Nasalance-Based Preclassification of Oral–Nasal Balance Disorders Results in Higher Agreement of Expert Listeners’ Auditory-Perceptual Assessments: Results of a Retrospective Listening Study

Abstract

Objective: Reliable perceptual and instrumental assessment of oral–nasal balance disorders is a persistent problem in speech-language pathology. The goal of the study was to evaluate whether nasalance-based preclassification of oral–nasal balance disorders improves listener agreement. Design: Retrospective listening study. Setting: Tertiary university hospital. Participants: Fifty-four randomly selected recordings of patients with repaired unilateral cleft lip and palate (UCLP). Three experienced speech-language pathologists participated as expert listeners. Interventions: Two listening experiments were based on nasalance scores and audio recordings of speakers with repaired UCLP. The speakers were preclassified as normal, hypernasal, hyponasal, or mixed based on their nasalance scores. Initially, the listeners determined the diagnostic category of the oral–nasal balance for 62 audio recordings (8 repeats). Six months later, they listened to 38 of the recordings (6 repeats) along with a spreadsheet indicating the nasalance-based categories for the oral–nasal balance. The listeners confirmed, or rejected and corrected, the nasalance-based preclassification. Main Outcome Measures: Intralistener, interlistener agreement, and agreement between listener categories and nasalance-based oral–nasal balance categories. Results: In the first study, the agreement between the listeners’ diagnostic category and the nasalance-based category was 45.1% and the interlistener agreement was 36.7%. In the second study, the agreement between the listeners’ category and the nasalance-based category was 67.1% (75% agreement for the correct nasalance-based categories and 41.7% for the misclassifications), and the interlistener agreement was 85.4%. Conclusions: Preclassification of oral–nasal balance disorders based on nasalance scores may help listeners achieve better diagnostic accuracy and higher agreement.

Evaluación perceptual de la insuficiencia velofaríngea en personas con fisura del paladar: una revisión integradora de literatura

“…Los tres parámetros señalados previamente, son considerados en los parámetros universales para informar resultados de habla en personas con fisura del paladar descritos por Henningsson et al (2008). Además, Henningsson et al (2008) consideran la hiponasalidad, los trastornos de voz, la turbulencia nasal, la inteligibilidad del habla y la aceptabilidad del habla, los que también fueron descritos en algunos de los estudios identificados en esta revisión (Abdali & Yaribakht, 2019;Álvarez et al, 2004;Bettens et al, 2016;Chapman et al, 2016;de Boer et al, 2020;Georgievska-Jancheska et al, 2016;Hubbard et al, 2013;John et al, 2006;Keuning et al, 1999Keuning et al, , 2002Keuning et al, , 2004Konst et al, 2003;Kummer et al, 2003;Lipira et al, 2011;Nellis et al, 1992;Nguyen et al, 2015;Paniagua et al, 2013;Rullo et al, 2009;Scarmagnani et al, 2015;Sell et al, 2001Sell et al, , 2015Williams et al, 1998).…”

Response to “Nasalance-Based Preclassification of Oral–Nasal Balance Disorders Results in Higher Agreement of Expert Listeners: Methodological Issue”

“…Careful reading of our paper will show that we have provided percent agreement alongside the k statistic values throughout the results section. The discussion section and the abstract focus on the changes in percent agreement, rather than the k coefficients (de Boer et al, 2020).…”

“…We thank Drs Siamak Sabour and Mehdi Naderi for their interest in our paper “Nasalance-Based Preclassification of Oral-Nasal Balance Disorders Results in Higher Agreement of Expert Listeners’ Auditory-Perceptual Assessments: Results of a Retrospective Listening Study” (de Boer et al, 2020). In this paper, we investigated whether nasalance-based preclassification of oral–nasal balance disorders improves listener agreement.…”

Nasalance-Based Preclassification of Oral–Nasal Balance Disorders Results in Higher Agreement of Expert Listeners: Methodological Issue

“…We were interested to read an article that recently published by de Boer G and colleagues in the April 2020 issue of Cleft Palate Craniofac J (de Boer et al, 2020). Evaluation of nasalance-based preclassification of oral-nasal balance disorders for improve listener agreement was the aim of the authors' study.…”

“…In terms of inter listener agreement, listeners 1 and 2 agreed on 31 (96.9%) of the 32 nasality categories (κ = 0.96), listeners 1 and 3 agreed on 25 (78.1%, κ = 0.70), and listeners 2 and 3 agreed on 26 (81.3%, κ = 0.75) of the categories. (de Boer et al, 2020).…”