Document Detail


Utility of the Voice Handicap Index as an Indicator of Postthyroidectomy Voice Dysfunction.
MedLine Citation:
PMID:  23294708     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESES: The Voice Handicap Index (VHI) is a simple, reliable, self-administered questionnaire that has been used to identify negative voice outcomes after thyroidectomy. This study provides an updated report of a multiyear study examining the predictive ability of the VHI to classify normal versus negative voice outcomes (VOs). STUDY DESIGN: Prospective observational, longitudinal study of the patient reported impact of voice changes after thyroidectomy using the VHI. Since the preliminary report, the sample size doubled and methods for classifying voice outcomes (VOs) were refined. METHODS: Ninety-one adults provided voice assessment data preoperatively (baseline) and at approximately 2 weeks postthyroidectomy. VO was defined according to endoscopic laryngeal examination, acoustic, auditory perceptual, and patient report parameters. The VHI was tested for its sensitivity and specificity for identifying VO. RESULTS: Twenty-two participants (24.2%) qualified as having adverse VOs during the early postoperative period. A change from baseline in VHI of 13-16 points had a diagnostic accuracy of 86% sensitivity and 88% specificity for classifying early VO and had 70% and 95% positive and negative predictive values, respectively. The Functional and Physical subscales of the VHI had higher predictive value than the Emotional subscale. Adjunctive analyses of a two-subscale version of the VHI and of the 10 items that comprises the VHI-10 also revealed high predictive value for differentiating groups by VO. CONCLUSIONS: Balanced sensitivity and specificity are achieved at a change in the total VHI score of 13-16. These results are generally consistent with several other studies examining voice problems over time. The VHI, as well as its alternate versions, appear to be useful and should be incorporated into the diagnostic process for identifying patients with voice problems after thyroidectomy.
Authors:
Nancy Pearl Solomon; Leah B Helou; Leonard R Henry; Robin S Howard; George Coppit; Ashok R Shaha; Alexander Stojadinovic
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-4
Journal Detail:
Title:  Journal of voice : official journal of the Voice Foundation     Volume:  -     ISSN:  1557-8658     ISO Abbreviation:  J Voice     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8712262     Medline TA:  J Voice     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The Voice Foundation. Published by Mosby, Inc. All rights reserved.
Affiliation:
Audiology and Speech Center, Department of Research Programs, Otolaryngology, and Surgical Oncology at Walter Reed National Military Medical Center, Bethesda, Maryland. Electronic address: Nancy.P.Solomon.civ@health.mil.
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