The relationship between subjective self-rating and objective voice assessment measures

Abstract

Introduction. Comprehensive protocols of voice disorders have to consist of both subjective and objective tools to study vocal performance. Comparing subjective to objective measures is essential to determine their usefulness in assessing dysphonia. Aim. The aim of the study is to study the correlation of objective voice measures and the patient's subjective self-rating assessment. Subjects and methodology. A total of 100 patients with voice complaints due to various pathological disorders were subjected to voice assessment protocol using: auditory perceptual assessment, acoustic voice assessment, aerodynamic measures, and Voice Problem Self-Assessment Scale (VPSS). Results. The results revealed a variable correlation between functional and emotional clusters of VPSS and overall grade of dysphonia. A moderate correlation between Dysphonia Severity Index (DSI) and VPSS total and emotional cluster was found. Acoustic parameters such as Shim (Shimmer Percent), APQ (Amplitude Perturbation Quotient), and NHR (Noise to Harmonic Ratio), in addition to MPT (Maximum Phonation Time), contributed to total VPSS and emotional cluster scores. The subglottic pressure was the only predictor variable for phonasthenic cluster scores. Conclusion. This cross-sectional study highlights that patients’ self-perception of a voice problem is related to their difficulty in sustaining controlled loudness and adequate glottic closure rather than in controlling frequency irregularity.