery, Kobe University Graduate School of Medicine, Hyogo, Japan.
Shinobu
S
Iwaki
Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Surgery, Kuma Hospital, Hyogo, Japan.
Hisanori
H
Sasai
Department of Surgery, Kuma Hospital, Hyogo, Japan.
Akira
A
Miyauchi
Department of Otorhinolaryngology, Osaka Police Hospital, Osaka, Japan; Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Naoki
N
Matsushiro
Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Hidenori
H
Inohara
Department of Otorhinolaryngology and Head & Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Makoto
M
Ogawa
Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; European Institute for ORL, Sint-Augustinus Hospital, Antwerp, Belgium; Faculty of Education, Health & Social Work, University College Ghent, Ghent, Belgium.
Youri
Y
Maryn
D000162:Acoustics; D000328:Adult; D000368:Aged; D019540:Area Under Curve; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007564:Japan; D007600:Judgment; D007802:Language; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010699:Phonation; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D013066:Speech-Language Pathology / Q000379:methods*; D013997:Time Factors; D014832:Voice Disorders / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D014833:Voice Quality
Acoustic Voice Quality Index; Japanese language; auditory-perceptual judgment; multivariate acoustic measurement; voice disorders