Study on the Simplified Chinese Version of the Voice Handicap Index

Conclusions
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

Differences in Self-Rated, Perceived, and Acoustic Voice Qualities Between High- and Low-Fatigue Groups

Conclusions
These findings suggest that self-rated symptoms and acoustic parameters related to voice quality are indicative of mental fatigue, and these features are prominent in men.

from the Journal of Voice

Speech and Voice after Laryngectomy: Perceptual and Acoustical Analyses of Tracheoesophageal Speech Related to Voice Handicap Index

Conclusion: The listeners’ ratings of overall degree of deviation in TE speech showed relations to both voice quality and temporal aspects in speech. The TE speakers’ voice handicap degree were mainly related to changes in temporal aspects of speech.

from Folia Phoniatrica et Logopaedica

Voice Handicap and Health-Related Quality of Life after Treatment for Small Laryngeal Carcinoma

Treatment of small carcinoma of the larynx may lead to voice handicap and restricted quality of life. The relationship between the two is revealed. Sixty-five patients aged 62.1 ± 10.0 years rated their voice handicap and quality of life after treatment of T1 (n = 35) or T2 (n = 30) laryngeal carcinoma during regular out-patient examinations. For the self-assessment of the voice, the Voice Handicap Index (VHI) and the disease-independent Short Form-36 Health Survery (SF-36) questionnaires were used. Voice handicap (total score 38.9 ± 26.0) did not differ in the two tested groups, T1 and T2, and the data of SF-36 (physical score 43.0 ± 10.7; mental score 50.2 ± 9.1) showed significant differences for the mental score. Patients rated their voice handicap worse than healthy persons did after treatment of laryngeal carcinoma. VHI and SF-36 data were strongly correlated. Voice handicap is significantly related to the quality of life, especially affecting the mental domain. Thus, the rehabilitation of voice disorders should have a beneficial impact on quality of life.

from Folia Phoniatrica et Logopaedica

Voice handicap index and voice-related quality of life in small laryngeal carcinoma

Laryngeal cancer can affect the patients’ voice. For assessment of the patients’ self-perception of their voice, several tools were introduced into clinical routine. The voice handicap index questionnaire (VHI) is regarded as the “gold standard”. However, in benign laryngeal pathologies and in functional dysphonia, the shorter voice-related quality of life questionnaire (V-RQOL) proved to be equivalent. This study examines the correlation of both questionnaires in patients who had been treated for small (T1 and T2) laryngeal cancer. It was performed during regular outclinic examinations. In total, 65 patients aged 62.1 ± 10.0 years completed the German versions of the VHI and V-RQOL. Their average VHI total score was 38.9 ± 26.0 points and the average V-RQOL score was 70.1 ± 24.4%. The total scores correlated with |ρ| = 0.92 and p < 0.01. Both questionnaires give quasi identical results, the shorter V-RQOL may be favoured for clinical application.

from the European Archives of Oto-Rhino-Laryngologyl

Voice Characteristics of Female Physical Education Student Teachers

In this study, the subjective and objective voice measures of seven female physical education student teachers during a semester of student teaching were investigated. The participants completed the voice measures at three data collection time points: baseline, middle, and end of the semester. The voice measures included acoustic and aerodynamic data, perceptual rating scales of vocal quality and vocal fatigue, an end-of-semester questionnaire, and the Voice Handicap Index. Results demonstrated that the subjective and objective voice measures changed at the middle and the end of the semester as compared with those at baseline. The change in the voice measures may suggest that the vocal mechanism was adapting to the increased vocal demands of teaching physical education.

from the Journal of Voice

Application of the Mandarin Chinese Version of the Voice Handicap Index

The Mandarin Chinese version of VHI appears to be a reliable and valid tool in assessing dysphonia in Mandarin Chinese speakers.

from the Journal of Voice

Cross-cultural Adaptation and Validation of the Voice Handicap Index Into Italian

The Italian VHI is highly reproducible, and exhibits excellent clinical validity.

