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

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.

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.