Screening and analysis of the risk of dysphonia based on general and specific screening protocols in teachers with and without voice disorders.

Both groups scored above the high-risk cutoff, so in this sample the protocols did not pick out the teachers who actually had voice disorders from those who did not. The voice disorders in the sample were mild to moderate, and the authors say further studies with larger samples are needed before the findings can be confirmed. The version of the teacher-specific protocol used during data collection is not the version being proposed: subitems on remote learning, mental health and orthodontic appliances or aligners were added, smoking was detailed, and the scoring of drug use and dental prosthesis was changed afterwards. Both groups were mostly women with few men, which the authors say limits any conclusions about the influence of sex. Risk was measured by self-report questionnaires, and the two judges agreed only moderately on how severe each voice was. The study is cross-sectional: risk factors and voice status were measured at the same time, so it cannot show what caused a teacher's voice problem.

The authors declare no financial support and nothing to declare for conflicts of interest. No company involvement in the design, conduct or writing of the study is reported.

Do not read the hydration and smoking differences as evidence that changing either one would prevent or resolve a teacher's voice disorder. They were two small differences among many comparisons, the main comparison between teachers with and without voice disorders found no difference at all, and the study measured everything at a single point in time so it cannot show cause. Note too that it was the teachers without voice disorders who had the higher hydration risk score.