Screening for Voice Disorders in Older Adults (Rastreamento de Alterações Vocais em Idosos--RAVI)--Part I: Validity Evidence Based on Test Content and Response Processes.

ABSTRACT

PURPOSE: To identify the validity evidence based on the content and response processes of the Rastreamento de Alterações Vocais em Idosos (RAVI; "Screening for Voice Disorders in Older Adults"), an epidemiologic screening for voice disorders in older adults. STUDY DESIGN: This is a prospective, nonrandomized, cross-sectional, validation study. METHODS: Criteria for defining the domains and elaborating the questions were established to confirm the validity evidence based on the content. A multidisciplinary committee of 19 experts evaluated the questions, and the relevance and representation of the domains were analyzed using the Content Validity Index for Items (CVI-I) and the Content Validity Index (CVI), respectively. For validity evidence based on the response processes, 40 individuals of both sexes, aged ≥60 years, were stratified by demographic and socioeconomic condition. They responded to the RAVI, made suggestions, and their verbal and nonverbal reactions were observed. RESULTS: The first version of the RAVI consisted of 20 questions related to sensations and perceptions associated with the voice. Although the CVI value of 0.80 was satisfactory, the CVI-I and the suggestions of the expert committee indicated that the scale needed to be reformulated. Consultation with older adults indicated a need for further adjustment. The preliminary version of the RAVI consisted of 16 questions. CONCLUSIONS: The two aspects of validity evidence described in the present study were essential for adapting the questions to better fit the construct of the questionnaire. Other aspects of validity evidence and reliability analysis will be described in part II of this study.