CAJ | 학술논문

目的通过对嗓音质量主观听感知评估方法的标准化研究,探讨影响听评委评估结果稳定性的因素.方法采用符合国际标准的录音设备对300例嗓音障碍患者和100例嗓音正常者进行录音,声音样本为话语声,6位来自不同医院的嗓音医学专家担任听评委,采用GRBAS嗓音评估系统中的总嘶哑度(grade,G)、粗糙声(rough,R)和气息声(breathy,B)作为评估参数.每位评委对3次不同排序嗓音样本的评估采用视觉模拟量表,结果取3次评估的平均值.采用改良分级量表将嗓音质量分为4级水平(0级正常,1级轻度障碍,2级中度障碍,3级重度障碍).采用κ值对评估结果的一致性进行统计学分析,采用回归分析探讨嗓音障碍程度对听评委评估稳定性的影响.结果不管是评委之间还是评委自身都存在着评估结果的不一致性.评委自身的一致性均达到比较好、好、甚至非常好的水平,其中对参数G评估的一致性最好(κ值0.46～0.85),其次是参数R(κ值0.41～0.84),参数B相对较差(κ值0.41～0.81).评委之间的一致性相对较差,除去1位评委的一致性未达到要求而被剔除外,其他5位评委之间对参数G评估的一致性最好(κ值0.43～0.96),其次是参数R(κ值0.33～0.78),参数B的一致性最差(κ值0.002～0.45).听评委对正常嗓音和重度障碍评估的稳定性高于轻度障碍和中度障碍.结论影响嗓音主观听感知评估稳定性的最主要因素是听评委之间的不一致性,不同评估参数和嗓音障碍程度影响听评委评估的稳定性.
목적 통과대상음질량주관은감지평고방법적표준화연구,탐토영향은평위평고결과은정성적인소.방법 채용부합국제표준적록음설비대300례상음장애환자화100례상음정상자진행록음,성음양본위화어성,6위래자불동의원적상음의학전가담임은평위,채용GRBAS상음평고계통중적총시아도(grade,G)、조조성(rough,R)화기식성(breathy,B)작위평고삼수.매위평위대3차불동배서상음양본적평고채용시각모의량표,결과취3차평고적평균치.채용개량분급량표장상음질량분위4급수평(0급정상,1급경도장애,2급중도장애,3급중도장애).채용κ치대평고결과적일치성진행통계학분석,채용회귀분석탐토상음장애정도대은평위평고은정성적영향.결과 불관시평위지간환시평위자신도존재착평고결과적불일치성.평위자신적일치성균체도비교호、호、심지비상호적수평,기중대삼수G평고적일치성최호(κ치0.46～0.85),기차시삼수R(κ치0.41～0.84),삼수B상대교차(κ치0.41～0.81).평위지간적일치성상대교차,제거1위평위적일치성미체도요구이피척제외,기타5위평위지간대삼수G평고적일치성최호(κ치0.43～0.96),기차시삼수R(κ치0.33～0.78),삼수B적일치성최차(κ치0.002～0.45).은평위대정상상음화중도장애평고적은정성고우경도장애화중도장애.결론 영향상음주관은감지평고은정성적최주요인소시은평위지간적불일치성,불동평고삼수화상음장애정도영향은평위평고적은정성.
Objective To explore the factors that influence the stability of evaluation results judged by a jury through a standard research on perceptual evaluation measurements of voice quality. Methods Voice samples from 300 patients with dysphonia and 100 control subjects with normal voice were recorded and assessed by a jury composed of 6 experienced listeners from different hospitals. The voice samples were discourse voices and ordered randomly 3 times, and the mean of 3 evaluations using visual analogue scale were the final results. The jury was instructed to classify voice samples according to the G ( grade) , R (rough) and B(breathy) components of the GRBAS scale on a 4-point scale ranging from 0 for normal to 3 for severe dysphonia. K value was used to analyze the concordance of evaluation results and regression analysis was used to research the effects of the extent of voice disorder to the stability of perceptual evaluation. Results The discordance of evaluation existed both between the jury and in listeners themselves. The concordance of listeners themselves of each evaluation parameter was not bad, good, or even very good, and the concordance of evaluation of G was the best (κ value: 0. 46 - 0. 85) , then R (κ value; 0.41 -0.84) and B(κ value: 0.41 -0.81). The concordance between the jury was worse than that in themselves. And except a listener whose concordance of evaluation was under the requirement, the concordance of evaluation of G was the best ( κ value: 0. 43 - 0. 96) , then R ( κ value: 0. 33 - 0. 78 ) and B ( κ value: 0. 002 - 0. 45 ). The stability of evaluation of normal voice and severe voice disorder was better than mild and moderate voice disorder. Conclusions The discordance between the jury was the main factor that influence the stability of perceptual evaluation. The evaluation parameters and extent of voice disorder will influence the stability of perceptual evaluation of the jury.