Cross-Cultural Adaptation, Validation, and Cutoff Values of the Chilean Version of the Voice Symptom Scale: VoiSS.

OBJECTIVE: To evaluate psychometric properties of the Voice Symptom Scale (VoiSS) - Chilean Spanish version. STUDY DESIGN: Cross-sectional, nonrandomized, prospective study with controls. METHODS: The validation of the Chilean Spanish VoiSS version met the criteria of the Scientific Advisory Committee of the Medical Outcomes Trust: Cultural and linguistic adaptation, by translation into Chilean Spanish and back-translation. Validity, employed external criteria (excellent, very good, fair, and poor). Reliability was made by test-retest and responsiveness to treatment, the initial voice and after vocal treatment of 12 dysphonic patients were analyzed, by GRBAS. The Chilean Spanish adapted VoiSS protocol, Escala de Síntomas Vocales (ESV-CL), was applied to 205 subjects, 89 with dysphonia and 116 of them vocally healthy. A cutoff value for the total score was determined by the efficiency characteristics. RESULTS: The ESV-CL demonstrates high validity, reliability, and responsiveness. A cutoff score of 35.5 was determined by using the high sensitivity (90%) and specificity (75%) found in subjects with dysphonia compared to vocally healthy subjects. CONCLUSIONS: The results of the Chilean version of VoiSS, renamed the ESV-CL, revealed it to be culturally equivalent to the original version, and to be a valid, reliable, and responsive instrument for voice symptoms in the Chilean population. Chilean speech-language pathologists can benefit from this adapted protocol in clinical research and voice management.

Cross-cultural adaptation of the Chilean Version of the Voice-Related Quality of Life (V-RQOL). / Equivalencia cultural de la Versión Chilena del Voice-Related Quality of Life (V-RQOL).

PURPOSE: To achieve a cross-cultural equivalence of the Chilean version of the V-RQOL protocol, through its cultural and linguistic adaptation. METHODS: First, two bilingual speech therapists made a translation of the V-RQOL into Spanish. Second, a back-translation to English was performed by a speech therapist who did not participate in the previous stages. Then, a comparison between the original and the back-translation versions of the test was conducted. The existing discrepancies were modified by a committee of five speech therapists, translating the name of the Voice-Related Quality of Life (V-RQOL) instrument into Spanish as Medición de la Calidad de Vida en Relación a la Voz (MCV-RV), with 10 questions and 5 possible answers for each. In order to analyze cultural equivalence, the protocol was applied to 15 individuals with voice disorders. For each question, a 'Not applicable' option was added to the possible answers to determine which questions were not clearly understood by the individuals being tested. Two of the assessed individuals had difficulties in answering a distinct question, though only one of these two questions was modified. The final version of MCV-RV protocol was applied to five individuals with voice disorders who had no difficulty understanding the questions properly. RESULTS: The MCV-RV reflects the original English version, both in the number and types of questions (including physical functioning and the social-emotional aspects). CONCLUSION: A cross-cultural equivalence of the V-RQOL was achieved, thereby creating an adapted Chilean-Spanish version (MCV-RV). The validation of the MCV-RV protocol for Chilean Spanish is currently in progress.

OBJETIVO: Lograr la equivalencia cultural de la versión Chilena del Protocolo V-RQOL, a través de su adaptación cultural y lingüística. MÉTODO: Primero, dos Fonoaudiólogos bilingües realizaron una traducción de V-RQOL al español. En segundo lugar, una Fonoaudióloga que no participó en las etapas previas, realizó una retrotraducción al inglés. Luego, se efectuó una comparación entre la versión original y la versión retrotraducida. Las discrepancias fueron modificadas por un comité de cinco Fonoaudiólogos, traduciendo el nombre al español como "Medición de la Calidad de Vida en Relación a la Voz" (MCV-RV) ", con 10 preguntas y 5 opciones de respuesta. Para la equivalencia cultural, se aplicó el protocolo a 15 personas con trastornos de voz. Para cada pregunta, se agregó la opción "No aplicable" entre las alternativas de respuesta con el fin de identificar preguntas incomprendidas o inapropiadas por la población. Dos de los sujetos evaluados tuvieron dificultad para responder dos preguntas diferentes, así que fue modificada solo una de ellas. La versión final del protocolo MCV-RV se aplicó a cinco personas con patología vocal, sin dificultades para comprender las preguntas adecuadamente. RESULTADOS: La MCV-RV refleja la versión original en inglés, tanto en número como en tipos de preguntas (incluido el funcionamiento físico y aspectos socioemocionales). CONCLUSIONES: Existe adaptación cultural de V-RQOL para el español Chileno (MCV-RV). La validación del MCV-RV para el español de Chile está actualmente en curso.