from the Journal of Voice

The efficacy of a voice training program: a case–control study in China

Abstract The objective of this study was to design a voice training program for Chinese speakers, and to evaluate its efficacy. It was a prospective, randomized, case–control study practiced in three middle schools in Beijing, China. Teachers in the treatment group received voice training for 4 weeks, whereas the control group subjects received no treatment. The voice training program, which was adapted for Chinese, contained vocal hygiene education and group voice training. The outcome was assessed by voice handicap index (VHI), maximum phonation time (MPT) and acoustic analysis parameters including, noise to harmonic ratio (NHR), jitter and shimmer. The results showed that at the onset of the study, no significant differences were found between the subjects in two groups for VHI, MPT and NHR. VHI of treatment group subjects who received voice training decreased significantly, whereas VHI of control group subjects showed no significant change. Treatment group MPT was significantly increased after training, whereas the control group one presented no significant change during the same period. NHR in treatment group decreased significantly after training, whereas the one in control group showed no significant change. There were no significant changes for jitter and shimmer in both groups before and after the study. So we conclude that the voice training program is suitable to treat voice diseases, particularly for middle school teachers. This result provided reliable evidence for carrying out further voice training in China.

from the European Archives of Oto-Rhino-Laryngologyl

Diagnostic Validity of Voice Handicap Index-10 (VHI-10) Compared With Perceptive-Auditory and Acoustic Speech Pathology Evaluations of the Voice

Background
The voice handicap index (VHI) questionnaire and its reduced version (VHI-10) have the aim of measuring voice problems from the subject’s self-perception. No studies on the predictive value of VHI-10 have been conducted.

Objective
To determine diagnostic validity indicators for VHI-10.

Method
Four hundred seventy-six elementary and high school teachers working in municipal public schools in Salvador, Bahia, were evaluated. Sensitivity, specificity, positive and negative predictive values, proportion of correct classification, Youden index, and positive and negative likelihood ratios were calculated.

Results
VHI-10 presented low rates for sensitivity (29%), proportion of correct classification (44%), positive predictive value (42%), and negative predictive value (33%). The validity indicators for VHI-10 were better in comparisons with perceptive-auditory analysis than with acoustic analysis.

Conclusion
Because of the low validity of VHI-10, its use in population-based studies is not recommended. This suggests that it has limitations as a diagnostic support instrument for clinical evaluations.

from the Journal of Voice

Voice handicap index in Swedish

The objective of this study was to evaluate a Swedish version of the voice handicap index questionnaire (Sw-VHI). A total of 57 adult, dysphonic patients and 15 healthy controls completed the Sw-VHI and rated the degree of vocal fatigue and hoarseness on visual analogue scales. A perceptual voice evaluation was also performed. Test-retest reliability was analyzed in 38 subjects without voice complaints. Sw-VHI distinguished between dysphonic subjects and controls (P0.84) and test-retest reliability (intraclass correlation coefficient>0.75) were good. Only moderate or weak correlations were found between Sw-VHI and the subjective and perceptual voice ratings. The data indicate that a difference above 13 points for the total Sw-VHI score and above 6 points for the Sw-VHI subscales is significant for an individual when comparing two different occasions. In conclusion, the Sw-VHI appears to be a robust instrument for assessment of the psycho-social impact of a voice disorder. However, Sw-VHI seems to, at least partly, capture different aspects of voice function to the subjective voice ratings and the perceptual voice evaluation.

from Logopedics Phoniatrics Vocology

Voice Handicap and Health-Related Quality of Life in Laryngectomees: Assessments with the Use of VHI and EORTC Questionnaires

Aims: To investigate the Voice Handicap Index (VHI), the health-related quality of life (HRQL), and the correlations between VHI and HRQL in laryngectomees. Methods: Forty-three laryngectomized persons participated (mean age 68;6 years, time since laryngectomy between 0;6 and 12 years). Evaluation of voice handicap was done with the VHI. HRQL was evaluated with questionnaires from the European Organization for Research and Treatment of Cancer, EORTC QLQ-C30 and EORTC QLQ-H&N35. Results: VHI for the whole group demonstrated a moderate voice handicap, with a mean score of 48/120. The functional scales of EORTC QLQ-C30 resulted in scores on the same level as the normal population with the exception of a lower global quality of life scale (Global QOL). EORTC QLQ-H&N35 revealed problems with smell and taste, speech, coughing, xerostomia, and sexuality. VHI correlated significantly with the Global QOL, the functional scales, dyspnea, pain, nausea and financial difficulties (EORTC QLQ-C30). Significant correlations were also found between VHI and speech problems, social contact, pain from the head and neck area, sense problems, sexuality and social eating (EORTC QLQ-H&N35). Conclusion: The EORTC questionnaires in combination with the VHI questionnaire seem to capture most of the problems following laryngectomy, including voice problems.

