scholarly journals Measuring voice outcomes: state of the science review

2009 ◽  
Vol 123 (8) ◽  
pp. 823-829 ◽  
Author(s):  
P N Carding ◽  
J A Wilson ◽  
K MacKenzie ◽  
I J Deary
Keyword(s):  
Rating Scale ◽  
Outcome Measurement ◽  
Voice Quality ◽  
Voice Disorder ◽  
Acoustic Measurement ◽  
Vocal Performance ◽  
Sensitivity To Change ◽  
Expert Rating ◽  
Voice Outcome ◽  
Measurement Tools

AbstractResearchers evaluating voice disorder interventions currently have a plethora of voice outcome measurement tools from which to choose. Faced with such a wide choice, it would be beneficial to establish a clear rationale to guide selection. This article reviews the published literature on the three main areas of voice outcome assessment: (1) perceptual rating of voice quality, (2) acoustic measurement of the speech signal and (3) patient self-reporting of voice problems. We analysed the published reliability, validity, sensitivity to change and utility of the common outcome measurement tools in each area. From the data, we suggest that routine voice outcome measurement should include (1) an expert rating of voice quality (using the Grade-Roughness-Breathiness-Asthenia-Strain rating scale) and (2) a short self-reporting tool (either the Vocal Performance Questionnaire or the Vocal Handicap Index 10). These measures have high validity, the best reported reliability to date, good sensitivity to change data and excellent utility ratings. However, their application and administration require attention to detail. Acoustic measurement has arguable validity and poor reliability data at the present time. Other areas of voice outcome measurement (e.g. stroboscopy and aerodynamic phonatory measurements) require similarly detailed research and analysis.

scholarly journals Assessing the stigma content of urinary incontinence intervention outcome measures

2017 ◽  
Vol 4 ◽  
pp. 205566831773894 ◽  
Author(s):  
Kenneth Southall ◽  
Joshua R Tuazon ◽  
Abdul H Djokhdem ◽  
Eleanor A van den Heuvel ◽  
Walter Wittich ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Rating Scale ◽  
Outcome Measurement ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Health Care Interventions ◽  
Measurement Tools ◽  
Representative Model ◽  
Therapy Treatment

The goal of this narrative review is to evaluate the efficacy of available questionnaires for assessing the outcomes of “continence difficulty” interventions and to assess the selected questionnaires concerning aspects of stigmatization. The literature was searched for research related to urinary incontinence, as well as questionnaires and rating scale outcome measurement tools. The following sources were searched: Cochrane Library, EMBASE, Medline, and PubMed. The following keywords were used separately or in combination: “Urinary incontinence,” “therapy,” ”treatment outcome,” “patient satisfaction,” “quality of life,” “systematic reviews,” “aged 65+ years,” and “questionnaire.” The search yielded 194 references, of which 11 questionnaires fit the inclusion criteria; 6 of the 11 questionnaires did not have any stigma content and the content regarding stigma that was identified in the other five was very limited. A representative model of how stigma impacts continence difficulty interventions was proposed. While the 11 incontinence specific measurement tools that were assessed were well researched and designed specifically to measure the outcomes of incontinence interventions, they have not been used consistently or extensively and none of the measures thoroughly assess stigma. Further studies are required to examine how the stigma associated with continence difficulty impacts upon health care interventions.

scholarly journals Effects of physical therapy on mental function in patients with stroke

2019 ◽  
Vol 48 (2) ◽  
pp. 030006051986116
Author(s):  
Shanqi Yuan ◽  
Yanping He
Keyword(s):  
Physical Therapy ◽  
Rating Scale ◽  
Outcome Measurement ◽  
Mental Function ◽  
Post Intervention ◽  
Disability Rating Scale ◽  
Measurement Tools ◽  
Patient Health ◽  
Disability Rating ◽  
Therapy Clinic

