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Šimkienė R, Šiupšinskienė N, Purlys P, Žvirblis T, Lesinskas E. Adaptation and Validation of the Lithuanian Version of the Pediatric Voice Handicap Index. J Voice 2024; 38:1247.e25-1247.e30. [PMID: 35361515 DOI: 10.1016/j.jvoice.2022.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim of this study was to develop the Lithuanian version of the Pediatric Voice Handicap Index (pVHI) and to assess its psychometric characteristics. METHODS The Lithuanian version of the pVHI was prepared according to the standard requirements for the questionnaire translation and adaptation procedure. It also included forward and backward translations of the original questionnaire, as well as a committee review and psychometric testing of the final version of the pVHI. A total of 126 children between 4 and 13 years of age were included in the study. Two study groups were formed: a group consisting of children with dysphonia (n = 70) and a control group of children without any alterations in their voice (n = 56). The questionnaire was always completed by their parents. The results were statistically analysed to assess the reliability, validity, sensitivity and specificity of the Lithuanian version of the pVHI. RESULTS High internal consistency of the Lithuanian version of the pVHI was determined (Cronbach's α = 0.938). The test-retest analysis also showed a high correlation between the two tests (r = 0.949) for both the dysphonic and control groups. The mean overall pVHI score was significantly higher (P < 0.001) in the dysphonic group than in the control group: 26.16 ± 11.84 and 2.43 ± 2.61, respectively. Similar results were obtained for all domains of pVHI. The most sensitive and specific limiting value for discrimination between the clinical and control groups was the sum of 8 points. CONCLUSIONS The Lithuanian version of the pVHI is a reliable and valid instrument for the evaluation of the Voice Handicap Index in the pediatric population and can be easily applied in daily clinical practice.
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Affiliation(s)
- Rita Šimkienė
- Vilnius University Hospital Santaros Klinikos Center for Ear, Nose and Throat Diseases, Vilnius, Lithuania.
| | - Nora Šiupšinskienė
- Lithuanian University of Health Sciences, Medicine Academy, Department of Otorhinolaryngology, Kaunas, Lithuania; Klaipeda University, Faculty of Health Sciences, Klaipeda, Lithuania
| | | | - Tadas Žvirblis
- Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Eugenijus Lesinskas
- Vilnius University Hospital Santaros Klinikos Center for Ear, Nose and Throat Diseases, Vilnius, Lithuania
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Ribeiro VV, Batista DDJ, de Castilho WLS, da Silva IKLB, Casmerides MCB, do Carmo RD, Behlau M. Reliability, Measurement Error, and Responsiveness of the Voice Handicap Index: A Systematic Review and Meta-analysis. J Voice 2024:S0892-1997(24)00169-3. [PMID: 39030149 DOI: 10.1016/j.jvoice.2024.05.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/26/2024] [Accepted: 05/28/2024] [Indexed: 07/21/2024]
Abstract
OBJECTIVE To analyze the reliability, measurement error, and responsiveness of the Voice Handicap Index (VHI) for measuring voice handicap in individuals with voice disorders. METHODS This systematic review followed the recommendations of the COnsensus-based Standards for the Selection of Health Measurement INstruments. Studies that validated the VHI, analyzed the measurement properties of reliability, measurement error, or responsiveness, and had dysphonic individuals as the study population were included. The following electronic databases were searched: Cochrane Library, EMBASE, LILACS, PubMed, Scopus, and Web of Science. The manual search was carried out on gray literature in the Biblioteca Digital Brasileira de Teses e Dissertações and ProQuest Dissertation & Theses, in addition to mapping citations and consulting an expert in the field. Evidence selection, data extraction, risk of bias analysis, certainty of evidence, and good psychometric measurements were performed by two blinded and independent reviewers. A meta-analysis was performed using Fisher's transformed r-to-z correlation coefficient and standardized mean difference. Heterogeneity was calculated using Tau² and I² statistical tests in JAMOVI 2.3.2 software. RESULTS Eighty studies were included in the meta-analysis. When assessing the risk of bias, most studies were classified as inadequate during the reliability and measurement error stages. In the responsiveness stage, they were classified as doubtful in the sensitivity and specificity sub-boxes and good in the comparison sub-box with a gold standard instrument. For psychometric properties, most studies were classified as indeterminate in terms of both reliability and responsiveness. In test-retest reliability and responsiveness, the average outcome differed significantly from zero, indicating agreement between the test and retest moments and a significant reduction in the VHI score after intervention. Considering certainty of the evidence, the level of evidence was very low in both the reliability and responsiveness stages. The analyzed studies did not evaluate observational errors, and hence, they were not considered in this review. CONCLUSION The VHI proved to be reliable and responsive in measuring voice handicap. However, it should be used with caution, as there is heterogeneity, a risk of bias, and no adherence to the analysis of observational error.