Equivalencia cultural de la Versión Chilena del Voice-Related Quality of Life (V-RQOL) / Cross-cultural adaptation of the Chilean Version of the Voice-Related Quality of Life (V-RQOL)

RESUMEN Objetivo Lograr la equivalencia cultural de la versión Chilena del Protocolo V-RQOL, a través de su adaptación cultural y lingüística. Método Primero, dos Fonoaudiólogos bilingües realizaron una traducción de V-RQOL al español. En segundo lugar, una Fonoaudióloga que no participó en las etapas previas, realizó una retrotraducción al inglés. Luego, se efectuó una comparación entre la versión original y la versión retrotraducida. Las discrepancias fueron modificadas por un comité de cinco Fonoaudiólogos, traduciendo el nombre al español como "Medición de la Calidad de Vida en Relación a la Voz" (MCV-RV) ", con 10 preguntas y 5 opciones de respuesta. Para la equivalencia cultural, se aplicó el protocolo a 15 personas con trastornos de voz. Para cada pregunta, se agregó la opción "No aplicable" entre las alternativas de respuesta con el fin de identificar preguntas incomprendidas o inapropiadas por la población. Dos de los sujetos evaluados tuvieron dificultad para responder dos preguntas diferentes, así que fue modificada solo una de ellas. La versión final del protocolo MCV-RV se aplicó a cinco personas con patología vocal, sin dificultades para comprender las preguntas adecuadamente. Resultados La MCV-RV refleja la versión original en inglés, tanto en número como en tipos de preguntas (incluido el funcionamiento físico y aspectos socioemocionales). Conclusiones Existe adaptación cultural de V-RQOL para el español Chileno (MCV-RV). La validación del MCV-RV para el español de Chile está actualmente en curso.

ABSTRACT Purpose To achieve a cross-cultural equivalence of the Chilean version of the V-RQOL protocol, through its cultural and linguistic adaptation. Methods First, two bilingual speech therapists made a translation of the V-RQOL into Spanish. Second, a back-translation to English was performed by a speech therapist who did not participate in the previous stages. Then, a comparison between the original and the back-translation versions of the test was conducted. The existing discrepancies were modified by a committee of five speech therapists, translating the name of the Voice-Related Quality of Life (V-RQOL) instrument into Spanish as Medición de la Calidad de Vida en Relación a la Voz (MCV-RV), with 10 questions and 5 possible answers for each. In order to analyze cultural equivalence, the protocol was applied to 15 individuals with voice disorders. For each question, a 'Not applicable' option was added to the possible answers to determine which questions were not clearly understood by the individuals being tested. Two of the assessed individuals had difficulties in answering a distinct question, though only one of these two questions was modified. The final version of MCV-RV protocol was applied to five individuals with voice disorders who had no difficulty understanding the questions properly. Results The MCV-RV reflects the original English version, both in the number and types of questions (including physical functioning and the social-emotional aspects). Conclusion A cross-cultural equivalence of the V-RQOL was achieved, thereby creating an adapted Chilean-Spanish version (MCV-RV). The validation of the MCV-RV protocol for Chilean Spanish is currently in progress.

Cross-cultural adaptation of the Chilean version of the Voice Symptom Scale - VoiSS.

