Validity and reliability of the Korean version of the Speech Handicap Index in patients with oral cavity cancer

Comparing apples to manzanas and oranges to naranjas: A new measure of English-Spanish vocabulary for dual language learners

The valid assessment of vocabulary development in dual-language-learning infants is critical to developmental science. We developed the Dual Language Learners English-Spanish (DLL-ES) Inventories to measure vocabularies of U.S. English-Spanish DLLs. The inventories provide translation equivalents for all Spanish and English items on Communicative Development Inventory (CDI) short forms; extended inventories based on CDI long forms; and Spanish language-variety options. Item-Response Theory analyses applied to Wordbank and Web-CDI data (n = 2603, 12-18 months; n = 6722, 16-36 months; half female; 1% Asian, 3% Black, 2% Hispanic, 30% White, 64% unknown) showed near-perfect associations between DLL-ES and CDI long-form scores. Interviews with 10 Hispanic mothers of 18- to 24-month-olds (2 White, 1 Black, 7 multi-racial; 6 female) provide a proof of concept for the value of the DLL-ES for assessing the vocabularies of DLLs.

Feasibility of Home-Based Pulmonary Rehabilitation of Pediatric Patients with Chronic Respiratory Diseases

BACKGROUND AND OBJECTIVE

Chronic respiratory diseases in children deteriorate their daily life due to dyspnea and reduced lung function. We aimed to evaluate the feasibility of home-based pulmonary rehabilitation in pediatric chronic respiratory diseases.

METHODS

This prospective, single-arm, cohort study included children with chronic lung disease. They were instructed to perform home-based pulmonary rehabilitation 30 min/session, three sessions/week for three months. Pulmonary function test (PFT) using spirometry, respiratory muscle strength (RMT), cardiopulmonary exercise test (CPET), 6 min walk test (6MWT), dyspnea questionnaires, speech evaluation, and pediatric quality of life inventory (PedsQL) were assessed pre- and post-pulmonary rehabilitation. Compliance and satisfaction of the program were also evaluated.

RESULTS

Twenty children (mean age: 11.2 ± 3.1 years) with chronic respiratory diseases without cardiopulmonary instability participated. The overall compliance was 71.1% with no related adverse events. After pulmonary rehabilitation, forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), RMT, 6MWT, dyspnea questionnaire, speech rate, and PedsQL (child) significantly improved (p < 0.05), particularly better in the FEV1 < 60% group than in the FEV1 ≥ 60% group and in the high-compliance group (compliance ≥ 50%) than in the low-compliance group (compliance < 50%).

CONCLUSIONS

Home-based pulmonary rehabilitation for children with chronic lung disease was feasible with high compliance and effective in terms of objective functions, subjective dyspnea symptom, and quality of life.

An investigation of the cutoff point of the English version of speech handicap index in the American total laryngectomees

OBJECTIVES

The present article aims to identify the optimal cutoff score and the diagnostic accuracy for the English version of Speech Handicap Index (SHI) to screen out individuals with and without speech disorders in daily life.

MATERIALS AND METHODS

In this cross-sectional cohort study, a volunteer sample of 104 adult patients after total laryngectomy and 99 healthy controls in the United States completed the English version of SHI online questionnaire. Sensitivity and specificity were computed for a range of cut-off values using the Receiving Operating Characteristics (ROC) analysis to establish an optimal cutoff point for the SHI. Other measures of diagnostic accuracy, such as likelihood ratios (LR), positive predictive values (PPV), and negative predictive values (NPV) were also computed.

RESULTS

Patients after total laryngectomy obtained a higher score than the healthy controls on the mean scores of SHI. According to the ROC analysis, an optimal cutoff score of 17 points determined by Youden index was identified on the head and neck cancer population with a sensitivity of 92.31%, specificity of 92.31%, PPV of 90.60%, NPV of 91.75%, LR + of 9.14, and LR- of 0.09.

CONCLUSIONS

The cutoff score of the English version of SHI applied on the English-speaking population in the United States demonstrated promising diagnostic accuracy.