from Folia Phoniatrica et Logopaedica

Item Reduction of the Voice Handicap Index Based on the Original Version and on European Translations

Objective: Constructing an internationally applicable short-scale of the Voice Handicap Index (VHI). Methods: Subjects were 1,052 patients with 5 different types of voice disorder groups from Belgium, France, Sweden, Germany, Italy, The Netherlands, Portugal, and the USA. Different 9- and 12-item subsets were selected from the 30 VHI items using (1) the first factor of an unrotated factor analysis (narrow range subsets) and (2) the first three factors after promax rotation (broad range subsets). Country-specific subsets were selected to test deviations from the international subsets. For all subsets, reliability was investigated using Cronbach’s alphas and correlations with the total VHI. Validity was investigated using regression on voice disorder groups. All analyses were performed for the total and for all country-specific subject samples. Results: Reliability was high for all item subsets. It was lower for the international compared to the country-specific subsets and for the broad range compared to the narrow range subsets. Validity was best for the broad range subsets. Validity was better for the international than for the country-specific subsets. For all statistics the 12-item subsets were not essentially better than the 9-item subsets. Conclusion: The international broad range 9-item subset forms a scale which approximates well the total VHI.

from Folia Phoniatrica et Logopaedica

The Applicability of the Dysphonia Severity Index and the Voice Handicap Index in Evaluating Effects of Voice Therapy and Phonosurgery

The objective was to investigate the applicability of the Dysphonia Severity Index (DSI) and the Voice Handicap Index (VHI) in evaluating effects of intervention between groups of patients and for intrasubject differences and whether DSI and VHI are complementing measurements. Analyses of measurement data before and after intervention of 171 patients with voice disorders. The voice quality was measured objectively with the DSI. The perceived voice handicap was measured with the VHI. Three groups of patients were used: patients who had voice therapy, phonosurgery, or no intervention. DSI and VHI improved significantly after intervention in the voice therapy and the surgery group (median difference DSI 1.19 and 3.03, VHI -8 and -26, respectively). The intrasubject results were analyzed based on the test-retest variability of DSI and VHI. Significant better DSI and VHI scores after intervention were found in, respectively, 22% and 38% of the patients with voice therapy, and 56% and 78% of the patients with surgery. In the no intervention group, this was 11% and 12%. In 37% of the patients, the differences before and after intervention in DSI and VHI were in discordance. The DSI and VHI are able to show significant differences after intervention for voice disorders between groups of patients. The DSI and VHI can be used to determine a significant intrasubject result of intervention. The DSI and VHI measure each different aspects of the voice and are complementing measurements. The DSI is therefore applicable in clinical practice for objective evaluation of voice quality and the VHI for subjective evaluation of the perceived handicap by the patient self.

from the Journal of Voice

Cross-Cultural Adaptation and Validation of the Voice Handicap Index Into Greek

from the Journal of Voice

The objective was to culturally adapt and validate the Voice Handicap Index (VHI) to the Greek language. The study design used was a psychometric analysis. The VHI was translated into Greek with cultural adaptations to accommodate certain words. The translated version was then completed by 67 subjects with various voice disorders and by a control group of 79 subjects. All the participants also completed a self-rating scale regarding the severity of their voice disorder. Statistical analyses demonstrated high internal consistency and high test-retest reliability both for the overall VHI score and for the functional, physical, and emotional domains of the VHI. A moderate correlation was found between the VHI and the self-rating severity scale. The subjects in the control group had lower scores compared to the subjects with voice disorders for the overall VHI score and for the three domains. Based on the internal consistency values and the test-retest reliability, the Greek version of VHI is a valid and reliable measure for use by Greek subjects with voice disorders.