Objective In this study, we aimed to determine the effects of physical therapy intervention on mental function in patients with stroke. Methods In this retrospective experimental study, we included 134 patients previously diagnosed with anxiety and depression who presented to our outdoor physical therapy clinic with hemiplegia owing to stroke during 2016 to 2018. The main interventions were neurodevelopmental techniques, strength training, stationary cycling, and shoulder wheel exercise. The treatment duration was 6 months, 5 days a week. Key outcome measurement tools included the Patient Health Questionnaire-9 (PHQ-9), Disability Rating Scale (DRS), and Functional Independent Measure (FIM). Baseline and post-interventional measurements were compared using a paired-sample t-test. Results Baseline scores on the PHQ-9, DRS, and FIM were 24.77±1.24, 19.67±1.25, and 20.77±1.74, respectively; post-intervention scores on these three scales were 9.08±0.49, 7.78±1.49, and 82.52±10.03 respectively. In the comparison, significant differences were observed between baseline and post-interventional scores. Conclusion We found that physiotherapy interventions improved motor function in patients with stroke as well as their mental function. Patients with stroke with impaired mental function can improve by participating in a physiotherapy treatment program.

scholarly journals Responsiveness of Impairment-based Outcome Measures in Individuals With Anterior Cruciate Ligament Reconstruction Following Physiotherapy

2021 ◽  
Vol 22 (2) ◽  
pp. 228-245
Author(s):  
Neda Mostafaee ◽  
◽  
Hossein Negahban ◽  
Mohammad Jafar Shaterzadeh Yazdi ◽  
Shahin Goharpey ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Rating Scale ◽  
Outcome Measurement ◽  
Dynamic Balance ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Measurement Tools ◽  
Anterior Cruciate ◽  
Clinical Changes

Objective: The primary purpose of physiotherapy in patients with Anterior Cruciate Ligament (ACL) reconstruction is to reduce pain, improve Range of Motion (ROM), muscle strength, and balance after surgery. Thus, therapists need outcome measurement tools with acceptable validity, reproducibility, and responsiveness to assess these changes after the intervention. This study investigates the responsiveness of the tools used to measure pain, ROM, knee muscle strength, and dynamic balance. We also want to determine minimal clinically significant change for these outcomes in patients with ACL reconstruction after physiotherapy. Materials & Methods: The study participants were 54 young patients with ACL reconstruction evaluated using impairment-based outcome measures of visual analog scale, goniometer, hand-held dynamometer, and Star Excursion Balance Test (SEBT) at baseline (2 weeks after ACL reconstruction ) and 4 weeks after physiotherapy. At the second phase of evaluation, the participants also completed the 7-point global change rating scale. For assessing the responsiveness of the tools, we used the Receiver Operating Characteristics (ROC) curve and correlation analysis Results: Analyzing the ROC curve showed that the knee extension ROM, quadriceps and hamstring strength, and medial and posteromedial directions under SEBT had acceptable responsiveness (>0.70). The Spearman correlation coefficient between the scores obtained for these outcomes and the score of 7-point global change rating scale were significant in the range of 0.36-0.51. For all the study outcome measurement tools, minimal significant clinical changes were reported. Conclusion: The results of this study support the responsiveness of goniometer for knee extension ROM, hand-held dynamometer for quadriceps and hamstring strength, and SEBT for dynamic balance at medial and posteromedial directions in the assessment of clinical changes in patients with ACL reconstruction. The reported minimal significant clinical changes for each tool can help the clinicians and researchers to decide on determining the actual significant change in the ACL patient’s clinical conditions after physiotherapy.

Optimising outcome assessment of voice interventions, I: reliability and validity of three self-reported scales

2007 ◽  
Vol 121 (8) ◽  
pp. 763-767 ◽  
Author(s):  
A L Webb ◽  
P N Carding ◽  
I J Deary ◽  
K MacKenzie ◽  
I N Steen ◽  
...  
Keyword(s):  
Reliability And Validity ◽  
Voice Handicap Index ◽  
Voice Disorder ◽  
Royal Infirmary ◽  
Data Sets ◽  
Vocal Performance ◽  
Symptom Scale ◽  
Voice Outcome ◽  
The Voice ◽  
Newcastle Upon Tyne