Validation and Psychometric Evaluation of the Kannada Version of the Speech Handicap Index in Individuals with Oral and Oropharyngeal Cancer

The current study aimed to adapt and validate the speech handicap index into the Kannada language, and also to investigate its psychometric properties in Kannada speaking individuals with oral and oropharyngeal cancers. This is a cross-sectional study and it was carried out in two phases. The first phase dealt with the translation of the English version of SHI into the Kannada language, and its validation on 95 healthy individuals and 25 individuals with oral or oropharyngeal cancer. The second phase dealt with the investigation of speech-related quality of life among 50 Kannada speaking individuals with oral and oropharyngeal cancers. The SHI-K has very good internal consistency (Cronbach's Alpha is 0.98) and exhibited good test-retest reliability (ICC = 0.94). The mean scores of the disordered group, for the psychosocial scores (t (118) = 25.87, p < 0.01), for speech scores (t (118) = 19.74, p < 0.01), for total SHI scores (t (188) = 26.45, p < 0.01), for overall rating (t (118) = 16.81, p < 0.01) were statistically significant and greater than the healthy group (p < 0.01). A statistically significant association was found between clinical-stage, total SHI scores, and rating [χ2 (4, N = 50) = 3.82, p = 0.02], but not for sex, tumor site, and type of treatment received. SHI-K is a valid and reliable tool to assess the speech-related quality of life of individuals with speech disorders. This tool can allow clinicians to plan better rehabilitation, and it can be used as an outcome tool for any treatment studies. The findings of the study emphasize the importance of considering patient priorities before commencing surgical or therapeutic interventions.

Substitution voicing index: towards improved speech assessment in patients who have undergone laryngeal oncosurgery

This study aimed to develop a multidimensional model for the evaluation of substitution voicing (SV) after laryngeal oncosurgery. The study group consisted of 121 adult male individuals: 59 patients with SV after laryngeal oncosurgery (endolaryngeal cordectomy, partial laryngectomy, total laryngectomy with tracheoesophageal prosthesis) and 62 healthy controls. A multidimensional protocol for the assessment of SV included, 1) self-reported speech evaluation with a short version of the Speech Handicap Index, 2) auditory-perceptual assessment, and 3) acoustic speech analysis using AMPEX® (Auditory Model Based Pitch Extractor) software. Moderate correlations were observed between parameters from self-reported auditory-perceptual and acoustic speech analysis domains. The multidimensional Substitution Voicing Index (SVI), including markers from these domains, was elaborated by using linear stepwise regression to determine the optimal set of parameters for categorising SV patients. The lowest mean SVI score was revealed in the control subgroup corresponding to the normal speech, followed by cordectomy subgroup and partial laryngectomy subgroup. The highest mean SVI score was revealed in the total laryngectomy subgroup, reflecting the most severely deteriorated quality of SV. One-way analysis of variance identified statistically significant differences between the mean SVI scores in separate subgroups. The results demonstrated the potential benefits of the SVI for a multidimensional evaluation of SV in patients after laryngeal oncosurgery.

Cross-Cultural Adaptation and Validation of the Speech Handicap Index into Persian

PURPOSE

The aim of the present study was to adapt and validate the Speech Handicap Index (SHI) into the Persian language.

PATIENTS AND METHODS

The original published English version of the SHI was translated into Persian using the translation protocol and guidelines of the International Quality of Life Assessment. One hundred participants with oral and oropharyngeal cancer and 40 healthy participants completed the Persian SHI. Forty participants of the patient group completed the Persian SHI a second time after a 2-weeks period to evaluate test-retest reliability. Content validity (content validity index and content validity ratio), internal consistency (Cronbach α coefficient), test-retest reliability (intraclass correlations), and construct validity (confirmatory factor analysis) were examined. Control group and patient group values were compared to determine the clinical validity.

RESULTS

A significant discrimination coefficient was found across all items, and the content and clinical validity were found to be acceptable. The Persian SHI showed a high internal consistency and test-retest reliability. The construct validity was within the acceptable range.

CONCLUSIONS

The P-SHI is considered to be a valid and reliable questionnaire for speech assessment in Persian-speaking patients with head and neck cancer.

Data mining of an acoustic biomarker in tongue cancers and its clinical validation

The promise of speech disorders as biomarkers in clinical examination has been identified in a broad spectrum of neurodegenerative diseases. However, to the best of our knowledge, a validated acoustic marker with established discriminative and evaluative properties has not yet been developed for oral tongue cancers. Here we cross-sectionally collected a screening dataset that included acoustic parameters extracted from 3 sustained vowels /ɑ/, /i/, /u/ and binary perceptual outcomes from 12 consonant-vowel syllables. We used a support vector machine with linear kernel function within this dataset to identify the formant centralization ratio (FCR) as a dominant predictor of different perceptual outcomes across gender and syllable. The Acoustic analysis, Perceptual evaluation and Quality of Life assessment (APeQoL) was used to validate the FCR in 33 patients with primary resectable oral tongue cancers. Measurements were taken before (pre-op) and four to six weeks after (post-op) surgery. The speech handicap index (SHI), a speech-specific questionnaire, was also administrated at these time points. Pre-op correlation analysis within the APeQoL revealed overall consistency and a strong correlation between FCR and SHI scores. FCRs also increased significantly with increasing T classification pre-operatively, especially for women. Longitudinally, the main effects of T classification, the extent of resection, and their interaction effects with time (pre-op vs. post-op) on FCRs were all significant. For pre-operative FCR, after merging the two datasets, a cut-off value of 0.970 produced an AUC of 0.861 (95% confidence interval: 0.785-0.938) for T_3-4 patients. In sum, this study determined that FCR is an acoustic marker with the potential to detect disease and related speech function in oral tongue cancers. These are preliminary findings that need to be replicated in longitudinal studies and/or larger cohorts.

