CoChat
Sign Up
Cited by 107Voice and Speech DisordersRespiratory and Cough-Related ResearchTracheal and airway disorders

Consensus for voice quality assessment in clinical practice: Guidelines of the European Laryngological Society and Union of the European Phoniatricians

Open access
Lechien, Jerome R., Geneid, Ahmed, Bohlender, Jörg E., Cantarella, Giovanna, Avellaneda, Juan C., Desuter, Gauthier, Sjogren, Elisabeth V., Finck, Camille +11 more·2023·European Archives of Oto-Rhino-Laryngology
DOI 10.1007/s00405-023-08211-6
Open this paper in CoChat — free accountOpen PDF

Abstract

Introduction To update the European guidelines for the assessment of voice quality (VQ) in clinical practice.Methods Nineteen laryngologists-phoniatricians of the European Laryngological Society (ELS) and the Union of the European Phoniatricians (UEP) participated to a modified Delphi process to propose statements about subjective and objective VQ assessments. Two anonymized voting rounds determined a consensus statement to be acceptable when 80% of experts agreed with a rating of at least 3/4. The statements with ≥ 3/4 score by 60-80% of experts were improved and resubmitted to voting until they were validated or rejected.Results Of the 90 initial statements, 51 were validated after two voting rounds. A multidimensional set of minimal VQ evaluations was proposed and included: baseline VQ anamnesis (e.g., allergy, medical and surgical history, medication, addiction, singing practice, job, and posture), videolaryngostroboscopy (mucosal wave symmetry, amplitude, morphology, and movements), patient-reported VQ assessment (30- or 10-voice handicap index), perception (Grade, Roughness, Breathiness, Asthenia, and Strain), aerodynamics (maximum phonation time), acoustics (Mean F0, Jitter, Shimmer, and noise-to-harmonic ratio), and clinical instruments associated with voice comorbidities (reflux symptom score, reflux sign assessment, eating-assessment tool-10, and dysphagia handicap index). For perception, aerodynamics and acoustics, experts provided guidelines for the methods of measurement. Some additional VQ evaluations are proposed for voice professionals or patients with some laryngeal diseases.Conclusion The ELS-UEP consensus for VQ assessment provides clinical statements for the baseline and pre- to post-treatment evaluations of VQ and to improve collaborative research by adopting common and validated VQ evaluation approach.

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1007/s00405-023-08211-6

Cites

99 of 99 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • AI-based acoustic analysis offers a non-invasive adjunctive approach for voice quality diagnosis, triage, and follow-up.

    “artificial intelligence (AI)-based acoustic analysis offers a non-invasive adjunctive approach for VQ diagnosis, triage, and follow-up [20,21,22,23,24].”

    From Diagnostic Accuracy of Artificial Intelligence in Laryngeal Disorders: An Integrative Review (2026) · cites this paper as [20]

    The acoustic measurements section (page unavailable) describes acoustic analysis as an objective way to detect subtle voice changes and monitor treatment effectiveness. The perceptual voice quality evaluation section (page unavailable) calls AI-based assessment promising, but does not establish AI-based acoustic analysis as an adjunct for diagnosis or triage; it does not characterize the approach as non-invasive. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • A multidimensional approach to voice evaluation in individuals with MTD can include laryngeal visualization, auditory-perceptual measures, acoustic measures, aerodynamic measures, and patient-reported measures of quality of life.

    “A multidimensional approach to voice evaluation in individuals with MTD can include laryngeal visualization, auditory-perceptual measures, acoustic measures of voice, aerodynamic measures of voice, and patient-reported measures of quality of life [9,10].”

    From Correlation of Multiple Measures of Voice Evaluation Among Individuals with Muscle Tension Dysphonia: An Exploratory Study (2024) · cites this paper as [9]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Cites

