Patient Perception and Clinician Ratings of Voice Disorder Severity

Student: Elissa DollResearch Advisor: Sue Hume, Ph.D., CCC-SLPStatistical Analysis: Mark Hedrick, Ph.D.

Background• “A voice disorder occurs when voice quality,

pitch, and loudness differ or are inappropriate for an individual’s age, gender, cultural background, or geographic location” (American Speech-Language Hearing Association [ASHA], “Voice Disorders")

• It is estimated that 3-9% of Americans have a voice disorder (dysphonia). (American Speech-Language Hearing Association [ASHA], “Voice Disorders")

• How speech pathologists assess dysphonia: perceptual and acoustic measures, stroboscopy(if ordered by a physician), case history, and patient rating

Purpose of the Study• The goal of this study was to determine if there is

a correlation between patient perception of the severity of their voice disorder and clinician rating of severity.

Participants• 89 patients from the UTHSC Hearing and

Speech Center diagnosed with dysphonia• 15-88 years old, 16 males and 73 females

Procedure• Retrospective analysis of patient records from

2015 to 2019• Assessments chosen for this study:Ø Consensus Auditory Perceptual Evaluation of

Voice (CAPE-V) to measure the clinician perception of the severity of dysphonia based on overall severity, roughness, breathiness, strain, and pitch (American Speech-Language Hearing Association, “Consensus Auditory Perceptual Evaluation [CAPE-V]," 2006)

Ø Voice Handicap Index (VHI) to measure patient’s perceived impact of their dysphonia on as it relates to functional, physical, and emotional aspects of their lives (Behrman, Sulica, He, 2004)

• CAPE-V and VHI scores were recorded• Statistically analyzed using the Pearson Product

Moment Correlation to determine the correlation between the CAPE-V and VHI scores

Results

(Scatterplot from Dr. Hedrick)

Results Continued• A correlation of r=0.558 (<0.001) was found

between CAPE-V and VHI scores for all patients• Results indicate that patients’ perception and

clinicians’ perception have a positive correlation• Patients’ perception of the impact of their voice

disorder on the VHI is generally consistent with clinician rating of severity on the CAPE-V

• No statistically significant difference in gender or occupation / lack thereof

• However, the sample has an unequal ratio between genders

Discussion• Clinicians should take patients’ feelings and

impacts into consideration when diagnosing and treating voice disorders.

• Occupation did not seem to be a significant factor.• Future research should consider identifying

differences between gender and occupationLiterary Discussion• Results are consistent with findings by Sardesai

et al. where patient perception of impact and clinician ratings are consistent when the CAPE-V, VHI, and GRBAS are used.

• Sardesai et al. also did not find a relationship between age and gender for patients’ perceptions

ReferencesBehrman, A., Sulica, L., & He, T. (2004). Factors Predicting Patient Perception of Dysphonia Caused by Benign Vocal Fold Lesions. The Laryngoscope,114(10), 1693-1700. doi:10.1097/00005537-200410000-00004Bonilha, H. S., Desjardins, M., Garand, K. L., & Martin-Harris, B. (2017, November 2). Parameters and Scales Used to Assess and Report Findings From Stroboscopy: A Systematic Review. Journal of Voice, 32(6), 734-755. doi:10.1016 Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). (2006). Retrieved September 18, 2018, from www.asha.org/uploadedFiles/members/divs/D3CAPEVprocedures.pdf.Golub, J. S.; Chen, P., Otto; K. J., Hapner, E.; and Johns, M. M. (2006), Prevalence of Perceived Dysphonia in a Geriatric Population. Journal of the American Geriatrics Society, 54: 1736-1739. doi:10.1111/j.1532-5415.2006.00915.xSardesai, M. G., Merati, A. L., Hu, A., & Birkent, H. (2016). Impact of Patient-Related Factors on the Outcomes of Office-Based Injection Laryngoplasty. The Laryngoscope,(126), 1806-1809. doi:10.1002 (Sardesai, Merati, Birkent, 2016)Voice Disorders. (n.d.). Retrieved March 4, 2019, from http://www.asha.org/PRPSpecificTopic.aspx?folderid=8589942600§ion

18%

82%

Gender of Participants

Male Female

VH

I

CAPE-V