Cultural Adaptation and Validation of Speech Handicap Index: A Scoping Review

Objectives The Speech Handicap Index (SHI) is a self-reported speech-related quality of life assessment originally developed for measuring the psychosocial speech impact in patients with oral or pharyngeal cancer. This review article provides a scoping review of the literature on the validated SHI, with the purpose of identifying and documenting available studies and procedures for the cultural adaption and validation of SHI. Method Prime databases including PubMed, EMBASE, and Google Scholar were searched for journal publications reporting validation of the SHI. Reviews and reference cross-checking were performed using a priori selection criteria. A body of literature related to SHI was scoped and publication quality was categorized independently by two investigators. After applying all the screening criteria, articles that met the eligibility criteria were included in the review. Results The scoping review yielded 10 articles that met the inclusion criteria presenting the SHI in eight different languages, including Dutch, U.K. English, French, Korean, Simplified Chinese (Mandarin), Lithuanian, Italian, and European Portuguese. All of them reported validity, reliability, and translation method. Discussion and Conclusions High reliability and validity between various language versions of the SHI were identified. The current scoping review provides a useful summary and could be a helpful precursor to a systematic review on SHI in the future. Supplemental Material https://doi.org/10.23641/asha.14082704.

Development of the German Speech Intelligibility Index for the treatment of oral cancer patients

OBJECTIVES

This study aimed at 1) adapting the well-established Speech Handicap Index (SHI) to German, 2) testing the suitability of the instrument for assessing speech-related quality of life, 3) comparing it to the German Voice-Handicap-Index (VHI), in order to support treatment of oral cancer patients who experience posttreatment speech difficulties that affect their quality of life.

MATERIAL AND METHODS

Participants completed a web-based survey that employed a 2 (experienced problem: speech/articulation-related vs. voice-related) x 2 (SHI vs. VHI) between-subject experimental design, enabling it to distinguish between the experiences of voice and intelligibility impairments, and to determine the discriminatory ability of the two instruments.

RESULTS

The German SHI reliably assessed speech intelligibility and articulation-related Quality of life. While voice impairments were equally well assessed by both, VHI: M 2.48, SD 0.65; SHI: M 2.52, SD 0.63; only the latter appropriately registered intelligibility handicap in speech impairments (VHI: M 2.05, SD 0.70; SHI: 2.68, SD 0.73). The responsivity of the SHI in capturing the experienced handicap was significantly greater in the speech/articulation-impairment condition (p = .001).

CONCLUSION

The German SHI is a reliable and responsive measure for speech intelligibility and articulation-related quality of life that should be chosen in preference to the VHI.

Speech handicap index: cross-cultural adaptation and validation in European Portuguese speakers with oral and oropharyngeal cancer

INTRODUCTION

To date, no valid outcome measure has been developed in European Portuguese (EP) to assess the opinion of the patients with oral and oropharyngeal cancer about the speech impact in his/her related quality of life.

OBJECTIVES

This study aimed to cross-culturally adapt the speech handicap index (SHI) in EP and contribute to its validation in oral and oropharyngeal cancer patients.

MATERIALS AND METHODS

A cross-sectional study was carried out in two phases: (i) SHI translation, back-translation, expert analysis, and pilot study; (ii) application of the EP version of the SHI (EP-SHI) to 95 patients with oral and oropharyngeal cancer and 83 gender- and age-matched healthy individuals. A total of 23 randomly chosen patients were asked to re-fill the EP-SHI questionnaire after 3 weeks. The psychometric properties (feasibility, practicability, reliability, and validity) were assessed.

