A Comparison among Repeated Measures of the Voicing Efficiency Protocol in the Aerodynamic Assessment

Abstract

Objectives: The purpose of the present study was to determine whether voicing efficiency measures derived from the Phonatory Aerodynamic System differ according to repeated trials and the presence of voice disorders upon controlling for severity. In addition, the diagnostic ability of the first and averaged measures were compared. Methods: A total of 160 participants (80 patients and 80 controls; 23 males and 57 females for each group) participated in the study. Each participant was asked to perform the voicing efficiency protocol three times. Selected aerodynamic parameters including mean sound pressure level (PHODB), mean pitch (MEAP), mean peak air pressure (MPAP), mean airflow during voicing (MFPHO) were measured. A two-way repeated measures of ANCOVA upon controlling for severity and ROC curve analysis were performed. Results: Results indicated that there was no difference in MPAP and MFPHO among repeated trials upon controlling for severity, although a significant difference was found in PHODB (trial 1<trial 2=trial 3). The patient group showed lower MFPHO compared to the control group. ROC curve analysis revealed that the AUCs were .683 and .687 for the first and averaged MPAP; and .644 and .625 for the first and averaged MFPHO, respectively, suggesting no difference between measurement methods. Conclusion: In sum, the current data showed that MPAP and MFPHO measures did not differ according to repeated trials. Furthermore, the diagnostic ability of the first and averaged measures was similar, providing a rationale for the use of a time-efficient single trial protocol in clinics and research.