This research aims to accomplish the cross-cultural equivalence of the Chilean version of the VoiSS protocol through its cultural and linguistic adaptation. After the translation of the VoiSS protocol to Chilean Spanish by two bilingual speech therapists and its back translation to English, we compared the items of the original tool with the previous translated version. The existing discrepancies were modified by a consensus committee of five speech therapists and the translated version was entitled Escala de Sintomas Vocales - ESV, with 30 questions and five answers: "Never", "Occasionally", "Sometimes", "Most of the time", "Always". For cross-cultural equivalence, the protocol was applied to 15 individuals with vocal problems. In each question the option of "Not applicable" was added to the answer choices for identification of the questions not comprehended or not appropriate for the target population. Two individuals had difficulty answering two questions, which made it necessary to adapt the translation of only one of them. The modified ESV was applied to three individuals with vocal problems, and there were incomprehensible inappropriate questions for the Chilean culture. The ESV reflects the original English version, both in the number of questions and the limitations of the emotional and physical domains. There is now a cross-cultural equivalence of VoiSS in Chilean Spanish, titled ESV. The validation of the ESV for Chilean Spanish is ongoing. RESUMEN Este estudio tuvo como objetivo realizar la equivalencia cultural de la versión Chilena del protocolo Voice Symptom Scale - VoiSS por medio de su adaptación cultural y lingüística. Después de la traducción del VoiSS para el Español Chileno, por dos fonoaudiólogos bilingües, y de la retro traducción para el inglés, se realizó una comparación de los ítems del instrumento original con la versión traducida, surgiendo discrepancias; tales divergencias fueron resueltas por un comité compuesto por cinco fonoaudiólogos, que llegaron a un consenso de donde surgió la denominada Escala de Síntomas Vocales - ESV, compuesta de 30 preguntas y 5 respuestas: "Nunca", "Casi nunca", "A veces", "Casi siempre", "Siempre". Con el objetivo de lograr la equivalencia cultural, la ESV fue aplicada a 15 individuos con problemas vocales. A cada pregunta se le agregó la opción "No aplicable" en las elecciones de respuesta, con el fin de identificar preguntas incomprendidas o inapropiadas para la población en cuestión. Dos de los individuos tuvieron dificultades en el momento de contestar dos preguntas, haciéndose necesario adaptar solamente la traducción de una de ellas. La ESV modificada fue aplicada a tres personas más con problemas vocales, no encontrándose preguntas incomprendidas o inapropiadas para la cultura Chilena. La ESV refleja la versión original de inglés, tanto en la cantidad de preguntas como en la limitación de los dominios emocional y físico. Existe una equivalencia cultural del VoiSS para el Español Chileno, que recibe el nombre de ESV. La validación de la ESV para el Español Chileno está en proceso de conclusión.

Acoustic markers to differentiate gender in prepubescent children's speaking and singing voice.

OBJECTIVES: Investigation sought to determine whether there is any acoustic variable to objectively differentiate gender in children with normal voices. METHODS: A total of 30 children, 15 boys and 15 girls, with perceptually normal voices were examined. They were between 7 and 10 years old (mean: 8.1, SD: 0.7 years). Subjects were required to perform the following phonatory tasks: (1) to phonate sustained vowels [a:], [i:], [u:], (2) to read a phonetically balanced text, and (3) to sing a song. Acoustic analysis included long-term average spectrum (LTAS), fundamental frequency (F0), speaking fundamental frequency (SFF), equivalent continuous sound level (Leq), linear predictive code (LPC) to obtain formant frequencies, perturbation measures, harmonic to noise ratio (HNR), and Cepstral peak prominence (CPP). Auditory perceptual analysis was performed by four blinded judges to determine gender. RESULTS: No significant gender-related differences were found for most acoustic variables. Perceptual assessment showed good intra and inter rater reliability for gender. Cepstrum for [a:], alpha ratio in text, shimmer for [i:], F3 in [a:], and F3 in [i:], were the parameters that composed the multivariate logistic regression model to best differentiate male and female children's voices. CONCLUSION: Since perceptual assessment reliably detected gender, it is likely that other acoustic markers (not evaluated in the present study) are able to make clearer gender differences. For example, gender-specific patterns of intonation may be a more accurate feature for differentiating gender in children's voices.