Blog Archives

The Cost-Effectiveness of an Intensive Treatment Protocol for Severe Dyslexia in Children

Studies of interventions for dyslexia have focused entirely on outcomes related to literacy. In this study, we considered a broader picture assessing improved quality of life compared with costs. A model served as a tool to compare costs and effects of treatment according to a new protocol and care as usual. Quality of life was measured and valued by proxies using a general quality-of-life instrument (EQ-5D). We considered medical cost and non-medical cost (e.g. remedial teaching). The model computed cost per successful treatment and cost per quality adjusted life year (QALY) in time. About 75% of the total costs was related to diagnostic tests to distinguish between children with severe dyslexia and children who have reading difficulties for other reasons. The costs per successful treatment of severe dyslexia were €36 366. Successful treatment showed a quality-of-life gain of about 11%. At primary school, the average cost per QALY for severe dyslexia amounted to €58 647. In the long term, the cost per QALY decreased to €26 386 at secondary school and €17 663 thereafter. The results of this study provide evidence that treatment of severe dyslexia is cost-effective when the investigated protocol is followed. Copyright © 2011 John Wiley & Sons, Ltd.

from Dyslexia

Vocal Handicap and Quality of Life After Treatment of Advanced Squamous Carcinoma of the Larynx and/or Hypopharynx

Patients treated for advanced cancer of the larynx/hypopharynx present slight to moderate voice handicap and good/excellent HR-QOL. Stricter analysis of both the VHI and UW-QOL data suggests that more attention be given to the vocal handicap of the individual patient.

from the Journal of Voice

Vocal Symptoms, Voice Activity, and Participation Profile and Professional Performance of Call Center Operators

The presence of vocal symptoms does not necessarily relate to decreased professional performance. However, an association between higher vocal activity limitation and participation scores and poorer professional performance was observed.

from the Journal of Voice

Evaluation of voice and quality of life after transoral endoscopic laser resection of early glottic carcinoma

Conclusion: Transoral laser resection of T1 and T2 glottic carcinoma enables adequate tumour tissue excision with preservation of acceptable vocal function. Most patients’ post-operative quality of life is very good. Anterior commissure web formation is associated with poorer vocal function.

from the Journal of Laryngology and Otology

Voice handicap in singing: analysis of the Modern Singing Handicap Index – MSHI questionnaire

CONCLUSION: The questionnaire proved to be sensitive for modern singers with vocal complaints. Choir singers with vocal complaints had higher self-reported handicap in comparison to choir singers without vocal complaints and non-singers. Aspects of organic nature were highlighted with larger deviations.

from Revista de Sociedade Brasileira de Fonoaudiologia

Study on the Simplified Chinese Version of the Voice Handicap Index

Both of the simplified Chinese versions, VHI-10 and VHI-13, had good reliability and validity. They could be used in the dysphonic self-assessment as the simplified Chinese VHI questionnaire. VHI-10 was found to be more concise and more widely applicable than VHI-13.

from the Journal of Voice

The impact of sertraline on health-related quality of life in severe refractory tinnitus: A double-blind, randomized, placebo-controlled study

Objective: Little is known about the influence of antidepressants on tinnitus patients’ health-related quality of life (HR-QoL). We have addressed this question by investigating the efficacy of sertraline on severe refractory tinnitus. Study design: Seventy-five consecutive patients without socially disabling hearing loss, who fulfilled risk criteria for developing severe refractory tinnitus based on a screening procedure with established validity, were randomly assigned to 16 weeks of placebo (n = 38) or sertraline (n = 37) at a fixed dose (50 mg/day) in a double-blind treatment trial. After completion of the placebo-controlled trial, all patients were offered to continue with sertraline and to participate in another follow-up after 12 weeks. The remaining sertraline group at 16 weeks was studied for a total of 28 weeks treatment. Psychological General Well-Being (PGWB) index served as an indicator of HR-QoL and was administered at baseline before treatment and at 16 and 28 weeks follow-up. Results: The intention-to-treat analysis showed sertraline to be more effective than placebo (p < 0.001) in improving HR-QoL after 16 weeks treatment. The improvement after 16 weeks was maintained at 28 weeks. Conclusion: We conclude that sertraline improves the HR-QoL in severe refractory tinnitus compared to placebo and that improvements in HR-QoL are maintained over time.

from Audiological Medicine

Development and validation of first-ever speech-specific perceptual speech evaluation tool for patients with head and neck cancer: The London speech evaluation (LSE) Scale

