Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Azerbaijani-Turkish Version of the Voice Symptom Scale (At-Voiss) Publisher Pubmed



Fekar Gharamaleki F ; Ghorbani E ; Ahadi J ; Fathipourazar Z
Source: Journal of Voice Published:2025

Abstract

Objectives: Currently, there is no validated Azerbaijani-Turkish instrument specifically designed to comprehensively assess the multidimensional symptom profile of voice disorders in this language. This study aimed to translate the Azerbaijani-Turkish version of the Voice Symptom Scale (AT-VoiSS) to Azerbaijani-Turkish and evaluate its validity and reliability through cross-cultural adaptation. Study Design: A cross-sectional and prospective validation design was adopted. Methods: After permission, the VoiSS was translated and culturally adapted into the Azerbaijani-Turkish language according to the standard methodology of forward-backward translation. Eight experts assessed content validity through the Content Validity Index (CVI). Face validity and the pilot study were assessed through cognitive interviewing with 20 voice patients. The study included 160 participants, with 80 having voice complaints and 80 not having voice complaints. Construct validity was obtained by comparing the total and subtotal scores with and without the voice complaint groups. The criterion validity was calculated by comparing the correlation of the total score of the AT-VoiSS with the Azerbaijani-Turkish version of voice-related quality of life (AT-VRQOL). The discriminant validity was evaluated by evaluating the area under the curve (AUC), sensitivity, specificity, and cutoff points. The internal consistency of AT-VoiSS was examined using Cronbach’s alpha coefficient. To calculate the test-retest reliability coefficient, 30 participants completed the AT-VoiSS twice, including 20 with voice complaint disorders and 10 without voice complaints, at 2-week intervals. Results: Differences in the AT-VoiSS scores between participants with and without voice complaints were statistically significant (P < 0.001). The construct validity results showed significant differences in the scores between the two groups in three factor scores (P < 0.001). The criterion validity results showed that the total score of AT-VoiSS is negatively correlated with the AT-VRQOL results (r = −0.85, P < 0.001). The area under the curve value from the ROC curve was 100. The optimal cutoff point was 30.55, with a sensitivity of 100% and a specificity of 55%. The AT-VoiSS had high internal consistency, indicating excellent reliability (Cronbach’s alpha coefficient = 0.99). A high degree of correlation was found between the scores obtained in the two administrations, indicating excellent test-retest reliability (r =0.98, P < 0.001). Conclusions: The AT-VoiSS is a valid, reliable, and sensitive scale that can assess patients with voice disorder symptoms in the Azerbaijani-Turkish population. © 2025 Elsevier B.V., All rights reserved.