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Guimarães I, Torrejano G, Aires R, Caetano M, Fernandes A, Martins P, Luís L. Voice Handicap Index: Cut-Off Points for Screening European Portuguese With Voice Disorders. J Voice 2023:S0892-1997(23)00265-5. [PMID: 37805301 DOI: 10.1016/j.jvoice.2023.08.018] [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: 06/15/2023] [Revised: 08/16/2023] [Accepted: 08/17/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVES To determine cut-off values of the Voice Handicap Index (VHI) and the shortened version (VHI-10) for European Portuguese (EP) with voice disorders. In addition, to analyze the discriminatory power of individual items of the VHI-10 and the ability to detect differences in various Ear Nose and Throat (ENT) diagnoses. STUDY DESIGN Cross-sectional cohort study. METHODS All participants completed the EP VHI and a 4-point self-assessment of voice disorder severity. The case group (subjects with voice disorders) underwent assessment through strobovideolaryngoscopy examinations by ENT surgeons and perceptual analyses by speech-language pathologists (SLPs). In contrast, the control group was evaluated solely by SLPs. Data were analyzed using a receiver-operating characteristic curve to determine the accuracy and cut-off values of the VHI and VHI-10. RESULTS The study involved a sample of 350 adults (171 cases and 179 controls), predominantly women aged 18-88 years. The area under curve (AUC) for VHI and VHI-10 was 0.997 [95% confidence interval (CI): 0.992-1] and 0.998 [95% CI: 0.995-0.999], respectively. Optimal cut-off values were identified as 13.5 for VHI (0.994 sensitivity and 0.989 specificity) and 5.5 for VHI-10 (0.977 sensitivity and 0.955 specificity). Each individual item within the VHI-10 significantly contributed to the overall assessment, exhibiting varying discriminatory power ranging from excellent (AUC = 0.937) to poor (AUC = 0.637). Significant differences were found in the case group between neurogenic disorders and healthy larynx (P = 0.014), structural and physiologic minor laryngeal abnormalities (P = 0.006), and inflammatory disorders (P = 0.043). CONCLUSIONS The VHI and the VHI-10 exhibited accurate screening properties for predicting EP speakers with voice disorders.
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Affiliation(s)
- Isabel Guimarães
- Clinical and Therapeutics Pharmacological Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal; Speech Therapy Department, Alcoitão Health School of Sciences, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal
| | - Gabriela Torrejano
- ENT Department, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal.
| | - Raquel Aires
- ENT Department, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal
| | - Mariana Caetano
- ENT Department, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal
| | - António Fernandes
- ENT Department, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal
| | - Paulo Martins
- ENT Department, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal
| | - Leonel Luís
- ENT Department, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal
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Batista DDJ, da Silva RD, Martins AA, de Araújo CM, Santos RS, Filho OG, Taveira KVM, Ribeiro VV. Internal Consistency of the Voice Handicap Index in Individuals With Dysphonia: A Systematic Review and Meta-Analysis. J Voice 2023:S0892-1997(23)00253-9. [PMID: 37778959 DOI: 10.1016/j.jvoice.2023.08.012] [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: 04/14/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVE To analyze the internal consistency of the Voice Handicap Index (VHI) for evaluating the vocal handicap of individuals with dysphonia. METHODS This is a systematic review. Studies with a cross-sectional design and including a population of individuals with dysphonia, which validated the VHI and analyzed its internal consistency, were included. The following electronic databases were searched: Cochrane Library, EMBASE, LILACS, and PubMed, including Medline, Scopus, and Web of Science. A manual search was performed in gray literature through the Biblioteca Digital Brasileira de Teses e Dissertações and ProQuest Dissertation & Theses. In addition, the list of references of studies selected in the electronic search was mapped, and an expert in the area was consulted. Two reviewers blindly and independently conducted the selection, data extraction, and analysis of the risk of bias, the certainty of the evidence, and good psychometric measures. A meta-analysis was performed with a random effects model using the JAMOVI 2.3.2 software. RESULTS Forty-nine studies were analyzed. In risk of bias assessment, the studies were classified as having inadequate structural validity and very good internal consistency. The analysis of good psychometric properties indicated indeterminate structural validity and insufficient internal consistency. The overall value of Cronbach's alpha was estimated at 0.94, thus suggesting a very good internal consistency. However, there was high heterogeneity. The level of certainty of the evidence was too low for internal consistency. CONCLUSION The VHI proved to be a consistent and reliable patient-reported outcome measure to evaluate voice handicap in individuals with dysphonia; however, studies are heterogeneous, and the certainty of evidence is very low.
