이중음성 판별에 있어 청지각적 평가의 임상적 유용성
Clinical utility of auditory perceptual assessments in the discrimination of a diplophonic voice
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Diplophonia is generally defined as the perception of more than one fundamental frequency component in a voice. Its perceptual aspect has traditionally been used to evaluate diplophonia because the perceptions can be easily evaluated, but there are limitations in the validity of the reliability of the intra- and inter-raters, examination situation, and variation of voice sample. Therefore, the purpose of this study is to confirm the reliability and accuracy of auditory perceptual evaluation by comparing non-invasive indirect assessment methods (sound waveform and EGG analysis), and to identify their usefulness with diplophonia. A total of 28 diplophonic voices and 39 non-periodic voices were assessed. Three raters assessed the diplophonia by performing an auditory perception evaluation and identifying the quasi-periodic perturbations of the acoustic waveform and EGG. Among the three discrimination methods, intra- and inter-rater reliability, sensitivity, specificity, accuracy, positive likelihood ratio, and negative likelihood ratio were examined, and the McNemar test was performed to compare the discriminant agreement. The accuracy of the auditory perceptual evaluation (86.57%) was not significantly different from that of sound waveform acoustic (88.06%), but it was significantly different from that of EGG (83.33%). The reading time (6.02 s) for the auditory perceptual evaluation was significantly different from that for sound waveform analysis (30.15 s) and EGG analysis (16.41 s). In the discrimination of diplophonia, auditory perceptual evaluation has sufficient reliability and accuracy as compared to sound waveform and EGG. Since immediate feedback is possible, auditory perceptual evaluation is more convenient. Therefore, it can continue to be used as a tool to discriminate diplophonia in clinical practice.
Abstract
Diplophonia is generally defined as the perception of more than one fundamental frequency component in a voice. Its perceptual aspect has traditionally been used to evaluate diplophonia because the perceptions can be easily evaluated, but there are limitations in the validity of the reliability of the intra- and inter-raters, examination situation, and variation of voice sample. Therefore, the purpose of this study is to confirm the reliability and accuracy of auditory perceptual evaluation by comparing non-invasive indirect assessment methods (sound waveform and EGG analysis), and to identify their usefulness with diplophonia. A total of 28 diplophonic voices and 39 non-periodic voices were assessed. Three raters assessed the diplophonia by performing an auditory perception evaluation and identifying the quasi-periodic perturbations of the acoustic waveform and EGG. Among the three discrimination methods, intra- and inter-rater reliability, sensitivity, specificity, accuracy, positive likelihood ratio, and negative likelihood ratio were examined, and the McNemar test was performed to compare the discriminant agreement. The accuracy of the auditory perceptual evaluation (86.57%) was not significantly different from that of sound waveform acoustic (88.06%), but it was significantly different from that of EGG (83.33%). The reading time (6.02 s) for the auditory perceptual evaluation was significantly different from that for sound waveform analysis (30.15 s) and EGG analysis (16.41 s). In the discrimination of diplophonia, auditory perceptual evaluation has sufficient reliability and accuracy as compared to sound waveform and EGG. Since immediate feedback is possible, auditory perceptual evaluation is more convenient. Therefore, it can continue to be used as a tool to discriminate diplophonia in clinical practice.
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