嗓音主观评估中文测试文本的信度和效度研究  

Reliability and Validity of Auditory-perceptual Evaluation Dodumentation of the Mandarin Version

作　　者：舒敏[1] 张毅[1] 蒋家琪[1] Shu Min;Zhang Yi;Jiang Jiaqi(EENT Hospital Affiliated to Fudan University,Shanghai,200031,China)

机构地区：[1]复旦大学附属眼耳鼻喉科医院

出　　处：《听力学及言语疾病杂志》2020年第1期19-23,共5页Journal of Audiology and Speech Pathology

基　　金：国家自然科学基金青年科学基金（81800896）、国家自然科学基金面上项目（81870710）资助

摘　　要：目的对已建立的嗓音主观评估中文测试文本进行信度和效度分析。方法随机选择以发声障碍就诊的患者196例(试验组),其中男92例,年龄22~75岁,平均45.6±10.3岁,女104例,年龄18~69岁,平均40.9±9.6岁;选择无嗓音障碍病史、无咽喉疾患、无吸烟饮酒史、喉镜检查声带无明显异常者24例作为对照组,其中男10例,年龄29~58岁,平均33.9±9.0岁,女14例,年龄23~71岁,平均38.0±12.4岁。对两组受试者的嗓音元音样本/a/进行声学分析,观察频率微扰、振幅微扰、信噪比、倒频谱峰值突出、关联维、二阶墒等指标,10名听评委通过已建立的主观评估中文测试文本对275例声音样本(包括55例重复样本)进行主观分析,信度分析包括评委自身稳定性及评委间一致性;效度分析为主观评估和声学分析的一致性,以及该测试文本对正常嗓音和病理嗓音的鉴别能力。结果评委自身稳定性较高,Pearson相关系数为0.687~0.748;评委间一致性较好,组内相关系数为0.589~0.685;主观分析结果与客观分析值显著相关(P<0.01);受试者操作特征曲线下面积为0.948~0.96,测试文本对正常及病理嗓音的鉴别力良好,相邻嗓音障碍等级的受试者其客观分析值差异有显著统计学意义(P<0.01)。结论所设计的主观评估中文测试文本具有较高的信度和效度,具有潜在临床应用价值。Objective To examine the reliability and validity of the Mandarin perceptual evaluation scale.Methods A total of 196 disordered voice patients,24 normal voice recruiters and 10 experienced raters were recruited in the study. The Pearson correlation coefficient was used for evaluating intra-rater reliability and inter-rater reliability was evaluated by intraclass correlation coefficient. The validity was examined by comparing the correlation between perceptual evaluation and objective measurements. The receiver operating characteristic analysis was used for estimating the ability of discriminating normal from disordered voices.Results The Pearson’s r for each dimension ranged from 0.687 to 0.748, and ICC ranged from 0.589 to 0.685. Perceptual evaluation scores had a good correlation with acoustic measurements;cepstral parameters achieved the highest correlation coefficient. The area under the curve for ROC analysis was 0.948 to 0.96, indicating a satisfactory discrimination between normal and disordered voice.Conclusion The perceptual evaluation scale has a relatively high reliability and validity and is potentially useful for clinical use.

关 键 词：嗓音疾病 主观评估 声学分析 中文 

分 类 号：R767.92[医药卫生—耳鼻咽喉科]