Validation of an Intelligibility Assessment Tool in an Indian Language for Perceptual Speech Analysis in Oral Cancer Pat
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ORIGINAL ARTICLE
Validation of an Intelligibility Assessment Tool in an Indian Language for Perceptual Speech Analysis in Oral Cancer Patients Yogesh Dokhe 1 & Krishnakumar Thankappan 1 & Ridhi Sood 1 & Arya Chandrababu Jaya 1 & Deepak Balasubramanian 1 & Shilpa Chatni 1 & Bibitha Kizhakkevalappil Babu 1 & Sajith Babu 2 & Swapna Sebastian 3 & Shaji Thomas 4 & Paul Sebastian 4 & Subramania Iyer 1 Received: 21 June 2020 / Accepted: 9 September 2020 # Indian Association of Surgical Oncology 2020
Abstract This study aimed to develop a speech intelligibility tool in Malayalam, an Indian language, based on the perceptual analysis. The tool had components of vowel, consonant, word, passage, and overall intelligibility. After face and content validation, a sample of 30 consecutive oral cancer patients underwent preliminary testing for internal consistency, inter- and intra-rater reliability, concurrent, and known-group validity. Subsequent validation was done in 80 T1–T4 patients from two centers. The scale had a high level of internal consistency; the Cronbach’s alpha was 0.847 and good intra-rater and inter-rater agreement amongst all raters. There was a strong correlation between the Malayalam and the English passage. Pearson correlation coefficient of 0.646 proved concurrent validity. On known-group and subsequent validation, the tool showed expected differences between the treatment groups. The speech tool proved to be reliable and valid for perceptual evaluation of speech intelligibility in oral cancer patients. Keywords Oral cancer . Head and neck cancer . Speech analysis . Functional outcome . Tool validation
Introduction The physiology of speech production is intricately orchestrated by the respiratory system, the phonatory system, and the articulatory system. The phonatory system (lungs with the vibration of vocal cords) produces voice. The mobile structures in the oral cavity the jaw, the lips and the tongue (active or moveable articulators) and the static structures, the hard Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13193-020-01216-1) contains supplementary material, which is available to authorized users. * Krishnakumar Thankappan [email protected] 1
Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical SciencesAIMS, Amrita Vishwa Vidyapeetham, Ponekkara PO, Kochi, Kerala, India
2
Department of Surgical Oncology, Malabar Cancer Centre, Moozhikkara (PO), Thalassery, Kerala 670111, India
3
Department of ENT, Christian Medical College, Vellore, India
4
Division of Surgical Oncology, Regional Cancer Centre, Trivandrum, India
palate, and the teeth (Passive or fixed articulators) modulate this sound into a speech [1]. Head and neck cancer and its treatment can significantly affect the speech function [2]. There are existing scales for evaluation of the laryngeal function of voice, but the evaluation of speech outcomes is not well described. The speech evaluation can be subjective based on questionnaires or objective us
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