AbstractBackground:There is an increasing choice of voice outcome research tools, but good comparative data are lacking.Objective:To evaluate the reliability and validity of three voice-specific, self-reported scales.Design:Longitudinal, cohort comparison study.Setting:Two UK voice clinics: the Freeman Hospital, Newcastle upon Tyne, and the Glasgow Royal Infirmary.Participants:One hundred and eighty-one patients presenting with dysphonia.Main outcome measures:All patients completed the vocal performance questionnaire, the voice handicap index and the voice symptom scale. For comparison, each patient's voice was recorded and assessed perceptually using the grade–roughness–breathiness–aesthenia–strain scale. The reliability and validity of the three self-reported vocal performance measures were assessed in all subjects, while 50 completed the questionnaires again to assess repeatability.Results:The results of the 170 participants with completed data sets showed that all three questionnaires had high levels of internal consistency (Cronbach's alpha = 0.81–0.95) and repeatability (voice handicap index = 0.83; vocal performance questionnaire = 0.75; voice symptom scale = 0.63). Concurrent and criterion validity were also good, although, of the grade–roughness–breathiness–aesthenia–strain subscales, roughness was the least well correlated with the self-reported measures.Conclusion:The vocal performance questionnaire, the voice handicap index and the voice symptom scale are all reliable and valid instruments for measuring the patient-perceived impact of a voice disorder.

Implementation of Guidance nuanced Learning Model at MAN 1 Bandar Lampung

2020 ◽  
Vol 7 (1) ◽  
pp. 47-52
Author(s):  
Rifda El Fiah ◽  
Saiful Bahri
Keyword(s):  
Learning Outcomes ◽  
Learning Process ◽  
Formal Education ◽  
Rating Scale ◽  
Soft Skills ◽  
Student Learning Outcomes ◽  
Learning Model ◽  
Expert Rating ◽  
Hard Skills ◽  
Process Implementation

This research was conducted based on the problems that often arise in formal education learning. This problem has an impact on learning achievement results obtained by students. This research was conducted at MAN 1 Bandar Lampung. The purpose of this study was to determine the feasibility of the instructional model nuanced guidance data collection techniques using expert rating scale and user rating scale. The results of this study indicate that the nuanced learning model meets the achievement of student learning outcomes in MAN 1 Bandar Lampung, by developing students' knowledge and skills in the form of soft skills and hard skills. Guidance nuanced learning model design consists of learning process planning standards, learning process implementation standards, learning process outcome standards, and learning process control standards. 

scholarly journals Modelling of Amplitude Modulated Vocal Fry Glottal Area Waveforms Using an Analysis-by-Synthesis Approach

2021 ◽  
Vol 11 (5) ◽  
pp. 1990
Author(s):  
Vinod Devaraj ◽  
Philipp Aichinger
Keyword(s):  
Voice Quality ◽  
Low Frequency ◽  
Voice Disorder ◽  
Support Vector ◽  
Svm Classifier ◽  
Power Spectral ◽  
Analysis By Synthesis ◽  
Simple Support ◽  
Frequency Modulations ◽  
Synthesis Approach

The characterization of voice quality is important for the diagnosis of a voice disorder. Vocal fry is a voice quality which is traditionally characterized by a low frequency and a long closed phase of the glottis. However, we also observed amplitude modulated vocal fry glottal area waveforms (GAWs) without long closed phases (positive group) which we modelled using an analysis-by-synthesis approach. Natural and synthetic GAWs are modelled. The negative group consists of euphonic, i.e., normophonic GAWs. The analysis-by-synthesis approach fits two modelled GAWs for each of the input GAW. One modelled GAW is modulated to replicate the amplitude and frequency modulations of the input GAW and the other modelled GAW is unmodulated. The modelling errors of the two modelled GAWs are determined to classify the GAWs into the positive and the negative groups using a simple support vector machine (SVM) classifier with a linear kernel. The modelling errors of all vocal fry GAWs obtained using the modulating model are smaller than the modelling errors obtained using the unmodulated model. Using the two modelling errors as predictors for classification, no false positives or false negatives are obtained. To further distinguish the subtypes of amplitude modulated vocal fry GAWs, the entropy of the modulator’s power spectral density and the modulator-to-carrier frequency ratio are obtained.

