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GRBAS和CAPE-V量表中文听感知评估一致性分析

The Intra-rater and Inter-rater Consistency of GRBAS and CAPE-V in Chinese Context

刘阳;刘恒鑫;屈歌;李瑞香;黄冬雁

1:中国人民解放军总医院第六医学中心/耳鼻咽喉头颈外科医学部/国家耳鼻咽喉疾病临床医学研究中心

2:国家儿童医学中心/首都医科大学附属北京儿童医院耳鼻咽喉头颈外科/儿童耳鼻咽喉头颈外科疾病北京市重点实验室

3:西安音乐学院嗓音研究中心

4:北京语言大学语言康复学院

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摘要

目的评估在中文语境下GRBAS和CAPE-V的评估者内和评估者间一致性。方法 5名嗓音相关专业人员使用《发音评估助手》APP对抽取自解放军总医院第六医学中心病理嗓音数据库V1.0的52例语音样本进行GRBAS和CAPE-V评估，52例用于评估者间一致性分析，其中的38例用于评估者内部一致性评估。使用ICC对CAPE-V进行评估者内和评估者间一致性分析，采用Cohen's Kappa方法对GRBAS的5个特征进行评估者内一致性分析，采用Fleiss Kappa方法对GRBAS评估者间一致性进行分析，并对两个量表中相同的特征进行Spearman相关性分析。结果评估者内一致性分析结果示，CAPE-V 6个特征均呈现出高的一致性，各特征的ICC系数分别为总体音质(OS)=0.80,粗糙度(R)=0.69,气息音(B)=0.77,紧张度(S)=0.75,音调异常程度(P)=0.74,响度异常程度(L)=0.78;GRBAS除特征G(0.48)和S(0.45)存在较弱的评估者内一致性外，其余特征的评估者内一致性均较差。评估者间一致性分析结果示，CAPE-V各特征的ICC相关系数均大于0.85,提示不同评估者对各特征的评分均具有很高的一致性；GRBAS除G特征(相关系数=0.48)外，其余特征的相关系数均小于0.40,说明除特征G外，其余特征的评估者间一致性均较差。在同时使用GRBAS和CAPE-V对同一样本进行评估时，总体音质(OS/G)、粗糙度(R)、气息音(B)、紧张度(S)的Spearman相关系数分别为0.89、0.85、0.91、0.91,提示两个量表中的这4个特征的评分结果具有高度相关性。结论在中文语音样本的听感知评估中，CAPE-V量表的评估者内和评估者间一致性更高，较GRBAS量表更适用于临床。

关键词

GRBAS评估;共识听觉-知觉嗓音评估;评估者内部一致性;评估者间一致性;中文语境

基金项目(Foundation):

北京市自然科学基金(7232170)

作者

刘阳;刘恒鑫;屈歌;李瑞香;黄冬雁

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GRBAS评估共识听觉-知觉嗓音评估评估者内部一致性评估者间一致性中文语境

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刘阳刘恒鑫屈歌李瑞香黄冬雁