Flagged first, then by citations

Research works printed but not linked: 7

  1. [4]4. Lechien JR, Akst LM, Hamdan AL, Schindler A, Karkos PD, Barillari MR, Calvo-Henriquez C, Crevier-Buchman L, Finck C, Eun YG, Saussez S, Vaezi MF (2019) Evaluation and manage- ment of laryngopharyngeal reflux disease: state of the art review. Otolaryngol Head Neck Surg 160(5):762-782. https:// doi. org/ 10. 1177/ 01945 99819 827488
  2. [20]20. Crevier Buchman L, Hans S, Behm E, Tissot V, Laccourreye O, Brasnu D (2006) How to perform and analyze a stroboscopic examination? Ann Otolaryngol Chir Cervicofac 123(4):203-206. https:// doi. org/ 10. 1016/ s0003-438x(06) 76667-1
  3. [47]47. Nawka T, Wiesmann U, Gonnermann U (2003) Validation of the German version of the Voice Handicap Index. HNO 51(11):921-930. https:// doi. org/ 10. 1007/ s00106-003-0909-8
  4. [55]55. Titze IR (1995) Workshop on acoustic voice analysis: summary statement. Front cover. National Center for Voice and Speech. J Voice 36:149
  5. [78]78. Lechien JR, Bobin F, Muls V, Thill MP, Horoi M, Ostermann K, Huet K, Harmegnies B, Dequanter D, Dapri G, Maréchal MT, Finck C, Rodriguez Ruiz A, Saussez S (2020) Validity and reli- ability of the reflux symptom score. Laryngoscope 130(3):E98- E107. https:// doi. org/ 10. 1002/ lary. 28017
  6. [82]82. Bruhn J, Brockmann-Bauser M, Swing T, Bohlender JE, Rung- galdier D (2022) Transcultural German translation of the reflux symptom score-12 questionnaire. HNO 70(12):886-890. https:// doi. org/ 10. 1007/ s00106-022-01233-2
  7. [92]92. Chung CYJ, Perkisas S, Vandewoude MFJ, De Cock AM (2019) Validation of the Dutch EAT-10 for screening of oropharyngeal dysphagia in the elderly population. Tijdschr Gerontol Geriatr. https:// doi. org/ 10. 36613/ tgg. 1875-6832/ 2019. 04. 03

Cited by

Sorted by citations

Related

Authors
Lechien, J. R., Geneid, A., Bohlender, J. E., Cantarella, G., Avellaneda, J. C., Desuter, G., Sjogren, E. V., Finck, C., Hans, S., Hess, M., Oguz, H., Remacle, M. J., Schneider-Stickler, B., Tedla, M., Schindler, A., Vilaseca, I., Zabrodsky, M., Dikkers, F. G., & Crevier-Buchman, L.
Affiliations
  • Centre National de la Recherche Scientifique (FR)
  • University of Helsinki (FI)
  • University of Zurich (CH)
  • University of Milan (IT)
  • Hospital Universitario Mayor, Mederi (CO)
  • Antwerp University Hospital (BE)
  • University of Liège (BE)
  • Centre Hospitalier de Luxembourg (LU)
  • University Hospital Bratislava (SK)
  • Hospital Clínic de Barcelona (ES)
  • Amsterdam UMC Location University of Amsterdam (NL)
Corresponding author
Lechien, Jerome R.
ORCID
Venue
European Archives of Oto-Rhino-Laryngology
Publisher
Springer Science and Business Media LLC
Published
2023-09-14
Volume
280
Issue
12
Pages
5459-5473
ISSN
  • 0937-4477 (ISSN-L)
  • 1434-4726
DOI
10.1007/s00405-023-08211-6
OpenAlex
W4386726848
Cited by
107
References
99
Citations by year
2026: 43 · 2025: 38 · 2024: 23 · 2023: 3
FWCI
18.98
Type
journal article
Language
en
Open access
Licence
Locations
  • European Archives of Oto-Rhino-Laryngology (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion, other-oa)
  • Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
  • ORBi (University of Liège) (submittedVersion, other-oa)
  • ORBi UMONS (submittedVersion, other-oa)
  • Leiden Repository (Leiden University) (submittedVersion, cc-by)
  • HAL (submittedVersion)
  • Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich) (submittedVersion)
  • Zurich Open Repository and Archive (University of Zurich)
Topics
  • Health Sciences › Medicine › Physiology › Voice and Speech Disorders
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Tracheal and airway disorders
Keywords
voice quality assessment, voice disorders, videolaryngostroboscopy, maximum phonation time, vocal acoustics, jitter and shimmer, reflux, dysphagia, Voice Handicap Index, professional voice users, laryngeal diseases, clinical guidelines
MeSH terms
Humans, Laryngeal Diseases, Otolaryngology, Voice, Voice Quality, Treatment Outcome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review