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Tracking Occupational Voice State with a Visual Analog Scale: Voice Quality, Vocal Fatigue, and Effort
Journal article   Peer reviewed

Tracking Occupational Voice State with a Visual Analog Scale: Voice Quality, Vocal Fatigue, and Effort

Adrián Castillo-Allendes, Daniel Guzmán-Ferrada, Eric J. Hunter and Eduardo Fuentes-López
The Laryngoscope, Vol.133(7), pp.1676-1682
07/2023
DOI: 10.1002/lary.30398
PMCID: PMC10972625
PMID: 36134759

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Abstract

Background Due to elevated vocal health risk in industries such as call centers, there is a need to have accessible and quick self‐report tools for voice symptoms. This study aimed to determine if the concurrent and construct validity of three visual analog scales (VASs) of voice quality and symptoms could be used as a screening tool in call center agents. Methods A cross‐sectional study was carried out in three call center companies. The Voice Handicap Index‐10 (VHI‐10) and a vocal hygiene and symptoms survey were administered to 66 call center workers. Further, acoustic parameters including harmonics‐to‐noise ratio (HNR), smoothed cepstral peak prominence (CPPs), L1‐L0 slope, and Alpha ratio were collected. Finally, workers completed three VASs capturing self‐perception of vocal effort (VAS‐1), voice quality (VAS‐2), and vocal fatigue (VAS‐3). Linear regression models with bootstrapping evaluated the possible relationship between the three VASs measurements, self‐perceived vocal symptoms, and acoustic parameters. Results VAS‐1 scores were associated with HNR and voice breaks, VAS‐2 with voice breaks, and VAS‐3 with Alpha ratio. Using the area under a receiver operating characteristic curve (AUC), the highest AUC for detecting an altered VHI‐10 questionnaire score was observed for the three VASs. Also, the highest AUC for detecting altered CPPs was reached for the VAS‐1. Conclusions VAS as a self‐report instrument of vocal symptoms is related to psychosocial voice impairment and alterations of acoustic voice parameters in call center workers. Such instruments could be easily implemented to identify voice complaints in these populations. Level of Evidence 2 (Diagnosis research question) Laryngoscope, 133:1676–1682, 2023 This study aimed to determine if the concurrent and construct validity of three visual analog scales (VASs) of voice quality and symptoms could be used as a screening tool in call center agents. VAS as a self‐report instrument of vocal symptoms was related to psychosocial voice impairment and alterations of acoustic voice parameters in call center workers. Such instruments could be easily implemented to identify voice complaints in these populations.
 visual analog scale vocal effort vocal fatigue voice quality

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