Application of Psychometric Theory to the Measurement of Voice Quality Using Rating Scales

2005 ◽  
Vol 48 (2) ◽  
pp. 323-335 ◽  
Author(s):  
Rahul Shrivastav ◽  
Christine M. Sapienza ◽  
Vuday Nandur
Keyword(s):  
Measurement Errors ◽  
Rating Scales ◽  
Rating Scale ◽  
Voice Quality ◽  
Random Order ◽  
Past Research ◽  
Poor Agreement ◽  
Psychometric Theory ◽  
Point Rating Scale ◽  
Exact Agreement

Rating scales are commonly used to study voice quality. However, recent research has demonstrated that perceptual measures of voice quality obtained using rating scales suffer from poor interjudge agreement and reliability, especially in the midrange of the scale. These findings, along with those obtained using multidimensional scaling (MDS), have been interpreted to show that listeners perceive voice quality in an idiosyncratic manner. Based on psychometric theory, the present research explored an alternative explanation for the poor interlistener agreement observed in previous research. This approach suggests that poor agreement between listeners may result, in part, from measurement errors related to a variety of factors rather than true differences in the perception of voice quality. In this study, 10 listeners rated breathiness for 27 vowel stimuli using a 5-point rating scale. Each stimulus was presented to the listeners 10 times in random order. Interlistener agreement and reliability were calculated from these ratings. Agreement and reliability were observed to improve when multiple ratings of each stimulus from each listener were averaged and when standardized scores were used instead of absolute ratings. The probability of exact agreement was found to be approximately .9 when using averaged ratings and standardized scores. In contrast, the probability of exact agreement was only .4 when a single rating from each listener was used to measure agreement. These findings support the hypothesis that poor agreement reported in past research partly arises from errors in measurement rather than individual differences in the perception of voice quality.

scholarly journals Optimising outcome assessment of voice interventions, II: sensitivity to change of self-reported and observer-rated measures

2007 ◽  
Vol 122 (1) ◽  
pp. 46-51 ◽  
Author(s):  
I N Steen ◽  
K MacKenzie ◽  
P N Carding ◽  
A Webb ◽  
I J Deary ◽  
...  
Keyword(s):  
General Health ◽  
Voice Quality ◽  
Voice Handicap Index ◽  
Effect Sizes ◽  
Voice Therapy ◽  
Vocal Performance ◽  
Symptom Scale ◽  
Wide Range ◽  
The Voice ◽  
Responsiveness To Change

AbstractObjectives:A wide range of well validated instruments is now available to assess voice quality and voice-related quality of life, but comparative studies of the responsiveness to change of these measures are lacking. The aim of this study was to assess the responsiveness to change of a range of different measures, following voice therapy and surgery.Design:Longitudinal, cohort comparison study.Setting:Two UK voice clinics.Participants:One hundred and forty-four patients referred for treatment of benign voice disorders, 90 undergoing voice therapy and 54 undergoing laryngeal microsurgery.Main outcome measures:Three measures of self-reported voice quality (the vocal performance questionnaire, the voice handicap index and the voice symptom scale), plus the short form 36 (SF 36) general health status measure and the hospital anxiety and depression score. Perceptual, observer-rated analysis of voice quality was performed using the grade–roughness–breathiness–asthenia–strain scale. We compared the effect sizes (i.e. responsiveness to change) of the principal subscales of all measures before and after voice therapy or phonosurgery.Results:All three self-reported voice measures had large effect sizes following either voice therapy or surgery. Outcomes were similar in both treatment groups. The effect sizes for the observer-rated grade–roughness–breathiness–asthenia–strain scale scores were smaller, although still moderate. The roughness subscale in particular showed little change after therapy or surgery. Only small effects were observed in general health and mood measures.Conclusion:The results suggest that the use of a voice-specific questionnaire is essential for assessing the effectiveness of voice interventions. All three self-reported measures tested were capable of detecting change, and scores were highly correlated. On the basis of this evaluation of different measures' sensitivities to change, there is no strong evidence to favour either the vocal performance questionnaire, the voice handicap index or the voice symptom scale.

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