{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:48:56Z","timestamp":1786978136799,"version":"build-2736575974"},"reference-count":8,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,3]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To evaluate the diagnostic accuracy of the Consensus Auditory\u2010Perceptual Evaluation of Voice (CAPE\u2010V), Pediatric Voice Handicap Index (pVHI), and computer\u2010assisted voice analysis (CVA) against flexible fiberoptic laryngoscopy in a pediatric cohort.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort of 116 children (4\u201318\u2009years) underwent same\u2010day CAPE\u2010V, pVHI, CVA (Visipitch), and flexible fiberoptic laryngoscopy at a tertiary pediatric voice clinic. Encounters were classified as dysphonia evaluation versus vocal fold surveillance, and age was grouped as preschool (\u2264\u20095\u2009years) versus school\u2010aged (>\u20095\u2009years). Diagnostic performance was assessed with receiver operating characteristic (ROC) curves, area under the curve (AUC), and optimal cutpoints by the Youden index. Multivariable logistic regression\u2014adjusted for age category and encounter type\u2014modeled odds of abnormal endoscopic findings.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n CAPE\u2010V demonstrated the highest individual accuracy (AUC 0.827;\n p<\/jats:italic>\n \u2009=\u20090.0034). Combined use of CAPE\u2010V, pVHI, and CVA yielded superior discrimination (AUC 0.846; sensitivity 0.886; specificity 0.771; positive predictive value 0.886; negative predictive value 0.771). Dysphonia encounters had lower odds of abnormal findings compared to vocal fold surveillance (OR 0.09; 95% CI 0.02\u20130.36). School\u2010aged children had lower odds of pathology than preschoolers (OR 0.18; 95% CI 0.03\u20130.09). Peak sensitivity occurred at Age 7; the probability of abnormal findings declined with increasing age.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n CAPE\u2010V is a robust single\u2010test predictor of pediatric vocal fold pathology, and integration with pVHI and CVA enhances diagnostic accuracy. A tiered, age\u2010tailored screening algorithm beginning with CAPE\u2010V may optimize referral pathways and improve early detection of vocal fold pathology while preserving laryngoscopy as the diagnostic standard.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n Level 3 (retrospective cohort study).<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70132","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T11:35:22Z","timestamp":1758022522000},"page":"1500-1506","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Predictive Efficacy of\n CAPE<\/scp>\n \u2010V,\n pVHI<\/scp>\n , and\n CVA<\/scp>\n in Detecting Vocal Fold Pathology in Children"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-2196","authenticated-orcid":false,"given":"Nicholas A.","family":"Rossi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Emory University School of Medicine Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy S.","family":"Puckett","sequence":"additional","affiliation":[{"name":"Department of Speech Pathology Nationwide Children's Hospital Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad W.","family":"deSilva","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Wexner Medical Center at Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Wiet","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Nationwide Children's Hospital Columbus Ohio USA"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Wexner Medical Center at Ohio State University Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12070\u2010023\u201003952\u20106"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2012.03.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2014.10.004"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2008.09.004"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431\u2010023\u201004879\u20104"},{"issue":"1","key":"e_1_2_8_7_1","first-page":"1","article-title":"Epidemiological Study on Vocal Disorders in Paediatric Age","volume":"49","author":"Angelillo N.","year":"2008","journal-title":"Journal of Preventive Medicine and Hygiene"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2021.110614"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1044\/2023_JSLHR\u201022\u201000713"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70132","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.70132","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.70132","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T12:14:46Z","timestamp":1772972086000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.70132"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,16]]},"references-count":8,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1002\/lary.70132"],"URL":"https:\/\/doi.org\/10.1002\/lary.70132","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,16]]},"assertion":[{"value":"2025-05-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}