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Affiliation(s)
- Vanessa Veis Ribeiro
- University de Brasília, Brasília, São Paulo, Brazil; Centro de Estudos da Voz, São Paulo, São Paulo, Brazil
| | - Denis de Jesus Batista
- Postgraduate Program in Decision Models and Health at the Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Centro de Estudos da Voz, São Paulo, São Paulo, Brazil.
| | | | | | - Maria Christina Bussamara Casmerides
- Centro de Estudos da Voz, São Paulo, São Paulo, Brazil; Postgraduate Program in Otorhinolaryngology at the Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, São Paulo
| | - Rodrigo Dornelas do Carmo
- Centro de Estudos da Voz, São Paulo, São Paulo, Brazil; Universidade Federal do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mara Behlau
- Centro de Estudos da Voz, São Paulo, São Paulo, Brazil
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Kaya T, Yılmaz G, Zraick RI, Konrot A, Cangi ME. Reliability and validity of the Turkish voice handicap index-partner (VHI-P-TR). JOURNAL OF COMMUNICATION DISORDERS 2023; 106:106380. [PMID: 37738707 DOI: 10.1016/j.jcomdis.2023.106380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 09/24/2023]
Abstract
OBJECTIVE This study examines the Turkish validity, reliability and diagnostic performance of the Voice Handicap Index-Partner (VHI-P-TR), which is used to obtain the perceptions of communication partners of individuals with dysphonia about the functional, physical and emotional handicap resulting from the patient experiencing dysphonia. METHOD The study included 160 individuals with dysphonia and their communication partners. First, translation, back translation, expert validity and pilot study were performed in the scale adaptation process. Then, a confirmatory factor analysis (CFA) was conducted to assess the construct validity of the VHI-P-TR. Correlations between the VHI-P-TR and Voice Handicap Index (VHI-TR) scores of dysphonic individuals were examined to evaluate the concurrent validity of the VHI-P-TR. To assess the reliability of the VHI-P-TR, a test-retest analysis was performed, and internal consistency coefficients (α) were calculated. A receiver operating characteristic (ROC) analysis was conducted to determine the cut-off point for the VHI-P scores. RESULTS A high positive correlation was found between the participants' VHI-P-TR and VHI-TR total and subscales mean scores (r's > 0.782; p < 0.01). The VHI-P-TR had high internal consistency regarding for its subscales and total score (α's > 0.94; p < 0.01). Factor loadings of all VHI-P-TR items were higher than 0.30 and their error variances were lower than 0.90. In addition, factor loadings were statistically significant for all the items (p < 0.05). The data fit the model well according to all CFA indices except for GFI (scale = 0.69). An adequate sensitivity and specificity were achieved for the VHI-P-TR, and the cut-off point was found as 11.50 for the total score and ranged from 2.50 to 5.50 for the subscales. CONCLUSION The VHI-P-TR is a valid and reliable measurement tool with high diagnostic performance in all subscales and total score, and has high levels of agreement with the VHI-TR.
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Affiliation(s)
- Tuğba Kaya
- University of Health Sciences, Speech and Language Deparment, İstanbul, Türkiye.