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Affiliation(s)
- Denis de Jesus Batista
- Decision Models and Health, Statistics Department, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil.
| | - Rayane Délcia da Silva
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Communication Disorders, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil.
| | - Agnes Andrade Martins
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Dentistry, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
| | - Cristiano Miranda de Araújo
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Communication Disorders, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil; Dentistry, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil.
| | - Rosane Sampaio Santos
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Graduate Program in Communication Disorders, Universidade Tuiuti do Paraná.
| | - Odilon Guariza Filho
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.
| | - Karinna Veríssimo Meira Taveira
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil; Universidade Federal do Rio Grande do Norte, Curitiba, Paraná, Brazil.
| | - Vanessa Veis Ribeiro
- Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil; Speech and Language Therapy Course and the Graduate Program in Medical Sciences, Universidade de Brasília, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Brasília, Distrito Federal, Brazil.
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Onder H, Bahtiyarca ZT, Comoglu S. Subjective Assessments of Voice in Parkinson's Disease Subjects with and without STN-DBS Therapy. Ann Indian Acad Neurol 2023; 26:491-495. [PMID: 37970309 PMCID: PMC10645232 DOI: 10.4103/aian.aian_1_23] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/19/2023] [Accepted: 03/10/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction The causal relation between STN-DBS and speech problems and the associated clinical features are in the incipient stages of being investigated. Methods All the Parkinson's disease (PD) subjects with and without STN-DBS who applied to our movement disorders outpatient clinics between January 2022 and June 2022 and agreed to participate in the study were enrolled. The demographic data and clinical features were noted. Besides, the MDS-UPDRS was administered during the medication off-state in all subjects. All the participants completed the voice handicap index (VHI). Besides, the Freezing of Gait Questionnaire (FOGQ) and the quality of life (QoL) scales including the Parkinson's Disease Questionnaire (PDQ-39) and the Schwab and England Activities of Daily Living (ADL) scale were also administered to all the individuals. Results We have included 66 patients with PD (F/M = 23/43). Thirty-five patients were those with DBS therapy whereas 31 patients were without. The results of the comparative analyses between the patients with and without DBS therapy revealed that the DBS group had a higher disease duration (P = 0.006) and FOGQ scores (P = 0.008). The VHI scores did not differ between groups (P = 0.577), and the correlation analyses did not reveal an association between the VHI scores and the duration of DBS therapy. However, the VHI scores correlated with the disease duration as well as the FOG scores. Conclusion We did not find convincing evidence supporting the increased risk of speech disturbance with STN-DBS therapy. We suggest that the frequent existence of speech disturbance in this patient subgroup with STN-DBS is associated with the classical nature of PD.
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Affiliation(s)
- Halil Onder
- Deparment of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Zeynep Tuba Bahtiyarca
- Deparment of Physical Therapy and Rehabilitation, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Selcuk Comoglu
- Deparment of Neurology, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Krtickova J, Svec JG, Haviger J, Phadke KV, Drsata J, Skoloudik L, Homolac M, Svejdova A, Mejzlik J, Hodacova L, Chrobok V. Validation of the Czech Version of the Voice Handicap Index. J Voice 2023:S0892-1997(23)00145-5. [PMID: 37344245 DOI: 10.1016/j.jvoice.2023.04.020] [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: 01/25/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 06/23/2023]
Abstract
OBJECTIVE(S) The present study aims to evaluate the reliability and construct validity of the Czech version of the Voice Handicap Index (VHI-CZ) and determine the cut-off value to distinguish dysphonic patients from nondysphonic individuals. STUDY DESIGN Prospective study, Parallel group design. METHODS The study investigated 100 adult patients with dysphonia, divided into three groups based on the etiology of the voice problem (neurogenic, functional, and structural). Out of these, 25 patients were used for test-retest analysis, and 45 patients to determine the responsiveness to change. The control group consisted of 51 healthy subjects. All 151 individuals completed the VHI-CZ and were examined with the videolaryngostroboscopy. The internal consistency (Cronbach's alpha), the test-retest reliability (Intra-class Correlation Coefficient, ICC), and the construct validity were analyzed and the normative cut-off value was determined. RESULTS The internal consistency of the VHI-CZ was excellent (Cronbach α = 0.984), and test-retest reliability was also excellent (ICC = 0.95, P < 0.001). The correlation between the self-assessed severity of the voice disorder and the VHI-CZ score was strong (Spearman's ρ = 0.877, P < 0.001). The VHI scores differences between dysphonic and nondysphonic patients were statistically significant (Mann-Whitney U test, P < 0.001). The differences among the three etiological subgroups (neurogenic, functional, and structural) were also statistically significant (Kruskal-Wallis test, P < 0.001). Moreover, the differences in the VHI-CZ total scores between pretreatment and posttreatment were statistically significant (Wilcoxon test, P < 0.001). The cut-off score of 13 points was found, by the analysis of the Receiver Operating Characteristic (ROC, Youden Index), to be most suitable for preselecting dysphonic individuals. CONCLUSION The existing VHI-CZ showed excellent reliability and construct validity. The Czech VHI is a useful and valid monitoring tool for clinicians.
