The Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) Psychometric Characteristics: II European Portuguese Version (II EP CAPE-V)

Abstract

The purpose of this study was to assure a reliable and valid European Portuguese (EP) version of Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V). This resulted in the second EP version of CAPE-V (II EP CAPE-V), with permission granted by American Speech-Language-Hearing Association. This is a transversal, observational, descriptive, and comparative study. Retranslation of CAPE-V into EP was reviewed by an EP linguistic expert for content validity. A total of 20 subjects: 10 male individuals (mean age = 45) and 10 female individuals (mean age = 43) formed a control group (n = 10) and a dysphonic group (n = 10) were matched by age and gender. All subjects' CAPE-V phonatory tasks were captured with PEYLE PMENI (China) microphone and recorded with TASCAM DR-05 (Tokyo, Japan). Fourteen speech-language pathologists voice experts (>5 years of clinical practice) rated 26 voice samples with 6 repeated samples added for intrarater reliability. All voice samples were heard using AKG K101 (Europe) headphones and were rated in two sessions with a 1-week interval: one with the II EP CAPE-V; and the second with the GRBAS scale to establish for inter-rater reliability and construct and concurrent validity. Statistical analysis for inter-rater reliability was obtained with the intraclass correlation coefficient. Intrarater reliability was obtained with Pearson correlation. Construct and concurrent validity were performed with Student t test and multiserial correlation coefficient, respectively. SPSS 22.0 (IBM Corp, Armonk, NY) and LISREL 8.8 (Scientific Software International, Inc, Chicago, IL) were used with significance level cut-off points: r > 0.70 and α = 0.05. High inter-rater reliability was obtained for all vocal parameters (intraclass correlation coefficient  > 0.84) revealing good equivalence. Intrarater reliability was high (r > 0.87) for overall severity, breathiness, and pitch; good (r = 0.73) for strain; and moderate (r > 0.61) for roughness and loudness. These results revealed good reproducibility and stability of the II EP CAPE-V over time. Content validity was assured by an EP linguistic expert. Construct validity was obtained for all vocal parameters (P < 0.05), except for strain (P = 0.52), revealing these were the salient parameters for rating normal and dysphonic voices samples. Concurrent validity between the II EP CAPE-V and the GRBAS scales had strong correlations (r > 0.89) for overall severity/grade, roughness, and breathiness parameters, suggesting both instruments measure the same construct. The II EP CAPE-V is a reliable and valid instrument for auditory-perceptual evaluation of the EP population, with all psychometric measures assured.