Screening for Voice Disorders in Older Adults (RAVI)-Part III: Cutoff Score and Clinical Consistency
Por:
Pernambuco, L, Espelt, A, de Lima, KC
Publicada:
1 ene 2017
Resumen:
Aim. The aim of the study was to determine the cutoff score and clinical consistency of "Screening for Voice Disorders in Older Adults" (RAVI-Rastreamento de Alteracoes Vocais em Idosos).
Study Design. This is a prospective, nonrandomized, cross-sectional diagnostic study.
Methods. A sample of 301 subjects, including both sexes, aged 60 and more, and all of whom were living in either a community or an institution, was studied. To determine which subjects had or did not have voice problems, we used a composite reference standard (auditory-perceptual analysis of sustained vowel phonation, auditory-perceptual analysis of connected speech, and vocal self-assessment). The best cutoff score was identified using the receiver operating characteristic (ROC) curve analysis. The clinical consistency indicators were co-positivity, co-negativity, positive and negative predictive values, positive and negative likelihood ratio, and test efficiency. The significance level was 5%.
Results. The area under the ROC curve was 0.763 (95% confidence interval: 0.706-0.821), and the best cutoff score for determining which older adults had or did not have a voice disorder was 2. All clinical consistency indicators were satisfactory: co-positivity (79%), co-negativity (60%), predictive positive value (51%), negative predictive value (84%), positive likelihood ratio (2.01), negative likelihood ratio (0.34), and test efficiency (69%).
Conclusions. RAVI has satisfactory indicators of clinical consistency and is able to determine which older adults have voice disorders by a cutoff score of 2. The use of RAVI as a screening tool is recommended to help determine the prevalence of voice disorders in older adults.
Filiaciones:
Pernambuco, L:
Univ Fed Paraiba UFPB, Dept Speech Language & Hearing Sci, Joao Pessoa, Paraiba, Brazil
Espelt, A:
ASPB, Serv Atencio Prevencio Drogodependencies, Barcelona, Spain
Univ Autonoma Barcelona UAB, Fac Psicol, Dept Psicobiol & Metodol Ciencies Salut, Bellaterra, Spain
Inst Salud Carlos III, CIBER Epidemiol & Salud Publ, Madrid, Spain
de Lima, KC:
Univ Fed Rio Grande Norte UFRN, Programa Posgrad Saude Colet PPGSCol UFRN, Natal, RN, Brazil
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