David M Johnson1, Edie R Hapner2, Adam M Klein2, Madeleine Pethan2, Michael M Johns3. 1. Emory University School of Medicine, Atlanta, Georgia. 2. The Emory Voice Center, Department of Otolaryngology, Emory University, Atlanta, Georgia. 3. The Emory Voice Center, Department of Otolaryngology, Emory University, Atlanta, Georgia. Electronic address: mmjohn2@emory.edu.
Abstract
OBJECTIVES/HYPOTHESIS: The objective of this study was to ascertain whether clinicians can reliably distinguish between spasmodic dysphonia (SD)/vocal tremor and other voice disorders by telephone, despite this modality's limited frequency response. STUDY DESIGN: Randomized, single-blinded, and prospective study. METHODS:Voice-disordered patients with (n = 22) and without (n = 17) SD and/or vocal tremor recorded standardized utterances via landline telephone. A laryngologist and two speech-language pathologists blinded to the diagnoses rated each recording as "yes" or "no" to "SD or tremor present?," and if "yes" categorized into adductor, abductor, tremor only, or adductor with tremor subtypes. Twenty-one recordings were presented twice at random so intrarater reliability could be assessed. All ratings were compared with gold standard diagnosis by a second laryngologist who performed a full examination, including videostroboscopy, on each patient. RESULTS: For the comparison "SD or tremor" yes versus no, sensitivity, specificity, positive predictive value, and negative predictive value are 90%, 95%, 96%, and 89%, respectively. Interrater reliability (Cohen kappa) compared with the gold standard ranged from 0.70 to 0.93 (substantial to almost perfect agreement). Cronbach alpha among three raters was 0.90 for this comparison. Intrarater reliability (number matched/number inspected) was very high, ranging from 0.97 to 1.0. Comparing gold standard and telephone rating of SD/tremor subtypes, kappa ranged from 0.48 to 0.60 (moderate agreement). Cronbach alpha among three raters was 0.88 for this comparison. Intrarater reliability ranged from 0.84 to 0.97. CONCLUSIONS: SD and tremor can be reliably distinguished from other voice disorders over the telephone.
RCT Entities:
OBJECTIVES/HYPOTHESIS: The objective of this study was to ascertain whether clinicians can reliably distinguish between spasmodic dysphonia (SD)/vocal tremor and other voice disorders by telephone, despite this modality's limited frequency response. STUDY DESIGN: Randomized, single-blinded, and prospective study. METHODS: Voice-disorderedpatients with (n = 22) and without (n = 17) SD and/or vocal tremor recorded standardized utterances via landline telephone. A laryngologist and two speech-language pathologists blinded to the diagnoses rated each recording as "yes" or "no" to "SD or tremor present?," and if "yes" categorized into adductor, abductor, tremor only, or adductor with tremor subtypes. Twenty-one recordings were presented twice at random so intrarater reliability could be assessed. All ratings were compared with gold standard diagnosis by a second laryngologist who performed a full examination, including videostroboscopy, on each patient. RESULTS: For the comparison "SD or tremor" yes versus no, sensitivity, specificity, positive predictive value, and negative predictive value are 90%, 95%, 96%, and 89%, respectively. Interrater reliability (Cohen kappa) compared with the gold standard ranged from 0.70 to 0.93 (substantial to almost perfect agreement). Cronbach alpha among three raters was 0.90 for this comparison. Intrarater reliability (number matched/number inspected) was very high, ranging from 0.97 to 1.0. Comparing gold standard and telephone rating of SD/tremor subtypes, kappa ranged from 0.48 to 0.60 (moderate agreement). Cronbach alpha among three raters was 0.88 for this comparison. Intrarater reliability ranged from 0.84 to 0.97. CONCLUSIONS: SD and tremor can be reliably distinguished from other voice disorders over the telephone.
Authors: Janet S Choi; Victoria Yin; Franklin Wu; Neel K Bhatt; Karla O'Dell; Michael Johns Journal: Laryngoscope Date: 2021-08-24 Impact factor: 2.970
Authors: Christy L Ludlow; Rickie Domangue; Dinesh Sharma; H A Jinnah; Joel S Perlmutter; Gerald Berke; Christine Sapienza; Marshall E Smith; Joel H Blumin; Carrie E Kalata; Karen Blindauer; Michael Johns; Edie Hapner; Archie Harmon; Randal Paniello; Charles H Adler; Lisa Crujido; David G Lott; Stephen F Bansberg; Nicholas Barone; Teresa Drulia; Glenn Stebbins Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-08-01 Impact factor: 6.223