Formal perceptual evaluation of voice quality in the United Kingdom.

This document is a position statement on the formal perceptual evaluation of voice quality in the United Kingdom (UK). It addresses a number of clinical issues pertaining to the complexity of voice quality analysis. There is also a brief description of the three formal perceptual protocols most commonly used in the UK: The Vocal Profile Analysis (VPA), GRBAS and The Buffalo III Voice Profile. Potential clinical problems with perceptual voice quality evaluation are highlighted. Problems associated with the lack of defined terminology, limitless variety of voice quality, general lack of reliability data and difficulties in determining specificity and sensitivity are discussed. A practical guide for selecting an evaluation scheme is described. The conclusion is that the GRBAS scheme should be recommended as the absolute minimum standard for practising UK voice clinicians. However, there is a clear need to develop a more satisfactory perceptual rating scheme that is clinically realistic, theoretically sound, internationally acceptable and has proven reliability.