Assessment of Dysphonia Using the Japanese Version of the Voice Handicap Index and Determination of Cutoff Points for Screening

Yu Sakaguchi; Takeharu Kanazawa; Ayako Okui; Mayu Hirosaki; Ujimoto Konomi; Taisuke Sotome; Nahoko Tashiro; Miyuki Kurihara; Takumi Omae; Yosuke Nakayama; Ayumi Yamamoto; Ayane Sato; Kiyoshi Misawa; Yusuke Watanabe

doi:10.1016/j.jvoice.2020.04.031

Assessment of Dysphonia Using the Japanese Version of the Voice Handicap Index and Determination of Cutoff Points for Screening

J Voice. 2022 Jan;36(1):144.e1-144.e9. doi: 10.1016/j.jvoice.2020.04.031. Epub 2020 Jun 23.

Authors

Affiliations

¹ Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
² Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan. Electronic address: tkanazawa@iuhw.ac.jp.
³ Center of Rehabilitation, Sanno Hospital, Tokyo, Japan.
⁴ Department of Otolaryngology-Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
⁵ Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan.

PMID: 32591235
DOI: 10.1016/j.jvoice.2020.04.031

Abstract

Introduction: The Voice Handicap Index (VHI) is recognized as a useful subjective assessment method for dysphonia. The original VHI has been translated into numerous other languages, including Japanese (J-VHI). Although the reliability and validity of the J-VHI have already been established, the cutoff point has not been determined. The aims of this study were to investigate the relationship between the J-VHI and other voice laboratory measurements, and determine the cutoff point.

Method: This study included 167 dysphonic patients and 55 healthy volunteers. All patients and volunteers completed the J-VHI at the initial visit, and the following outcomes were determined: VHI scores of patients with dysphonia and healthy volunteers, VHI scores according to disease, cutoff point, and correlations between VHI scores and other voice laboratory measurements.

Results: Both the total VHI (VHI-T) and individual domain (functional domain [VHI-F], emotional domain [VHI-E], physical domain [VHI-P]) scores were significantly higher in the dysphonia group compared to the healthy volunteer group. VHI-T, VHI-F, and VHI-E scores were significantly lower in the benign mucosal lesion subgroup, compared to the other disease subgroups. The G scale and B scale of the grade-roughness-breathiness-asthenia-strain scale showed a significant association with VHI-T, VHI-F, and VHI-P scores. Similarly, the A scale showed a significant association with VHI-T, VHI-F, and VHI-E scores. The cutoff point (12) for VHI-T was chosen from the receiver operating characteristic curve to maximize sensitivity and specificity. Similarly, the cutoff points for VHI-F (5), VHI-P (5), and VHI-E (3) were also obtained. Significant differences in maximum phonation time, pitch range, G scale, and B scale were observed between the VHI-T negative (VHI ≤ 12) and positive (VHI-T > 13) groups.

Conclusion: These findings suggest that self-evaluation using the VHI could serve as an independent assessment and screening tool for patients with dysphonia.

Keywords: Cutoff point; Dysphonia; Japanese language version; Objective assessment; Subjective assessment; Voice Handicap Index.

MeSH terms

Disability Evaluation
Dysphonia* / diagnosis
Humans
Japan
Reproducibility of Results
Severity of Illness Index
Surveys and Questionnaires
Voice Disorders* / diagnosis