Validity and reliability of the 2nd European Portuguese version of the “Consensus Auditory-Perceptual Evaluation of Voice” (II EP CAPE-V)

Abstract

Introduction: Auditory-perceptual evaluation of voice is a part of a multidimensional voice evaluation, and is claimed to be “golden standard”. The “Consensus Auditory-Perceptual Evaluation of Voice” (CAPE-V) has been demonstrated to be a valid and reliable instrument for voice evaluation, when applied in both clinical and scientific research fields. The CAPE-V was first translated into European Portuguese (EP) (Jesus et al., 2009) however it revealed some validity and reliability problems. The purpose of this study was to assure a valid and reliable EP version of CAPE-V. This resulted in the 2nd EP version of CAPE-V (II EP CAPE-V), with permission granted by ASHA. Method: This was a transversal, observational, descriptive, and comparative study. 14 Speech-language pathologists (SLPs) voice experts (>5 years of clinical practice), rated a total of 26 voice samples produced by 10 males (mean age=45) and 10 females (mean age=43) classified into two groups: a control group (n=10) and a dysphonic group (n=10), with subjects matched for age and gender. All voice samples were rated in one session with the II EP CAPE-V, and in a second session one week later with GRBAS. Content validity was supported by 6 new sentences conceptualized and adapted to EP linguistic and cultural context according to the rationale outlined in the original CAPE-V protocol. For construct validity analysis, an independent samples t-test (α=.05) was performed for all vocal parameter. Concurrent validity was estimated with the multi-serial correlation coefficient between II EP CAPE-V and GRBAS parameters (r>.70). Reliability was performed for all vocal parameters. Inter-rater reliability was determined by ICC, and intra-rater reliability by Pearson’s correlation coefficient (r>.70). Results/conclusion: Content validity was assured by an EP linguistic expert, who reviewed the six new sentences. Construct validity was obtained for all voical parameters (p<.05), except for strain (p=.52). Concurrent validity had high correlations (r>.89) for overall severity/grade, roughness, and breathiness parameters. High inter-rater reliability (ICC>.84) was obtained for all parameters. Intra-rater reliability was high (r>.87) for overall severity, breathiness, and pitch; good (r=.73) for strain; and moderate (r>.69) for roughness and loudness parameters. The II EP CAPE-V is a valid and reliable instrument for auditory-perceptual evaluation, with all psychometric characteristics established.