Risk of Dysphonia in Theater Actors: Proposal for a Screening Protocol

Eloisa Pinheiro Ferrari; João Marcos da Trindade Duarte; Marcia Simões-Zenari; Nadia Vilela; Suely Master; Katia Nemr

doi:10.1016/j.jvoice.2023.04.015

Risk of Dysphonia in Theater Actors: Proposal for a Screening Protocol

J Voice. 2023 May 25:S0892-1997(23)00138-8. doi: 10.1016/j.jvoice.2023.04.015. Online ahead of print.

Authors

Eloisa Pinheiro Ferrari¹, João Marcos da Trindade Duarte¹, Marcia Simões-Zenari², Nadia Vilela³, Suely Master⁴, Katia Nemr¹

Affiliations

¹ Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
² Department of Speech Therapy, Physiotherapy and Occupational Therapy, University of São Paulo Medical School, São Paulo, São Paulo, Brazil. Electronic address: marciasz@usp.br.
³ Escola de Atores Wolf Maya, Brazil.
⁴ Instituto de Artes, Universidade Estadual Paulista de Júlio Mesquita Filho-UNESP, São Paulo, São Paulo, Brazil.

PMID: 37244760
DOI: 10.1016/j.jvoice.2023.04.015

Abstract

Objective: To propose a Dysphonia Risk Screening Protocol for Actors (DRSP-A), test its usability in conjunction with the General Dysphonia Risk Screening Protocol (G-DRSP), determine the cut-off point for a high risk of dysphonia in actors, and compare the risk of dysphonia between actors with and without voice disorders.

Method: Observational cross-sectional study with 77 professional actors or students. The questionnaires were applied individually and the total scores were summed to calculate the final score of the Dysphonia Risk Screening (DRS-Final). The validity of the questionnaire was verified from the area under the Receiver Operating Characteristic (ROC) curve, and cut-offs were obtained based on diagnostic criteria for screening procedures. Voice recordings were collected for auditory-perceptual analysis and subsequent division into groups with and without vocal alteration.

Results: The sample showed a high risk of dysphonia. Higher scores in the G-DRSP and in the DRS-Final were found in the group that presented vocal alteration. The cut-off points established for the DRSP-A and DRS-Final were 0.623 and 0.789, respectively, with higher degrees of sensitivity than specificity. Thus, above these values, the risk of dysphonia is greater.

Conclusion: A cut-off value was calculated for the DRSP-A. This instrument was proven to be viable and applicable. The group with vocal alteration had a higher score in the G-DRSP and DRS-Final, but there was no difference in the DRSP-A.

Keywords: Occupational health; Surveys and questionnaires; Vocal quality; Voice; Voice disorders.