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Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)

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 es...

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Autores principales: Caffier, Felix, Nawka, Tadeus, Neumann, Konrad, Seipelt, Matthias, Caffier, Philipp P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347778/
https://www.ncbi.nlm.nih.gov/pubmed/34362112
http://dx.doi.org/10.3390/jcm10153325
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author Caffier, Felix
Nawka, Tadeus
Neumann, Konrad
Seipelt, Matthias
Caffier, Philipp P.
author_facet Caffier, Felix
Nawka, Tadeus
Neumann, Konrad
Seipelt, Matthias
Caffier, Philipp P.
author_sort Caffier, Felix
collection PubMed
description 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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spelling pubmed-83477782021-08-08 Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i) Caffier, Felix Nawka, Tadeus Neumann, Konrad Seipelt, Matthias Caffier, Philipp P. J Clin Med Article 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. MDPI 2021-07-28 /pmc/articles/PMC8347778/ /pubmed/34362112 http://dx.doi.org/10.3390/jcm10153325 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Caffier, Felix
Nawka, Tadeus
Neumann, Konrad
Seipelt, Matthias
Caffier, Philipp P.
Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)
title Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)
title_full Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)
title_fullStr Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)
title_full_unstemmed Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)
title_short Validation and Classification of the 9-Item Voice Handicap Index (VHI-9i)
title_sort validation and classification of the 9-item voice handicap index (vhi-9i)
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347778/
https://www.ncbi.nlm.nih.gov/pubmed/34362112
http://dx.doi.org/10.3390/jcm10153325
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