The London Speech Evaluation (LSE) scale demonstrated a high reliability and validity in our cohort of patients with head and neck cancer. surgery.

from Head and Neck

Applying the Correlation Between Aphasia Severity and Quality of Life Measures to a Life Participation Approach to Aphasia

When clinicians are operating under a Life Participation Approach to Aphasia (LPAA) while treating persons with aphasia (PWAs), one measurement used to quantify outcomes is quality of life (QOL). Studies of QOL after stroke have identified multiple factors as cause agents. There is not an extensive body of research in the literature that compares the extent of aphasia and QOL and no literature as to how this applies in an LPAA. This article reports a comparison of aphasia quotients obtained from the Western Aphasia Battery-Revised with QOL scores obtained from the Stroke and Aphasia Quality of Life Scale-39 and discusses how the results are incorporated into long-term communication programs at a community-based center that employs an LPAA.

from Topics in Stroke Rehabilitation

Quality of Life in adults who stutter

Although persistent developmental stuttering is known to affect daily living, just how great the impact is remains unclear. Furthermore, little is known about the underlying mechanisms which lead to a diminished quality of life (QoL). The primary objective of this study is to explore to what extent QoL is impaired in adults who stutter (AWS). In addition, this study aims to identify determinants of QoL in AWS by testing relationships between stuttering severity, coping, functioning and QoL and by testing for differences in variable scores between two AWS subgroups: receiving therapy versus not receiving therapy. A total of 91 AWS filled in several questionnaires to assess their stuttering severity, daily functioning, coping style and QoL. The QoL instruments used were the Health Utility Index 3 (HUI3) and the EuroQoL EQ-5D and EQ-VAS. The results indicated that moderate to severe stuttering has a negative impact on overall quality of life; HUI3 derived QoL values varied from .91 (for mild stuttering) to .73 (for severe stuttering). The domains of functioning that were predominantly affected were the individual’s speech, emotion, cognition and pain as measured by the HUI3 and daily activities and anxiety/depression as measured by the EQ-5D. AWS in the therapy group rated their stuttering as more severe and recorded more problems on the HUI3 speech domain than AWS in the non-therapy group. The EQ-VAS was the only instrument that showed a significant difference in overall QoL between groups. Finally, it was found that the relationship between stuttering severity and QoL was influenced by the individual’s coping style (emotion-oriented and task-oriented). These findings highlight the need for further research into stuttering in relation to QoL, and for a broader perspective on the diagnosis and treatment of stuttering, which would take into consideration quality of life and its determinants.

from the Journal of Communication Disorders

Voice, swallowing, and quality of life after total laryngectomy—Results of the west of Scotland laryngectomy audit†

Radiotherapy has a highly significant and detrimental effect on voice and swallowing outcome after total laryngectomy. Surgical voice restoration confers significant benefit in terms of self-reported voice outcome. These findings have implications for patients with advanced laryngeal cancer considering laryngectomy and organ preservation. © 2011 Wiley Periodicals, Inc. Head Neck, 2011

from Head and Neck

Functional outcomes related to the prevention of radiation-induced xerostomia: Oral pilocarpine versus submandibular salivary gland transfer

The SGT should be the treatment of choice between the 2 treatments offered to prevent xerostomia in the present study. © 2011 Wiley Periodicals, Inc. Head Neck, 2011

from Head and Neck

Botulinum toxin treatment of adductor spasmodic dysphonia: Longitudinal functional outcomes

It is important to consider longitudinal functional outcomes in BoNT treatment of AdSD. An individuated dosing regimen helps minimize side effects and maximize functional and quality-of-life outcomes.

from The Laryngoscope

Combined Modality Treatment of Adductor Spasmodic Dysphonia

Results and Conclusions
Significant effects were observed on perceived quality of life and acoustic variables for all participants, over time. Participants who received voice therapy after BTX-A injection did not experience longer injection effect duration or significantly greater improvements in V-RQOL or acoustic variables than participants in BTX-A only or BTX-A plus sham therapy groups. Additionally, perceptual ratings of voice quality improved for all participants in response to BTX-A injection. For participants in this investigation, undertaking voice therapy did not appear to exert significant beneficial effects on the variables of interest.

from the Journal of Voice

Use of Glasgow Benefit Inventory (GBI) in Meniere’s disease managed with intratympanic dexamethasone perfusion: Quality of life assessment

The mean GBI score indicates substantial improvement in patients’ overall quality of life following intratympanic dexamethasone perfusion, which was also confirmed by the audiometric results.

from Auris Nasus Larynx