Auditory-Perceptual Evaluation of Voice Quality of Cochlear-implanted and Normal-hearing Individuals: A Reliability Study.
OBJECTIVE
This study aimed to present an experience in rating voices of adults with normal hearing and adults with cochlear implants and critically examine the outcomes, discussing pros and cons of the methodology used.


METHODS
This is a cross-sectional, prospective study.


METHODS
One hundred and fifty voice samples, consisting of 50 sustained vowels, 50 samples of connected speech, and 50 samples of conversational speech, belonging to 25 adults with hearing impairment with cochlear implants and 25 adults with normal hearing, were perceptually analyzed for inter-rater agreement and intra-rater reliability. Three experienced judges rated the voice samples using visual analog scales of parameters considered relevant for cochlear-implanted population such as articulation, intonation, and resonance. The raters participated in three training sessions for calibration and had 1 month to complete the ratings individually. Twenty percent of the samples were repeated randomly to verify intra-rater reliability. The levels of agreement and reliability were verified using the interclass correlation coefficient.


RESULTS
The inter-rater agreement varied widely across the parameters and speech tasks, from poor to excellent agreement. The only parameter for which the raters maintained consistently good or excellent agreement for all groups and emissions was the pitch. For intra-rater reliability, two of the raters presented excellent reliability for most parameters across all of the speech tasks, whereas one rater presented more inconsistencies.


CONCLUSIONS
In this reliability study, factors such as extensive deadline for the auditory perceptual evaluation, lack of periodic recalibration, speech tasks, and familiarity with the population studied were identified as factors that contributed to inconsistent reliability results.
Postgraduate Program in Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília, Distrito Federal 70910-900, Brazil. Electronic address: anacrisccoelho@yahoo.com.br.
Ana Cristina
AC
Coelho
Speech-Language Pathology Department, Bauru School of Dentistry, University of São Paulo, Al Octávio Pinheiro Brisola, 9-75, Bauru, São Paulo 17012-901, Brazil.
Alcione Ghedini
AG
Brasolotto
Speech-Language Pathology Course, Centro Universitário Planalto do Distrito Federal, Avenida Pau Brasil, lote 02 S/N, Águas Claras, Brasília, Distrito Federal, Brazil.
Ana Carolina Nascimento
ACN
Fernandes
Brasília Teaching Hospital, University of Brasília, SGAN 605, Av. L2 Norte, Brasília, Distrito Federal 70840-901, Brazil.
Daniela Malta
DM
de Souza Medved
Speech-Language Pathology Course, University of Brasília, Centro Metropolitano, Conjunto A, lote 01, Brasília, Distrito Federal 72220-275, Brazil.
Eduardo Magalhães
EM
da Silva
Postgraduate Program in Health Sciences, University of Brasília, Campus Universitário Darcy Ribeiro, Brasília, Distrito Federal 70910-900, Brazil.
Fayez Bahmad
FB
Júnior
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D019929:Cochlear Implantation / Q000295:instrumentation*; D003054:Cochlear Implants; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007600:Judgment; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D019986:Persons with Hearing Disabilities / Q000523:psychology / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D013061:Speech Acoustics; D013067:Speech Perception; D013068:Speech Production Measurement; D014833:Voice Quality; D055815:Young Adult
Auditory-perceptual evaluation; Voice; Voice assessment; Voice disorders; Voice quality