Validation and Cutoff Value of the Brazilian Version of the Evaluation of the Ability to Sing Easily—EASE

Abstract

Objective: To validate the Evaluation of the Ability to Sing Easily (EASE) scale for Brazilian Portuguese. Methods: A total of 391 singers participated in the study—192 females and 198 males, with a mean age of 33 years. Validation was performed according to the criteria recommended by the COnsensus-based Standards for the selection of health Measurement INstruments, evaluating the following domains, properties, and measurement: reliability (reliability and internal consistency), construct validity (transcultural validity and structural validity), and criterion validity (concurrent criterion validity). Hence, participants responded to the EASE for Brazil (EASE-BR), the Voice Symptoms Scale (VoiSS), the list of signs and symptoms (LSS), and a vocal self-assessment. The EASE-BR was answered a second time 2-15 days after the first application. Results: The Brazilian version of the EASE scale, called EASE-BR, was found to have adequate cross-cultural validity. In construct validity, the 22-item, three-factor model had its structure validated in confirmatory factor analysis with an standardized root mean square residual of 0.066; internal consistency with a high Cronbach's coefficient between 0.902 and 0.779; test-retest reliability with an ICC between 0.72 and 0.52; and concurrent criterion validity significantly correlated with the VoiSS, LSS, and vocal self-assessment (P < 0.05). The cutoff values that differentiated individuals with and without risk for voice changes were 10.5 points for the total, 4.5 for vocal fatigue, 5.5 for the vocal risk index, and 1.5 for vocal concern. Conclusions: The EASE-BR proved to be a valid and reliable vocal self-assessment instrument in its structure with 22 items and three factors.