Correlation between the Dysphonia Severity Index and the Voice Handicap Index

Svakodnevno korištenje glasa govori o njegovoj važnosti, a svaki poremećaj glasa ima negativan utjecaj na socijalno i radno okruženje osobe. Iz navedenog su razloga sveobuhvatna procjena i dijagnoza krucijalne u tretiranju navedenih poremećaja. Perceptivna procjena još je uvijek primarna metoda mjerenja glasovne kvalitete u kliničkoj sredini, no ona ovisi o iskustvu i prosudbi ispitivača, a mogućnost usporedbe rezultata je ograničena. Zbog toga nastaju objektivne mjere koje pomoću akustičkih analiza određuju jačinu poremećaja. Osim toga, rezultati upitnika samoprocjene nisu zanemarivi jer daju širu sliku o tome kako poremećaj glasa utječe na osobu i njezin život, što je korisno za samu terapiju i kreiranje terapijskih ciljeva. Cilj ovog istraživačkog rada je ispitati postoji li statistički značajna povezanost između objektivne procjene Indeksom jakosti disfonije (DSI) i samoprocjene kvalitete glasa Indeksom vokalnih teškoća (VHI-HR) kod osoba s poremećajem glasa različite etiologije. U istraživanju je sudjelovalo 20 ispitanika s već dijagnosticiranim poremećajem glasa dobnog raspona od 28 do 59 godina, a provođeno je na otorinolaringološkim odjelima Kliničkog bolničkog centra Rebro i Kliničkog bolničkog centra Sestre milosrdnice. Za akustičku obradu i analizu prikupljenih fonacija glasa /a/ korišten je program Praat. Analizirane akustičke varijable su: najviša frekvencija, maksimalno vrijeme fonacije, najniži intenzitet i jitter. Rezultati su pokazali da ne postoji statistički značajna povezanost između ukupnog broja bodova na Indeksu vokalnih teškoća, kao ni njegovih triju podskala (funkcionalna, fizička i emocionalna) s rezultatom Indeksa jakosti disfonije. Također, statistički značajna povezanost između dvije navedene mjere zasebno kod skupine ispitanika s organskim te skupine ispitanika s funkcionalnim poremećajem glasa nije pronađena. VHI i DSI su komplementarne mjere s obzirom na to da je svaka usmjerena na određeni aspekt glasovne patologije i zbog toga ne moraju značajno korelirati. Budući da su oba instumenta pouzdana i lako primjenjiva te svaki daje korisne informacije za sveobuhvatni pristup osobi s poremećajem glasa, poželjno ih je koristiti prilikom procjene ili evaluacije napretka.Daily use of the voice speaks of its importance, and each voice disorder has a negative impact on the social and working environment of a person. For these because of these facts, comprehensive assessment and diagnosis are crucial in treating these disorders. Perceptual assessment is still the primary method of measuring voice quality in a clinical practice, but it depends on the experience and judgment of the examiner, and the possibility to compare results is limited. That is why objective measures are developed to determine the level of the disorder by acoustic analysis. In addition, the results of the self-assessment questionnaire are not negligible because they give a wider picture of how speech disorder affects the person and their life, which is useful for the therapy itself and the determination of therapeutic goals. The aim of this research is to examine whether there is a statistically significant correlation between the objective assessment by the Dysphonia Severity Index (DSI) and the selfassessment of the voice quality by Voice Handicap Index (VHI-HR) in persons with a distinct etiology of voice disorder. The study included 20 subjects with already diagnosed voice disorder age ranging between 28 and 59 years, and was performed at the Otorhinolaryngological Departments of the Clinical Hospital Center Rebro and the Clinical Hospital Center Sestre milosrdnice. The Praat program was used for acoustic processing and analysis of the phonations that were collected. The analyzed acoustic variables are: highest frequency, maximum phonation time, lowest intensity and jitter. The results showed that there is no statistically significant correlation between the total number of points on the Voice Handicap Index as well as its three subclasses (functional, physical and emotional) with the result of the Dysphonia Severity Index. Also, statistically significant correlation between the two measures obtained separately in a group of subjects with a organic voice disorder and the group of functional voice disorder was not found. VHI and DSI are complementary measures since each is directed to a certain aspect of voice pathology and therefore does not have to correlate significantly. Since both instruments are reliable and easy to apply and each provides useful information for a comprehensive approach to a person with a voice disorder, it is desirable to use them in assessment or in evaluating progress