Assessment of the voice handicap index as a screening tool in dysphonic patients

Abstract

Objective: The aim of the study was to assess the applicability of the Voice Handicap Index (VHI) in the screening diagnostics of voice dysfunction and in the evaluation of the level of handicap due to dysphonia.

Patients and methods: A total of 165 patients with voice disorders (vocal paresis, benign vocal fold masses, and functional dysphonia) and 65 healthy controls completed the VHI questionnaire. All the participants were subjected to maximum phonation time (MPT) assessment, the patients also to laryngovideostroboscopy.

Results: The VHI scores for the patients and controls differed significantly (p<0.001). A significant correlation (p<0.05) was found when MPT and VHI were compared. The cutoff point, at which VHI sensitivity (for distinguishing between subjects with voice dysfunction and with vocal health) reached its maximal value (98%) at the highest level of specificity (95%), was assumed to be 12.

Conclusions: The study revealed that the VHI is a reliable tool for identifying patients who experience vocal dysfunction and should be used in multidimensional diagnostics of voice disorders. The level of 12 points in the VHI test should be considered to be a threshold for rating the biopsychosocial impact of dysphonia.