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Affiliation(s)
- Jana Krtickova
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic.
| | - Jan G Svec
- Voice Research Laboratory, Department of Experimental Physics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Jiri Haviger
- Department of Informatics and Quantitative Methods, Faculty of Informatics and Management, University of Hradec Kralove, Hradec Kralove, Czech Republic
| | - Ketaki Vasant Phadke
- Voice Research Laboratory, Department of Experimental Physics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Jakub Drsata
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Lukas Skoloudik
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Michal Homolac
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Anna Svejdova
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Jan Mejzlik
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
| | - Lenka Hodacova
- Department of Preventive Medicine, Charles University, Faculty of Medicine in Hradec Kralove, Hradec Kralove, Czech Republic
| | - Viktor Chrobok
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic; Faculty of Medicine in Hradec Kralove, Charles University, Hradec Kralove, Czech Republic
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Miaśkiewicz B, Gos E, Dębińska M, Panasiewicz-Wosik A, Kapustka D, Szkiełkowska A, Skarżynski H. Validation of the Polish Version of Voice Handicap Index-10. J Voice 2023:S0892-1997(23)00089-9. [PMID: 37173195 DOI: 10.1016/j.jvoice.2023.02.031] [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: 12/21/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 05/15/2023]
Abstract
PURPOSE The aim of this study was to adapt and evaluate the psychometric properties of the Polish version of the VHI-10. METHODS We enrolled 183 subjects-118 patients with voice disorders and 65 without voice disorders. RESULTS All items were correlated with each other and were strongly correlated with the total score (rho ≥ 0.70), the only exception being item five (rho = 0.56). Internal consistency was very high, with Cronbach's alpha = 0.92. There was a statistically significant difference between patients with voice disorders and healthy controls in terms of VHI-10 global score (U = 251.0; P < 0.001). There was a statistically significant negative correlation between mean phonation time (MPT) and VHI-10 (rho = -0.30; P < 0.01). Only the amplitude perturbation quotient (APQ) was correlated positively with the global score (rho = 0.22; P = 0.020). There were statistically significant and positive correlations between VHI-10 scores and GRBAS evaluation. Correlations between global scores of VHI-30 and VHI-10, and between VHI-30 subscales and the corresponding items from VHI-10, were very strong (respectively 0.97 and 0.89-0.94). In the patient group, there was high test-retest reproducibility (intraclass correlation = 0.91). A cut-off value of 8.5 points was estimated. CONCLUSION The Polish version of VHI-10 showed excellent internal consistency, good test-retest reproducibility, and had clinical validity. It is a useful brief tool for self-reported evaluation and reliable assessment of patients with voice disorders.
