Validity and Reliability of the Arabic Thyroidectomy-Related Voice and Symptom Questionnaire (A-TVSQ) for Assessing Post-Thyroidectomy Patients

Mashal Abaalkhail; Mohammed Alessa; Raghad AlKhashan; Yara Saleh Alasmari; Tamer A Mesallam; Mohamed Farahat; Saleh Aldhahri; Saleh Alqaryan; Khalid Al-Qahtani; Khalid H Malki

doi:10.1016/j.jvoice.2023.10.001

Validity and Reliability of the Arabic Thyroidectomy-Related Voice and Symptom Questionnaire (A-TVSQ) for Assessing Post-Thyroidectomy Patients

J Voice. 2023 Oct 28:S0892-1997(23)00312-0. doi: 10.1016/j.jvoice.2023.10.001. Online ahead of print.

Affiliations

¹ College of Medicine, King Saud University, Riyadh, Saudi Arabia.
² Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
³ Research Chair of Voice, Swallowing, and Communication Disorders, Department of Otolaryngology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
⁴ Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
⁵ Research Chair of Voice, Swallowing, and Communication Disorders, Department of Otolaryngology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Electronic address: kalmalki@ksu.edu.sa.

PMID: 37903686
DOI: 10.1016/j.jvoice.2023.10.001

Abstract

Objective: Post-thyroidectomy patients commonly experience voice changes, swallowing symptoms, and neck discomfort, a condition known as post-thyroidectomy syndrome. The Thyroidectomy-Related Voice and Symptom Questionnaire (TVSQ) is a validated tool showing strong correlations with established tools with a potential predictive value for post-thyroidectomy voice outcomes. Our study aims to translate and validate the TVSQ into Arabic.

Methods: This validation study was conducted at King Abdulaziz University Hospital and King Khalid University Hospital in Riyadh, Saudi Arabia. Forward and backward translations ensured the conceptual equivalence of the Arabic TVSQ (A-TVSQ) and were reviewed by an expert panel. A pilot test assessed the A-TVSQ's face validity and clarity, leading to necessary cultural adjustments. The final A-TVSQ was preoperatively and postoperatively administered to thyroidectomy patients to evaluate its test-retest reliability.

Results: Data were collected from 116 participants (53 cases [45.6%] and 63 controls [54.3%]). The internal consistency analysis showed strong intercorrelation among the A-TVSQ items, with Cronbach's alpha coefficients (0.951) indicating excellent estimated internal consistency within both domains. Test-retest reliability showed a moderate level of reliability with an intraclass correlation coefficient of 0.696. A-TVSQ item discrimination analysis showed significant associations between the total and domain scores pre- and post-thyroidectomy. External validity analysis showed significant changes in A-TVSQ voice change (P < 0.010) and neck discomfort (P = 0.011) domains and total scores (P < 0.010) between before and 2 weeks after thyroidectomy. However, no significant changes were observed between 2 and 4 weeks after thyroidectomy.

Conclusions: The translated and validated A-TVSQ showed excellent internal consistency and moderate test-retest reliability, comparable to the original version. Voice change significantly worsened after thyroidectomy, highlighting the need for continued monitoring and management strategies for this complication.

Keywords: Discomfort; Dysphonia; TVSQ; Thyroidectomy.