Vocal Effort in Clinical Settings of North and South American Countries: Characterization From Argentinian, Chilean, Colombian, and the United States Clinician's Reports.
Lady Catherine Cantor-Cutiva, Büşra Ensar, Miriam van Mersbergen and 2 others
PMID 39505599WHAT IT FOUND
Voice clinicians across four countries report vocal effort in over 60% of their caseloads, but prevalence varies significantly by location and experience.
Most patients struggle to define the symptom. Using specific self-report measures like the Vocal Fatigue Index was associated with higher identification rates.
Key findings
01Over 60% of surveyed speech-language pathologists reported working with patients exhibiting vocal effort issues, though the specific percentage of caseload varied significantly between Argentina, Chile, Colombia, and the United States.
02The majority of clinicians (56% to 71%) reported that their patients had difficulty defining vocal effort, while a much smaller percentage of clinicians (6% to 38%) reported having difficulty explaining it themselves.
03Multivariate analysis showed that years of experience and the use of the Vocal Fatigue Index or Visual Analogue Scales were significant predictors of reporting higher rates of vocal effort in a clinician's caseload.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relied on clinician self-report rather than direct patient assessment, which introduces potential bias regarding what clinicians perceive as vocal effort. Response bias may have occurred if clinicians who are more sensitive to vocal effort were more likely to participate in the survey. The sample may not be fully representative of all voice-focused SLPs across North and South America. Spanish translation was based on American usage, which may not capture linguistic nuances in different South American countries. The study did not measure actual vocal effort physiologically, only its perceived prevalence and identification by clinicians.
Declared interests
No conflicts of interest were declared, and there was no significant financial support for the work.
The easy way to misread this
Do not interpret the association between using the Vocal Fatigue Index and higher reported prevalence as proof that the tool accurately measures vocal effort. The study shows that clinicians who use this tool are more likely to report vocal effort, but it does not establish that the tool's scores correlate with the actual perceptual experience of exertion, nor does it prove that other tools fail to detect it.