Validation of the European French Version of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf)

Abstract

ObjectiveThis study aimed to validate the French adaptation of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-Vf) for assessing voice disorders in France. The CAPE-Vf addresses limitations of the GRBAS by providing a more sensitive, standardized approach to evaluating six vocal parameters (overall severity, roughness, breathiness, strain, pitch, and loudness) on three tasks (sustained vowels, sentence reading, and spontaneous speech). The study focused on investigating the intra- and inter-rater reliability, as well as the convergent and discriminant validity of the CAPE-Vf. MethodsThirty-four dysphonic and seven euphonic native French speakers participated in the study. Thirteen speech-language pathologists from France evaluated the voice samples using both the CAPE-Vf and GRBAS tools at a one-week interval. Intra- and inter-rater reliability were calculated using intraclass correlation coefficients (ICC), while convergent and discriminant validity were measured by correlating CAPE-Vf with GRBAS and Voice Handicap Index (VHI) scores, respectively. ResultsThe CAPE-Vf showed good intra-rater reliability for overall severity (mean ICC: 0.89), strain (ICC: 0.83), and pitch (ICC: 0.88), while roughness, breathiness, and loudness exhibited moderate reliability. Inter-rater reliability was low for most parameters, except overall severity, which demonstrated good reliability (mean ICC: 0.77). Strong correlations were observed between CAPE-Vf and GRBAS Grade (mean r: 0.84), supporting its convergent validity. Moderate correlations were found for roughness, breathiness, and strain. The CAPE-Vf’s correlation with the VHI was moderate (mean r: 0.53), reflecting its discriminant validity. ConclusionThe CAPE-Vf is a valid and reliable tool for perceptual assessment of voice disorders in French-speaking populations, with stronger psychometric properties than the GRBAS, particularly for intra-rater reliability and overall severity. While inter-rater reliability was lower, qualitative feedback suggested that improvements to the protocol, particularly for pitch and loudness ratings, could enhance its clinical applicability. The findings support the CAPE-Vf as a comprehensive tool for standardized clinical voice assessment.