Abstract：
BACKGROUND: To update the European guidelines for the assessment of voice quality (VQ) in clinical practice.
METHODS: Nineteen laryngologists-phoniatricians of the European Laryngological Society (ELS) and the Union of the European Phoniatricians (UEP) participated to a modified Delphi process to propose statements about subjective and objective VQ assessments. Two anonymized voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 3/4. The statements with ≥ 3/4 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected.
RESULTS: Of the 90 initial statements, 51 were validated after two voting rounds. A multidimensional set of minimal VQ evaluations was proposed and included: baseline VQ anamnesis (e.g., allergy, medical and surgical history, medication, addiction, singing practice, job, and posture), videolaryngostroboscopy (mucosal wave symmetry, amplitude, morphology, and movements), patient-reported VQ assessment (30- or 10-voice handicap index), perception (Grade, Roughness, Breathiness, Asthenia, and Strain), aerodynamics (maximum phonation time), acoustics (Mean F0, Jitter, Shimmer, and noise-to-harmonic ratio), and clinical instruments associated with voice comorbidities (reflux symptom score, reflux sign assessment, eating-assessment tool-10, and dysphagia handicap index). For perception, aerodynamics and acoustics, experts provided guidelines for the methods of measurement. Some additional VQ evaluations are proposed for voice professionals or patients with some laryngeal diseases.
CONCLUSIONS: The ELS-UEP consensus for VQ assessment provides clinical statements for the baseline and pre- to post-treatment evaluations of VQ and to improve collaborative research by adopting common and validated VQ evaluation approach.
METHODS: Nineteen laryngologists-phoniatricians of the European Laryngological Society (ELS) and the Union of the European Phoniatricians (UEP) participated to a modified Delphi process to propose statements about subjective and objective VQ assessments. Two anonymized voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 3/4. The statements with ≥ 3/4 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected.
RESULTS: Of the 90 initial statements, 51 were validated after two voting rounds. A multidimensional set of minimal VQ evaluations was proposed and included: baseline VQ anamnesis (e.g., allergy, medical and surgical history, medication, addiction, singing practice, job, and posture), videolaryngostroboscopy (mucosal wave symmetry, amplitude, morphology, and movements), patient-reported VQ assessment (30- or 10-voice handicap index), perception (Grade, Roughness, Breathiness, Asthenia, and Strain), aerodynamics (maximum phonation time), acoustics (Mean F0, Jitter, Shimmer, and noise-to-harmonic ratio), and clinical instruments associated with voice comorbidities (reflux symptom score, reflux sign assessment, eating-assessment tool-10, and dysphagia handicap index). For perception, aerodynamics and acoustics, experts provided guidelines for the methods of measurement. Some additional VQ evaluations are proposed for voice professionals or patients with some laryngeal diseases.
CONCLUSIONS: The ELS-UEP consensus for VQ assessment provides clinical statements for the baseline and pre- to post-treatment evaluations of VQ and to improve collaborative research by adopting common and validated VQ evaluation approach.
摘要：
背景：更新临床实践中语音质量（VQ）评估的欧洲指南。
方法：欧洲喉科学会（ELS）和欧洲儿科医生联盟（UEP）的19名喉科医师-儿科医生参与了改良的Delphi程序，以提出有关主观和客观VQ评估的陈述。两轮匿名投票确定，当80％的专家同意至少3/4的评级时，共识声明是可以接受的。60-80％的专家评分≥3/4分的陈述得到了改善，并重新提交投票，直到得到验证或拒绝。
结果：在90个初始陈述中，经过两轮投票后，对51进行了验证。提出了一组多维的最小VQ评估，并包括：基线VQ回忆(例如，过敏,病史和手术史，药物,上瘾,唱歌练习,工作,和姿势)，电视喉镜检查(粘膜波对称性，振幅,形态学,和运动)，患者报告的VQ评估（30或10语音障碍指数），感知(年级，粗糙度,呼吸,Asthenia,和应变），空气动力学（最大发声时间），声学(平均F0，抖动，微光,和噪声谐波比)，和与语音合并症相关的临床仪器(反流症状评分，反流体征评估,饮食评估工具10和吞咽困难障碍指数)。为了感知，空气动力学和声学，专家提供了测量方法的指南。建议对语音专业人员或患有某些喉部疾病的患者进行一些额外的VQ评估。
结论：关于VQ评估的ELS-UEP共识为VQ的基线和治疗前后评估提供了临床陈述，并通过采用通用和经过验证的VQ评估方法来改善合作研究。
方法：欧洲喉科学会（ELS）和欧洲儿科医生联盟（UEP）的19名喉科医师-儿科医生参与了改良的Delphi程序，以提出有关主观和客观VQ评估的陈述。两轮匿名投票确定，当80％的专家同意至少3/4的评级时，共识声明是可以接受的。60-80％的专家评分≥3/4分的陈述得到了改善，并重新提交投票，直到得到验证或拒绝。
结果：在90个初始陈述中，经过两轮投票后，对51进行了验证。提出了一组多维的最小VQ评估，并包括：基线VQ回忆(例如，过敏,病史和手术史，药物,上瘾,唱歌练习,工作,和姿势)，电视喉镜检查(粘膜波对称性，振幅,形态学,和运动)，患者报告的VQ评估（30或10语音障碍指数），感知(年级，粗糙度,呼吸,Asthenia,和应变），空气动力学（最大发声时间），声学(平均F0，抖动，微光,和噪声谐波比)，和与语音合并症相关的临床仪器(反流症状评分，反流体征评估,饮食评估工具10和吞咽困难障碍指数)。为了感知，空气动力学和声学，专家提供了测量方法的指南。建议对语音专业人员或患有某些喉部疾病的患者进行一些额外的VQ评估。
结论：关于VQ评估的ELS-UEP共识为VQ的基线和治疗前后评估提供了临床陈述，并通过采用通用和经过验证的VQ评估方法来改善合作研究。
