Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-26T06:18:01.384Z Has data issue: false hasContentIssue false
  • English
  • Français

Optimising outcome assessment of voice interventions, I: reliability and validity of three self-reported scales

Published online by Cambridge University Press:  29 March 2007

A L Webb ,
P N Carding ,
I J Deary ,
K MacKenzie ,
I N Steen  and
J A Wilson
A L Webb
Affiliation:
Department of Speech & Language Therapy, Institute of Health and Society, Scotland, UK
P N Carding
Affiliation:
Department of Speech & Language Therapy, Institute of Health and Society, Scotland, UK
I J Deary
Affiliation:
Department of Psychology, University of Edinburgh, Scotland, UK
K MacKenzie*
Affiliation:
Department of Otorhinolaryngology–Head and Neck Surgery, Royal Infirmary, Glasgow, Scotland, UK.
I N Steen
Affiliation:
Department of Otolaryngology Head and Neck Surgery, Newcastle University, Newcastle, UK
J A Wilson
Affiliation:
Institute of Health and Society, Scotland, UK
*
Address for correspondence: Mr Kenneth MacKenzie, Department of ORL-HNS, Glasgow Royal Infirmary, Glasgow G31 2ER, Scotland, UK. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

There is an increasing choice of voice outcome research tools, but good comparative data are lacking.

Objective:

To evaluate the reliability and validity of three voice-specific, self-reported scales.

Design:

Longitudinal, cohort comparison study.

Setting:

Two UK voice clinics: the Freeman Hospital, Newcastle upon Tyne, and the Glasgow Royal Infirmary.

Participants:

One hundred and eighty-one patients presenting with dysphonia.

Main outcome measures:

All patients completed the vocal performance questionnaire, the voice handicap index and the voice symptom scale. For comparison, each patient's voice was recorded and assessed perceptually using the grade–roughness–breathiness–aesthenia–strain scale. The reliability and validity of the three self-reported vocal performance measures were assessed in all subjects, while 50 completed the questionnaires again to assess repeatability.

Results:

The results of the 170 participants with completed data sets showed that all three questionnaires had high levels of internal consistency (Cronbach's alpha = 0.81–0.95) and repeatability (voice handicap index = 0.83; vocal performance questionnaire = 0.75; voice symptom scale = 0.63). Concurrent and criterion validity were also good, although, of the grade–roughness–breathiness–aesthenia–strain subscales, roughness was the least well correlated with the self-reported measures.

Conclusion:

The vocal performance questionnaire, the voice handicap index and the voice symptom scale are all reliable and valid instruments for measuring the patient-perceived impact of a voice disorder.

Keywords

VoiceVoice QualityQuality of LifeOutcome Assessment (Healthcare)Outcome Measures
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 121 , Issue 8 , August 2007 , pp. 763 - 767
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Carding, P, Steen, N, Webb, A, Mackenzie, K, Deary, IJ, Wilson, JA. The reliability and sensitivity to change of the acoustic quality of voice. Clin Otolaryngol 2004;29:538–44CrossRefGoogle Scholar
2Deary, IJ, Webb, A, Mackenzie, K, Wilson, JA, Carding, P. Short self report voice symptom scales: psychometric characteristics of the Voice Handicap – 10 and the Vocal Performance Questionnaire. Otolaryngol Head Neck Surg 2004;131:232–5CrossRefGoogle ScholarPubMed
3Jacobson, BH, Johnson, A, Grywalski, C, Silbergleit, A, Jacobson, G, Benninger, MS. The Voice Handicap Index (VHI): development and validation. Am J Speech Lang Pathol 1997;6:66–70CrossRefGoogle Scholar
4Gliklich, RE, Glovsky, RW, Montgomery, WW. Validation of a voice outcome survey for unilateral vocal cord paralysis. Otolaryngol Head Neck Surg 1999;120:153–8Google ScholarPubMed
5Hogikyan, N, Sethuraman, G. Validation of an instrument to measure Voice-Related Quality of Life (V-RQOL). J Voice 1999;13:557–69CrossRefGoogle ScholarPubMed
6Ma, E, Yiu, E. Voice activity and participation profile: assessing the impact of voice disorders on daily activities. J Speech Lang Hear Res 2001;44:511–24CrossRefGoogle ScholarPubMed
7Wilson, JA, Webb, A, Carding, P, Steen, IN, Mackenzie, K, Deary, I. Comparing the Voice Symptom Scale (VoiSS) and the Voice Handicap Index (VHI) structure and content. Clin Otolaryngol 2004;29:169–74CrossRefGoogle ScholarPubMed
8Carding, P, Docherty, GJ. A study of the effectiveness of voice therapy in the treatment of 45 patients with nonorganic dysphonia. J Voice 1999;13:72–104CrossRefGoogle ScholarPubMed
9Benniger, MS, Ahuja, AS, Gardner, G, Grywalski, C. Assessing outcomes for dysphonic patients. J Voice 1998;12:540–50CrossRefGoogle Scholar
10Rosen, C, Murray, T. Nomenclature of voice disorders and vocal pathology. Otolaryngol Clin North Am 2000;33:1035–45CrossRefGoogle ScholarPubMed
11Scott, S, Robinson, K, Wilson, JA, MacKenzie, K. Patient reported problems associated with dysphonia. Clin Otolaryngol 1997;2:37–40CrossRefGoogle Scholar
12Carding, P, Horsley, I. An evaluation study of voice therapy in nonorganic dysphonia. Eur J Disord Commun 1992;27:137–57CrossRefGoogle Scholar
13Stewart, M, Chen, A, Stach, C. Outcome analysis of voice and quality of life in patients with laryngeal cancer. Arch Otolaryngol Head Neck Surg 1998;124:143–8CrossRefGoogle ScholarPubMed
14Rosen, CA, Murray, T, Zinn, A, Zullo, T, Sonbolian, M. