Yolanda D Heman-Ackah1, Robert T Sataloff2, Griet Laureyns3, Deborah Lurie4, Deirdre D Michael5, Reinhardt Heuer6, Adam Rubin7, Robert Eller8, Swapna Chandran9, Mona Abaza10, Karen Lyons2, Venu Divi2, Joanna Lott11, Jennifer Johnson12, James Hillenbrand13. 1. Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania. Electronic address: phillyvoicemd@aol.com. 2. Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania. 3. Ziekenhuis Oost Limburg, Genk and University Hospitals, Leuven, Belgium. 4. Department of Mathematics, St. Joseph's University, Philadelphia, Pennsylvania. 5. Department of Otolaryngology, Head and Neck Surgery, University of Minnesota, Minneapolis, Minnesota. 6. Department of Communication Sciences and Disorders, Temple University, Philadelphia, Pennsylvania. 7. Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan. 8. Department of Otolaryngology-Head and Neck Surgery, US Air Force. 9. Division of Otolaryngology, University of Louisville School of Medicine, Louisville, Kentucky. 10. Department of Otolaryngology-Head and Neck Surgery, University of Colorado-Denver, Denver, Colorado. 11. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland. 12. Department of Communication Disorders, Texas State University, San Marcos, Texas. 13. Department of Speech Pathology and Audiology, Western Michigan University, Kalamazoo, Michigan.
Abstract
OBJECTIVE: The purpose of this study is to establish normative values for the smoothed cepstral peak prominence (CPPS) and its sensitivity and specificity as a measure of dysphonia. STUDY DESIGN: Prospective cohort study. METHODS: Voice samples of running speech were obtained from 835 patients and 50 volunteers. Eight laryngologists and four speech-language pathologists performed perceptual ratings of the voice samples on the degree of dysphonia/normality using an analog scale. The mean of their perceptual ratings was used as the gold standard for the detection of the presence or absence of dysphonia. CPPS was measured using the CPPS algorithm of Hillenbrand, and the cut-off value for positivity that has the highest sensitivity and specificity for discriminating between normal and severely dysphonia voices was determined based on ROC-curve analysis. RESULTS: The cut-off value for normal for CPPS was set at 4.0 or higher, which gave a sensitivity of 92.4%, a specificity of 79%, a positive predictive value of 82.5%, and a negative predictive value of 90.8%. The area under the receiver operating characteristic (ROC) curve was 0.937 (P < 0.05). CONCLUSIONS: CPPS is a good measure of dysphonia, with the normal value of CPPS (Hillenbrand algorithm) of a running speech sample being defined as a value of 4.0 or higher.
OBJECTIVE: The purpose of this study is to establish normative values for the smoothed cepstral peak prominence (CPPS) and its sensitivity and specificity as a measure of dysphonia. STUDY DESIGN: Prospective cohort study. METHODS: Voice samples of running speech were obtained from 835 patients and 50 volunteers. Eight laryngologists and four speech-language pathologists performed perceptual ratings of the voice samples on the degree of dysphonia/normality using an analog scale. The mean of their perceptual ratings was used as the gold standard for the detection of the presence or absence of dysphonia. CPPS was measured using the CPPS algorithm of Hillenbrand, and the cut-off value for positivity that has the highest sensitivity and specificity for discriminating between normal and severely dysphonia voices was determined based on ROC-curve analysis. RESULTS: The cut-off value for normal for CPPS was set at 4.0 or higher, which gave a sensitivity of 92.4%, a specificity of 79%, a positive predictive value of 82.5%, and a negative predictive value of 90.8%. The area under the receiver operating characteristic (ROC) curve was 0.937 (P < 0.05). CONCLUSIONS: CPPS is a good measure of dysphonia, with the normal value of CPPS (Hillenbrand algorithm) of a running speech sample being defined as a value of 4.0 or higher.
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