| | - Göksu Yılmaz
- Uskudar University, Speech and Language Deparment, İstanbul, Türkiye
| | - Richard I Zraick
- University of Central Florida, School of Communication Sciences and Disorders, Orlando, United States of America
| | - Ahmet Konrot
- Uskudar University, Speech and Language Deparment, İstanbul, Türkiye
| | - Mehmet Emrah Cangi
- University of Health Sciences, Speech and Language Deparment, İstanbul, Türkiye
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Guimarães I, Almeida L, Quintal A, Batista AP, Teixeira A, Romeiro C, Ferreira DB, Fernandes IS, Saraiva M, Bom R, Almeida S, Freitas SV. Pediatric Voice Handicap Index (pVHI): Validation in European Portuguese Children. J Voice 2023; 37:804.e11-804.e19. [PMID: 34183214 DOI: 10.1016/j.jvoice.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/04/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To determine reliability and validity of the European Portuguese pVHI version (pVHI-EP). STUDY DESIGN Cross-sectional design. METHODS The pVHI-EP and the talkative and global voice assessment scales were administered to the caregivers of children aged from 3 to 16 years old with and without dysphonia. Reliability (internal consistency and test-retest) was analyzed. The validity analyses performed were: (1) content validity by analyzing the percentage of missing data; (2) construct validity with intraclass correlation coefficients among pVHI-EP domains and overall score; (3) concurrent validity was conducted between pVHI-EP, the caregivers' judgment of the child's voice severity on a visual analog scale and the Speech-Language Pathologist perceptual voice assessment; (4) known-groups validity between children with and without dysphonia, and (5) predictive validity by calculating receiver operating characteristics, sensitivity and specificity and determining cut-off points. RESULTS A total of 283 children (61.5% boys, mean age 8.3 years) participated in the study. The pVHI-EP showed an excellent internal consistency for the pVHI-EP total data. Strong to moderate test-retest reliability confirms pVHI-EP reproducibility. Excellent to good intraclass correlation coefficients between the pVHI-EP overall and the domains confirms its construct validity. Weak to moderate concurrent validity with visual analog scale and Speech-Language Pathologist perceptual voice assessment was confirmed. The pVHI-EP significantly distinguished two groups of different voice conditions. A cut-off point of 10.5 with 95.9% sensitivity and 92.5% specificity was determined for the overall score of the pVHI-EP. CONCLUSIONS The pVHI-EP is a reliable and valid caregiver voice outcome tool for EP children with dysphonia.
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Affiliation(s)
- Isabel Guimarães
- Speech and Language Pathologist (SLP), Speech Therapy Department, Alcoitão Health School of Sciences, Clinical and Therapeutics Pharmacological Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Lina Almeida
- SLP, ENT Department, Hospital dos Lusíadas, Lisboa, Portugal.
| | - Aldora Quintal
- SLP, MSc, ENT Department, Hospital Garcia de Orta, Almada, Portugal
| | - Ana Paula Batista
- SLP, MSc, ENT Department, Centro Hospitalar e Universitário do Algarve, Portimão, Portugal
| | - Ana Teixeira
- SLP, Physical Medicine and Rehabilitation, Hospital São João de Deus, Montemor-o-Novo, Portugal
| | - Cláudia Romeiro
- SLP, ENT Department, Hospital de Ponta Delgada-Hospital do Divino Espírito Santo de Ponta Delgada, EPE, São Miguel, Açores, Portugal
| | - Daniela Brás Ferreira
- SLP, ENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | | | - Madalena Saraiva
- SLP, ENT Department, Hospital de Ponta Delgada-Hospital do Divino Espírito Santo de Ponta Delgada, EPE, São Miguel, Açores, Portugal
| | - Rita Bom
- SLP, ENT Department, Hospital do Espírito Santo de Évora, EPE, Évora, Portugal
| | - Sancha Almeida
- SLP, MSc, ENT Department, Hospital da Luz, Lisboa, Portugal
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Yağcıoğlu D, Aydınlı FE, Aslan G, Kirazlı MÇ, Köse A, Doğan N, Akbulut S, Yılmaz T, Özcebe E. Development, Validation, and Reliability of the Teacher-Reported Pediatric Voice Handicap Index. Lang Speech Hear Serv Sch 2021; 53:69-87. [PMID: 34762816 DOI: 10.1044/2021_lshss-21-00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to develop a novel teacher-reported pediatric voice outcome measure and to investigate its psychometric properties. METHOD In the first stage, a new instrument, the Teacher-Reported Pediatric Voice Handicap Index (TRPVHI), was developed. After item generation, a panel of experts evaluated the items to assess the content validity. Subsequently, the final version of the preliminary instrument was applied to teachers of 306 children (57 dysphonic and 249 vocally healthy) between the ages of 4 and 11 years. Eventually, the construct validity, criterion-related validity, test-retest reliability, and internal consistency of the developed instrument were examined. RESULTS The items with a content validity ratio less than .8 were modified or removed, and accordingly, the preliminary version of the index was finalized. After the application of the preliminary version, item reduction was made based on the factor analysis. The index is composed of 27 questions and three subscales: Functional, Physical, and Emotional. A significant difference was observed between the dysphonic and vocally healthy children for the TRPVHI scores (p < .001). A positive moderate correlation was determined between the Pediatric Voice Handicap Index and TRPVHI scores. Correlation coefficients between the test and retest scores of the TRPVHI were in the range of .92-.98. Cronbach's alpha values computed to assess the internal consistency were in the range of .94-.98. CONCLUSIONS The TRPVHI is the only valid and reliable teacher-reported outcome measure of the effects of voice disorders on children. It is anticipated that the deployment of the TRPVHI in conjunction with other subjective tools, both in the initial evaluation and the follow-up of the treatment results, will allow a better understanding of the physical, functional, and emotional effects of voice disorders on children. Furthermore, it can potentially lead further research to enable the use of the TRPVHI for screening purposes.