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Affiliation(s)
- Beata Miaśkiewicz
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland.
| | - Elżbieta Gos
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Małgorzata Dębińska
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Aleksandra Panasiewicz-Wosik
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Dorota Kapustka
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Agata Szkiełkowska
- Audiology and Phoniatric Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
| | - Henryk Skarżynski
- Oto-rhino-laryngosurgery Clinic, World Hearing Centre of the Institute of Physiology and Pathology of Hearing, Warsaw, Poland
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Miaśkiewicz B, Gos E, Dębińska M, Panasiewicz-Wosik A, Kapustka D, Nikiel K, Włodarczyk E, Domeracka-Kołodziej A, Krasnodębska P, Szkiełkowska A. Polish Translation and Validation of the Voice Handicap Index (VHI-30). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710738. [PMID: 36078459 PMCID: PMC9518103 DOI: 10.3390/ijerph191710738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/16/2022] [Accepted: 08/26/2022] [Indexed: 05/27/2023]
Abstract
Traditional voice evaluations, including imaging techniques, auditory-perceptual ratings, and acoustic and aerodynamic analyses, fail to assess the global handicap that a patient experiences as a result of a voice disorder. The Voice Handicap Index (VHI) is currently one of the most widely used and psychometrically robust instruments for measuring voice disability. The aim of the study is to translate and validate a Polish version of the VHI. The original English-language version of VHI-30 was translated into Polish. We enrolled 188 subjects-123 patients (91 women and 32 men) with voice disorders and 65 controls (53 women and 12 men) without voice disorders. Results obtained by the patients were significantly higher than those obtained by the controls on the Emotional subscale (U = 519.0; p < 0.001), Functional (U = 829.0; p < 0.001), Physical (U = 331.0; p < 0.001), and the global score (U = 390.0; p < 0.001). There were statistically significant negative correlations between maximum phonation time and global score (rho = -0.31; p < 0.01) as well as all three subscales. Shimmer and Smoothed Amplitude Perturbation Quotient were correlated positively with the global score (rho = 0.22; p < 0.05; rho = 0.25; p < 0.01, respectively) and with all three subscales. There were also statistically significant correlations between VHI scores and auditory perceptual evaluation. In the patient group, there was excellent internal consistency (α = 0.97) and strong test-retest reliability (intraclass correlation = 0.94). The cut-off value equal to 17 points was estimated. The Polish VHI showed excellent internal consistency, good test-retest reproducibility, and clinical validity. It is a useful tool for evaluating the voice disability perceived by a patient.
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Affiliation(s)
- Beata Miaśkiewicz
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Elżbieta Gos
- Department of Teleaudiology and Screening, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Małgorzata Dębińska
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Aleksandra Panasiewicz-Wosik
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Dorota Kapustka
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Katarzyna Nikiel
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Elżbieta Włodarczyk
- Rehabilitation Clinic, World Hearing Centre, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Anna Domeracka-Kołodziej
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Paulina Krasnodębska
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
| | - Agata Szkiełkowska
- Audiology and Phoniatric Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
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Marzouki HZ, Al Taylouni NE, Tonkal A, Amer I, Halawani LK, Khoja M, Merdad M. Short and Long-Term Voice and Swallowing-Related Quality of Life in Patients Who Underwent Total Laryngectomy and Tracheoesophageal Puncture. Cureus 2022; 14:e27609. [PMID: 35928174 PMCID: PMC9345285 DOI: 10.7759/cureus.27609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 11/28/2022] Open
Abstract
Background Voice and swallowing disorders can create a profound psychosocial impact on the patient’s quality of life. The focus of this study is to assess the psychosocial disabling effects on patients after total laryngectomy (TLP) using pre-validated surveys called the Voice Handicap Index 10 (VHI) for voice disorders and the Dysphagia Handicap Index (DHI) for swallowing disorders. Methodology This is a retrospective cohort study that was done on a total of 21 patients. The study was conducted at King Abdulaziz University Hospital between 2017 and 2022. The Cronbach’s alpha value was used to evaluate internal consistency reliability. The relationship between DHI, VHI, and demographic and clinical variables was analyzed by correlation analysis. A p-value of <0.05 was considered statistically significant, and all the tests were two-sided. Results The Cronbach’s alpha coefficient satisfied the internal consistency reliability for VHI and DHI for both total and their subscale scores. For DHI, the total score and emotional subscale obtained an alpha of greater than 0.9, indicating excellent internal consistency, whereas both physical and functional alpha scores indicated good internal consistency (α = 0.888 and α = 0.863, respectively). For VHI, the total score and physical subscale of the VHI had excellent internal consistency (α = 0.957 and α = 0.937, respectively), while the functional and emotional subscales had good internal consistency (α = 0.865 and α = 0.894, respectively). The total DHI scores, as well as the functional subscale scores, were significant (p = 0.033, p = 0.025, respectively) in terms of self-reported dysphagia severity. A moderately severe group (69.00 ± 19.17) had higher mean total scores, whereas severe individuals had higher subscale mean scores according to self-reported dysphagia severity. Self-reported dysphagia severity was as follows: normal (n = 3, 14.3%), mild (n = 4, 19%), moderate (n = 8, 38.1%), and severe (n = 6, 28.6%).
