# Evaluation of a Newly Developed Device for Resonance Disorders: A Clinical Pilot Study
## 4 Discussion  
When the newly developed Smart Naso(tm) and existing Nasometer II 6450 were used in the hypernasality group, more than 90% similarity was observed; when both devices were applied to the normal group, a high similarity of 70-80% was observed. In a comparison of the two devices in the two groups, Smart Naso(tm) and Nasometer II 6450 exhibited comparable similarity. However, the newly developed Smart Naso(tm) demonstrated more than 90% similarity in patients with resonance disorders, indicating its clinical effectiveness. This difference can be induced owing to the system of nasalance calculations between the two devices, given that variations in nasalance can occur in different experimental environments and conditions among individuals [10; 14; 23]. In the reliability evaluation, ICC was utilized to verify the test-retest reliability for nasalance. During this process, low (0.50 \(<\) ICC), moderate (0.50 \(\leq\) ICC \(<\) 0.75), high (0.75 \(\leq\) ICC \(<\) 0.90), and very high (0.90 \(\leq\) ICC) categories were designated based on the 95% confidence interval. Smart Naso(tm) test-retest was conducted on the normal group to determine if consistent results were obtained for the same subject. The results revealed that the inspection words /nani nani nani/ and /arjin ajnjnjn/ demonstrated a reliability of 0.594 and 0.615, respectively, indicating a moderate level of reliability, while exhibiting high reliability for the sentence patterns /a/, /i/, /papi papi/, /phaphi phaphi phaphi/, /pap'pi p'ap'i/, /mamiamiamiamiami/, /phaphi phaphi/, and /sukhiu turesurull posip'sio/ and very high reliability for the sentence patterns /mamiamiamiamiami/ and /ammananum remontcusuurul mandur.ajo/. The test-retest using the Smart Naso(tm) in the hypernasality group with the inspection words /p'ap'i p'ap'i p'ap'i/, /nani nani nani/, and /anjin ajnjnjnjn/ demonstrated very \begin{table}
\begin{tabular}{c c c c c c} \hline \hline  & \multicolumn{4}{c}{**Test–Retest Reliability in the Hypernasality Group**} \\
**Sentence Pattern** & \multicolumn{2}{c}{**Reliability of Smart Naso(tm) Results**} & \multicolumn{2}{c}{**Reliability of Nasometer II 6450 Results**} \\  & **Session 1** & **Session 2** & **ICC** & **Session 1** & **Session 2** & **ICC** \\  & 29.78 & 29.11 & 0.948 & 24.78 & 23.44 & 0.935 \\ /a/ & \(\pm\)9.77 & \(\pm\)10.78 & 0.948 & \(\pm\)10.89 & \(\pm\)9.58 & 0.935 \\ /i/ & 49.78 & 51.33 & 0.948 & 45.67 & 48.56 & 0.953 \\  & \(\pm\)20.56 & \(\pm\)23.30 & 0.948 & \(\pm\)28.24 & \(\pm\)24.49 & 0.953 \\ /papi papi/ & 35.67 & 35.33 & 0.988 & 24.78 & 25.67 & 0.857 \\  & \(\pm\)17.44 & \(\pm\)15.28 & 0.988 & \(\pm\)13.74 & \(\pm\)12.30 & 0.857 \\  & 32.00 & 30.44 & 0.977 & 20.89 & 22.00 & 0.946 \\  & \(\pm\)20.35 & \(\pm\)19.38 & \(\pm\)13.23 & \(\pm\)14.29 & 0.946 \\  & 36.78 & 35.56 & 0.889 & 22.78 & 22.67 & 0.962 \\  & \(\pm\)24.36 & \(\pm\)19.35 & 0.889 & \(\pm\)11.85 & \(\pm\)13.34 & 0.962 \\  & 60.22 & 59.78 & 0.902 & 58.89 & 59.56 & 0.886 \\  & \(\pm\)8.91 & \(\pm\)9.52 & 0.902 & 58.93 & \(\pm\)6.67 & 0.886 \\  & 63.11 & 62.33 & & 57.89 & 60.44 & 0.836 \\  & \(\pm\)8.65 & \(\pm\)11.99 & 0.895 & \(\pm\)8.67 & \(\pm\)7.16 & 0.836 \\  & 68.56 & 70.00 & 0.793 & 69.89 & 73.33 & 0.856 \\  & \(\pm\)13.48 & \(\pm\)9.89 & & \(\pm\)9.60 & \(\pm\)6.18 & 0.856 \\  & 30.33 & 31.56 & & 22.89 & 22.67 & 0.951 \\  & \(\pm\)13.40 & \(\pm\)12.97 & 0.976 & \(\pm\)10.01 & \(\pm\)10.39 & 0.951 \\  & 25.11 & 27.56 & 0.958 & 24.33 & 21.89 & 0.864 \\  & \(\pm\)11.90 & \(\pm\)11.38 & & \(\pm\)10.72 & \(\pm\)14.13 & 0.864 \\  & 49.44 & 51.11 & 0.932 & 44.33 & 41.44 & 0.190 \\  & \(\pm\)12.47 & \(\pm\)8.43 & & \(\pm\)7.81 & \(\pm\)13.64 & 0.190 \\ \hline \hline \end{tabular}
\end{table} 
Table 6: Evaluation of the Smart Naso(tm) test–retest reliability in the hypernasality group. with an existing product through clinical evaluation.