Efficiency and cutoff values of the Voice Activity and Participation Profile for nonteachers and teachers.

Fabiana Zambon,Mara Behlau,Felipe Moreti,Aline Cristina Tafarelo Vargas

doi:10.1590/2317-1782/20152015028

Abstract

To identify the efficiency characteristics and cutoff values of the dimensions of the Voice Activity and Participation Profile (VAPP) protocol, which discriminates the dysphonic and vocally healthy individuals; to verify if the cutoff values remain the same for a sample of teachers. Efficiency characteristics and cutoff values of VAPP data from 171 subjects were analyzed by receiver-operating characteristic (ROC) curve: 90 teachers (60 dysphonic and 30 vocally healthy individuals, with a similar mean age, p=0.418) and 81 nonteachers (48 dysphonic and 33 vocally healthy individuals, with a similar mean age, p=0.934). The area under the ROC curve (AUC) and the cutoff values of the total score of VAPP for discriminating the individuals with and without dysphonia are different for the nonteachers and teachers. The nonteachers presented AUC=0.986 (p<0.001) and 4.5 points of cutoff of the total score of VAPP (sensitivity=95.8%; specificity=90.9%); the teachers presented AUC=0.872 (p<0.001) and 14.6 points of cutoff of the total score of VAPP (sensitivity=91.7%, specificity=75.9%). The cutoff values of VAPP are different for the nonteachers and teachers, being higher for the teachers but with greater sensitivity and specificity for the nonteachers, and can be used to screen large populations with the risk of voice disorders.

Highlights

Communication takes on an increasingly important role in the professional market for individuals who depend on it as their main working tool
Using the receiver-operating characteristic (ROC) curve, we evaluated the efficiency characteristics and cutoff values of the Voice Activity and Participation Profile (VAPP) protocol[19] for 171 subjects divided into nonteachers and teachers: 48 dysphonic nonteachers and 33 vocally healthy nonteachers; 60 dysphonic teachers and 30 vocally healthy teachers
For the total score of the VAPP, the nonteachers presented area under the ROC curve (AUC)=0.986 (p

Summary

Introduction

Communication takes on an increasingly important role in the professional market for individuals who depend on it as their main working tool. Vocal alterations may represent a professional limitation, which can cause leaves from work, reduced income and productivity, and even the need to change profession[2]. Teachers often teach in poor conditions, for many hours a day, for a large number of students and in unfavorable environmental conditions. These factors, coupled with the lack of vocal training, collaborate with the high prevalence of vocal signs and symptoms and voice alterations in these professionals[4,5]

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