Conclusions The disability caused by voice and swallowing disorders can be evaluated by VHI and DHI which have been statistically validated as reliable tools to assess the effects of dysphagia and dysphonia on quality of life. Patients after laryngectomy have higher mean DHI and VHI overall and functional subscale scores. However, this study failed to establish any relationship between clinical and demographical characteristics of the patients with DHI and VHI index.
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Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i). J Clin Med 2021; 10:jcm10153325. [PMID: 34362112 PMCID: PMC8347778 DOI: 10.3390/jcm10153325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/24/2021] [Accepted: 07/25/2021] [Indexed: 01/18/2023] Open
Abstract
The international nine-item Voice Handicap Index (VHI-9i) is a clinically established short-scale version of the original VHI, quantifying the patients’ self-assessed vocal handicap. However, the current vocal impairment classification is based on percentiles. The main goals of this study were to establish test–retest reliability and a sound statistical basis for VHI-9i severity levels. Between 2009 and 2021, 17,660 consecutive cases were documented. A total of 416 test–retest pairs and 3661 unique cases with complete multidimensional voice diagnostics were statistically analyzed. Classification candidates were the overall self-assessed vocal impairment (VHIs) on a four-point Likert scale, the dysphonia severity index (DSI), the vocal extent measure (VEM), and the auditory–perceptual evaluation (GRB scale). The test–retest correlation of VHI-9i total scores was very high (r = 0.919, p < 0.01). Reliability was excellent regardless of gender or professional voice use, with negligible dependency on age. The VHIs correlated best with the VHI-9i, whereas statistical calculations proved that DSI, VEM, and GRB are unsuitable classification criteria. Based on ROC analysis, we suggest modifying the former VHI-9i severity categories as follows: 0 (healthy): 0 ≤ 7; 1 (mild): 8 ≤ 16; 2 (moderate): 17 ≤ 26; and 3 (severe): 27 ≤ 36.
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The Effectiveness of Rehabilitation of Occupational Voice Disorders in a Health Resort Hospital Environment. J Clin Med 2021; 10:jcm10122581. [PMID: 34208078 PMCID: PMC8230770 DOI: 10.3390/jcm10122581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background: The aim of this study was to present a rehabilitation program of occupational voice disorders for teachers, conducted in the form of health resort stays, and evaluate its effectiveness depending on job seniority. Methods: The study included 420 teachers who participated in a complex vocal prophylactic and rehabilitation program carried out during a 24-day stay at a health resort hospital. Employment time varied from 4 to 45 years (mean 28.3 years). The participants were divided into three groups: employment time < 21 years (57 teachers), 21–30 years (182 teachers) and > 30 years (181 teachers). All of the subjects underwent maximum phonation time assessment as well as jitter, shimmer and NHR (noise to harmonic ratio) parameters assessment before and after the program; they also underwent perceptual evaluation using the GRBAS scale and voice self-assessment using the VHI-30 scale. Results: The perceptual evaluation using the GRBAS scale and self-report measures of voice function assessed using the VHI scale revealed improvement (p < 0.001). The parameters of jitter, shimmer and NHR improved significantly: jitter p < 0.001, shimmer p < 0.001 and NHR p < 0.003. Maximum phonation time increased slightly but significantly (p < 0.001). For all of the studied groups regardless of their employment time, maximum phonation time increased (p < 0.001). Initially, the lowest values of maximum phonation time were observed in teachers with longer job seniority, which improved after the rehabilitation but remained <15 s. Conclusions: Voice care for teachers is crucial regardless of their job seniority. Early prophylaxis for voice disorders is effective, as the results of rehabilitation are better in teachers with a shorter employment time.
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