RESULTS

The EP-SHI version brought together expert consensus and the acceptability of 75% of the participants in the pilot study. The EP-SHI questionnaire is feasible (no missing data and floor effect < 7%), practical (an average of 5.5 min to complete), possesses internal consistency reliability (Cronbach's alpha ≥ 0.90), test-retest reliability (interclass correlation coefficient, ICC ≥ 0.90), significantly strong convergent validity with EP-voice handicap index (VHI) (rô≥0.94), distinguishes patients from healthy speakers and within the patients' group according to individual speech rating and glossectomy surgery.

CONCLUSIONS

The EP-SHI is a culturally relevant, valid and reliable patient reported outcome measure (PROM), and therefore, it is appropriate to be recommended for used with oral and oropharyngeal cancer patients.

Validation and Reliability of the Italian Version of the Speech Handicap Index

<b><i>Background:</i></b> Speech problems negatively affect the quality of life of patients with oral and oropharyngeal cancer. An appropriate self-rating questionnaire named Speech Handicap Index (SHI) was developed for these individuals. The aim of this study was the cross-cultural adaptation and the validation of the Italian version of the SHI. <b><i>Methods:</i></b> Fifty-two patients surgically treated for oral or oropharyngeal cancer and 100 healthy individuals without speech articulation disorders were included in the study. An Italian version of the SHI was cross-culturally adapted. Internal consistency, test-retest reliability, construct, and clinical and group validity were calculated. <b><i>Results:</i></b> Cronbach’s alpha coefficient was 0.977. The test-retest reliability was excellent (<i>r</i> between 0.883 and 0.998). There was a good correlation between the total SHI score and the overall speech quality item (<i>p</i> &#x3c; 0.001), and between the former and speech intelligibility and articulation scales (<i>p</i> &#x3c; 0.001). The SHI was able to distinguish between patients and healthy subjects (<i>p</i> &#x3c; 0.001). There was a statistically significant correlation between the total SHI score and tumor stage (<i>p</i> = 0.003). <b><i>Conclusions:</i></b> The Italian version of the SHI showed high values of reliability and validity scores. It is a good instrument to evaluate the impact of speech impairment in patients with oral and oropharyngeal cancer.

Deglutition disorders as a consequence of head and neck cancer therapies: a systematic review and meta-analysis

PURPOSE

In this study, we aimed to estimate the frequency of deglutition disorders in patients pre- and post-treatment for head and neck cancer (HNC).

METHODS

Search strategies were developed for the following databases: LILACS, PubMed, SpeechBITE, LIVIVO, Web of Science, and Scopus. Additionally, the gray literature was searched using Google Scholar, OpenGrey, and ProQuest. Only studies that conducted an evaluation of deglutition before and after cancer treatment and had sufficient quantitative data were included. We conducted a proportion of random effects meta-analysis using R statistical software.

RESULTS

Seventeen studies were included. Aspiration showed a high frequency in the period less than 3 months post-treatment, with 28.6% (total sample = 229). Penetration of fluids above the vocal folds and reduced laryngeal elevation were more frequent in the period less than 6 months post-treatment.

CONCLUSION

The frequency of deglutition disorders and its complications, such as aspiration, appears to be higher in the immediate to 6-month post-treatment period in patients with HNC. The parameter pharyngeal residue continued to increase through the period analyzed.

[Systematic retrospective study of oral cancer-related quality of life scale]

OBJECTIVE

The quality of life (QOL) related to oral cancer has recently become a focus of clinical studies. This study aims to systematically review the current research situation of QOL of local and foreign oral cancer patients and explore the existing related problems and future research directions to provide references and solutions.

METHODS

Through relevant key words, PubMed, Wiley InterScience, Science Direct, CNKI, and Wanfang databases were first searched. The related target literature from 2000 to 2017 were screened. Finally, the frequency of oral cancer related to QOL scale used in literature was calculated, and the related scales were briefly introduced.

RESULTS

From the target literature, 218 English target literature, 55 Chinese target literature, 24 English scales, and 12 Chinese scales were selected. The most widely used scales for assessing the QOL of patients with oral cancer were as follows: University of Washington Quality of Life Questionnaire (UW-QOL), European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Core 30/Head and Neck 35 (EORTC QLQ-C30/H&N35), 36-Item Short-Form Health Survey (SF-36), Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N), and Oral Health Impact Profile (OHIP).

CONCLUSIONS

The QOL related to oral cancer was well underway, and the study of geographical distribution was widespread. However, the work on self-developed scale remains inadequate. UW-QOL, EORTC QLQ-C30/H&N35, and FACT-H&N can be utilized as the preferred scales for evaluating the QOL of oral cancer patients. A specific disease-related function scale can also be selected according to specific research objectives.