Auditory-perceptual Assessment of Healthy and Disordered Voices Using the Voice Deviation Scale

Objective: This study aims to (1) determine the cut-off values of the Global Severity of vocal deviation on the Visual Analog Scale (VAS) from the numerical scale ratings, and (2) identify the cut-off values according to different degrees of vocal deviation used by Voice-Specialized Speech-Language Pathologists (SLP). Study design: Prospective study. Methods: The auditory-perceptual assessment was performed by four SLPs using two protocols with different scales: the VAS and the 4-point numerical scale. Among the 211 voices analyzed, 147 corresponded to female participants, and 64 corresponded to males, plus 20% repeated voice samples. Participants were between 19 and 60 years. All of them were asked to count from 1 to 10 and were recorded in a sound-proof booth. For both protocols, the judges scored the overall severity. One SLP was excluded from the analysis due to inconsistency during the perceptual assessment. Results: For normal voice and mild deviations, overall severity cut-off score on the VAS was 21. For mild-moderate deviations, the cut-off was 55; and 81 points for moderate and severe deviations. The Area Under the Curve values correspond to 0.725, 0.905 and 0.851, respectively. Conclusions: Our results suggest that the VAS is a good instrument to be used during voice assessment performed by Chilean SLPs. However, it evidences possible differences in voice analysis perception with other cut-off scores performed in other countries, which can be compared to future studies.