嗓音主观评估中文测试文本的信度和效度研究

Reliability and Validity of Auditory-perceptual Evaluation Dodumentation of the Mandarin Version

舒敏;张毅;蒋家琪;

1:复旦大学附属眼耳鼻喉科医院

摘要

目的对已建立的嗓音主观评估中文测试文本进行信度和效度分析。方法随机选择以发声障碍就诊的患者196例(试验组),其中男92例,年龄22～75岁,平均45.6±10.3岁,女104例,年龄18～69岁,平均40.9±9.6岁;选择无嗓音障碍病史、无咽喉疾患、无吸烟饮酒史、喉镜检查声带无明显异常者24例作为对照组,其中男10例,年龄29～58岁,平均33.9±9.0岁,女14例,年龄23～71岁,平均38.0±12.4岁。对两组受试者的嗓音元音样本/a/进行声学分析,观察频率微扰、振幅微扰、信噪比、倒频谱峰值突出、关联维、二阶墒等指标,10名听评委通过已建立的主观评估中文测试文本对275例声音样本(包括55例重复样本)进行主观分析,信度分析包括评委自身稳定性及评委间一致性;效度分析为主观评估和声学分析的一致性,以及该测试文本对正常嗓音和病理嗓音的鉴别能力。结果评委自身稳定性较高,Pearson相关系数为0.687～0.748;评委间一致性较好,组内相关系数为0.589～0.685;主观分析结果与客观分析值显著相关(P<0.01);受试者操作特征曲线下面积为0.948～0.96,测试文本对正常及病理嗓音的鉴别力良好,相邻嗓音障碍等级的受试者其客观分析值差异有显著统计学意义(P<0.01)。结论所设计的主观评估中文测试文本具有较高的信度和效度,具有潜在临床应用价值。

关键词

嗓音疾病;主观评估;声学分析;中文

基金项目(Foundation):

国家自然科学基金青年科学基金（81800896）、国家自然科学基金面上项目（81870710）资助

作者

舒敏;张毅;蒋家琪;

参考文献

1 Kreiman J,Gerratt BR,Kempster GB,et al.Perceptual evaluation of voice quality:review,tutorial,and a framework for future research[J].J Speech Lang Hear Res,1993,36:21.

2 Revis J,Giovanni A,Wuyts F,et al.Comparison of different voice samples for perceptual analysis[J].Folia Phoniatr Logop,1999,51:108.

3 Zraick RI,Kempster GB,Connor NP,et al.Establishing validity of the consensus auditory-perceptual evaluation of voice (CAPE-V)[J].Am J Speech Lang Pathol,2011,20:14.

4 Kempster GB,Gerratt BR,Verdolini Abbott K,et al.Consensus auditory-perceptual evaluation of voice:development of a standardized clinical protocol[J].Am J Speech Lang Pathol,2009,18:124.

5 Gerratt BR,Kreiman J,Antonanzas-Barroso N,et al.Comparing internal and external standards in voice quality judgments[J].J Speech Lang Hear Res,1993,36:14.

6 Kreiman J,Gerratt BR,Precoda K,et al.Individual differences in voice quality perception[J].J Speech Lang Hear Res,1992,35:512.

7 Chan KM,Yiu EM.The effect of anchors and training on the reliability of perceptual voice evaluation[J].J Speech Lang Hear Res,2002,45:111.

8 Awan SN,Lawson LL.The effect of anchor modality on the reliability of vocal severity ratings[J].J Voice,2009,23:341.

9 Yu P,Revis J,Wuyts FL,et al.Correlation of instrumental voice evaluation with perceptual voice analysis using a modified visual analog scale[J].Folia Phoniatr Logop,2002,54:271.

10 Halberstam B.Acoustic and perceptual parameters relating to connected speech are more reliable measures of hoarseness than parameters relating to sustained vowels[J].ORL,2004,66:70.

11 Heman-Ackah YD,Heuer RJ,Michael DD,et al.Cepstral peak prominence:a more reliable measure of dysphonia[J].Ann Otol Rhinol Laryngol,2003,112:324.

12 Heman-Ackah YD,Michael DD,Goding GS.The relationship between cepstral peak prominence and selected parameters of dysphonia[J].J Voice,2002,16:20.

13 Awan SN,Roy N,Dromey C.Estimating dysphonia severity in continuous speech:application of a multi-parameter spectral/cepstral model[J].Clin Linguist Phon,2009,23:825.

14 Zhang Y,Jiang JJ,Wallace SM,et al.Comparison of nonlinear dynamic methods and perturbation methods for voice analysis[J].J Acoust Soc Am,2005,118:2551.

15 Choi SH,Zhang Y,Jiang JJ,et al.Nonlinear dynamic-based analysis of severe dysphonia in patients with vocal fold scar and sulcus vocalis[J].J Voice,2012,26:566.

16 Zhang Y,McGilligan C,Zhou L,et al.Nonlinear dynamic analysis of voices before and after surgical excision of vocal polyps[J].J Acoust Soc Am,2004,115:2270.

17 MacCallum JM,Olszewski AE,Zhang Y,et al.Effects of low-pass filtering on acoustic analysis of voice[J].J Voice,2011,25:15.

18 Karnell MP,Melton SD,Childes JM,et al.Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders[J].J Voice,2007,21:576.

19 Kelchner LN,Brehm SB,Weinrich B,et al.Perceptual evaluation of severe pediatric voice disorders:rater reliability using the consensus auditory perceptual evaluation of voice[J].J Voice,2010,24:441.

20 Kreiman J,Gerratt BR.Sources of listener disagreement in voice quality assessment[J].J Acoust Soc Am,2000,108:1867.

21 Bele IV.Reliability in perceptual analysis of voice quality[J].J Voice,2005,19:555.

22 Bielamowicz S,Kreiman J,Gerratt BR,et al.Comparison of voice analysis systems for perturbation measurement[J].J Speech Lang Hear Res,1996,39:126.

23 Awan SN,Roy N,Jiang JJ.Nonlinear dynamic analysis of disordered voice:the relationship between the correlation dimension (D2) and pre-/post-treatment change in perceived dysphonia severity[J].J Voice,2010,24:285.

24 Sprecher A,Olszewski A,Jiang JJ,et al.Updating signal typing in voice:addition of type 4 signals[J].J Acoust Soc Am,2010,127:3710.

25 Maryn Y,Corthals P,Van Cauwenberge P,et al.Toward improved ecological validity in the acoustic measurement of overall voice quality:combining continuous speech and sustained vowels[J].J Voice,2010,24:540.

26 Zhuang P,Sprecher AJ,Hoffman MR,et al.Phonation threshold flow measurements in normal and pathological phonation[J].Laryngoscope,2009,119:811.

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