Internal Consistency of the Voice Handicap Index in Individuals With Dysphonia: A Systematic Review and Meta-Analysis

Denis de Jesus Batista; Rayane Délcia da Silva; Agnes Andrade Martins; Cristiano Miranda de Araújo; Rosane Sampaio Santos; Odilon Guariza Filho; Karinna Veríssimo Meira Taveira; Vanessa Veis Ribeiro

doi:10.1016/j.jvoice.2023.08.012

Internal Consistency of the Voice Handicap Index in Individuals With Dysphonia: A Systematic Review and Meta-Analysis

J Voice. 2023 Sep 29:S0892-1997(23)00253-9. doi: 10.1016/j.jvoice.2023.08.012. Online ahead of print.

Authors

Denis de Jesus Batista¹, Rayane Délcia da Silva², Agnes Andrade Martins³, Cristiano Miranda de Araújo⁴, Rosane Sampaio Santos⁵, Odilon Guariza Filho⁶, Karinna Veríssimo Meira Taveira⁷, Vanessa Veis Ribeiro⁸

Affiliations

¹ Decision Models and Health, Statistics Department, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil; Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil. Electronic address: denis.batista@narsm.com.br.
² Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Communication Disorders, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil. Electronic address: rayanedsilva@narsm.com.br.
³ Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Dentistry, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil. Electronic address: agnesandrade7@gmail.com.
⁴ Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Communication Disorders, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil; Dentistry, Universidade Tuiuti do Paraná, Curitiba, Paraná, Brazil. Electronic address: cristianoaraujo@narsm.com.br.
⁵ Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Graduate Program in Communication Disorders, Universidade Tuiuti do Paraná. Electronic address: rosane.santos2@utp.br.
⁶ Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil. Electronic address: odilongfilho@gmail.com.
⁷ Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil; Universidade Federal do Rio Grande do Norte, Curitiba, Paraná, Brazil. Electronic address: karinnataveira@narsm.com.br.
⁸ Núcleo de estudos Avançados em Revisões Sistemáticas e Meta-análise (NARSM), Rua Padre Ladislau Kula, 395 - Santo Inácio, Curitiba, PR 82010-210, Brazil; Associated Graduate Program in Speech and Language Therapy, Universidade Federal da Paraíba, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Curitiba, Paraná, Brazil; Speech and Language Therapy Course and the Graduate Program in Medical Sciences, Universidade de Brasília, Universidade Federal do Rio Grande do Norte and Universidade Estadual de Ciências da Saúde de Alagoas, Brasília, Distrito Federal, Brazil. Electronic address: denis.batista@narsm.com.br.

PMID: 37778959
DOI: 10.1016/j.jvoice.2023.08.012

Abstract

Objective: To analyze the internal consistency of the Voice Handicap Index (VHI) for evaluating the vocal handicap of individuals with dysphonia.

Methods: This is a systematic review. Studies with a cross-sectional design and including a population of individuals with dysphonia, which validated the VHI and analyzed its internal consistency, were included. The following electronic databases were searched: Cochrane Library, EMBASE, LILACS, and PubMed, including Medline, Scopus, and Web of Science. A manual search was performed in gray literature through the Biblioteca Digital Brasileira de Teses e Dissertações and ProQuest Dissertation & Theses. In addition, the list of references of studies selected in the electronic search was mapped, and an expert in the area was consulted. Two reviewers blindly and independently conducted the selection, data extraction, and analysis of the risk of bias, the certainty of the evidence, and good psychometric measures. A meta-analysis was performed with a random effects model using the JAMOVI 2.3.2 software.

Results: Forty-nine studies were analyzed. In risk of bias assessment, the studies were classified as having inadequate structural validity and very good internal consistency. The analysis of good psychometric properties indicated indeterminate structural validity and insufficient internal consistency. The overall value of Cronbach's alpha was estimated at 0.94, thus suggesting a very good internal consistency. However, there was high heterogeneity. The level of certainty of the evidence was too low for internal consistency.

Conclusion: The VHI proved to be a consistent and reliable patient-reported outcome measure to evaluate voice handicap in individuals with dysphonia; however, studies are heterogeneous, and the certainty of evidence is very low.

Keywords: Internal consistency; Reliability; Systematic review; VHI; Voice Handicap Index; Voice disorder.

Publication types

Review