Background: Voice Handicap Index (VHI) has been used extensively in research and clinical settings. It has been suggested to be used as a diagnostic tool in the literature. However, little is known if it could be applied as a diagnostic tool to the Cantonese-speaking population. The study aims to establish cutoff points and the diagnostic accuracy for VHI-30 and VHI-10 to discriminate between Cantonese-speaking dysphonic and nondysphonic individuals.
Methods: Data from 256 adults from Hong Kong were extracted from a database at a local institution. There were a total of 91 nondysphonic individuals and 165 dysphonic individuals. Receiver operating characteristics curve analysis was conducted to establish cutoff points for VHI-30 and VHI-10. Diagnostic accuracy statistics such as sensitivity, specificity, positive, and negative predicted values (PPV and NPV) and likelihood ratios (LRs) were also reported.
Results: The dysphonic group scored higher than the nondysphonic group on the mean scores of both versions of VHI. Receiver operating characteristics curve analysis revealed a moderate to strong area under curve of 0.89 in both VHI-30 and VHI-10. A cutoff point of 18.5 point was yielded for VHI-30 (Sensitivity = 86.1%, Specificity = 81.3%, PPV = 89.3%, NPV = 76.3%, LR+ = 4.60, LR- = 0.17) and a cutoff point of 7.5 point was yielded for VHI-10 (Sensitivity = 80.6%, Specificity = 87.9%, PPV = 92.4%, NPV = 71.4%, LR+ = 6.66, LR- = 0.22).
Conclusions: Both the Chinese VHI-30 and VHI-10 for Cantonese speakers showed promising diagnostic accuracy. VHI can be used as adjunct to clinical diagnosis and treatment outcome measures for voice disorders in the Cantonese-speaking population.
Keywords: Cantonese speakers; Cutoff point; Dysphonia; Self-assessment; Voice; Voice-related quality of life.
Copyright © 2020 The Voice Foundation. Published by Elsevier Inc. All rights reserved.