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Affiliation(s)
- Damlasu Yağcıoğlu
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Fatma Esen Aydınlı
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Gizem Aslan
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Meltem Ç Kirazlı
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
| | - Nuri Doğan
- Department of Education, Hacettepe University, Ankara, Turkey
| | - Sevtap Akbulut
- Department of Otolaryngology, Demiroglu Bilim University, İstanbul, Turkey
| | - Taner Yılmaz
- Department of Ear-Nose-Throat, Hacettepe University, Ankara, Turkey
| | - Esra Özcebe
- Department of Speech and Language Therapy, Hacettepe University, Ankara, Turkey
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Carrera Fernández SM, Massé PG, Wilder F, Preciado D, Rodriguez HA. Index of pediatric voice handicap: Translation, transculturalization and validation to Argentinian Spanish. Int J Pediatr Otorhinolaryngol 2019; 127:109663. [PMID: 31526934 DOI: 10.1016/j.ijporl.2019.109663] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/26/2019] [Accepted: 08/28/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Voice disorders are very common in the pediatric population, with 6% and 23% of all children presenting with some form of dysphonia [1,2]. For many years, these patients have been underdiagnosed. There has been increasing awareness and interest in the study of voice alterations in children, and, most importantly, their impact in their quality of life. To do this, an instrument capable of measuring the quality of life in pediatric patients with vocal pathology is required, which can be used extensively in the scientific community. The objective of our study is to carry out the translation, transculturalization and validation of pVHI (Pediatric Voice Handicap Index) to Argentinian Spanish-speakers. MATERIAL AND METHODS A study was carried out in the Hospital de Pediatria Dr. JP Garrahan in the city of Buenos Aires, Argentina. It included patients between 3 and 18 years old. The pVHI was translated and transculturalized for said population and for its validation, a survey was carried out in two groups of patients: one group being children with a background of both reconstructive larynx surgery, and dysphonia (n = 35) and the other group being control patients, without any voice pathology (n = 35). The survey was conducted among either parents or caregivers of the children in question. RESULTS A significant difference was found between both groups, for both overall pVHI score and survey subgroups score (p < 0.001) with an optimal internal confidence and a good Alpha Cronbach for each of the subgroups (functional 0,92; organic 0,87 and emotional 0,88). Test-retest for reliability revealed "p-values" without any significant difference (p > 0.05) for each of all subgroups (functional 0,68; organic 0,32 and emotional 0,72). CONCLUSION The validation and transculturalization of the rate of pediatric vocal impairment to Argentinian Spanish population presented an adequate validity and reliability. The rate of pediatric vocal impairment was identified through this simple and practical survey, offering additional information on the child's own vocal perception by part of the caregiver. We recommend this survey being included as a valuable tool in the evaluation of pediatric dysphonia in Spanish-speaking families.
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Affiliation(s)
| | | | - Fabiana Wilder
- Hospital de Clinicas José de San Martín, Buenos Aires, Argentina
| | - Diego Preciado
- Department of Otolaryngology, Children's National Medical Center, Washington, D.C, USA
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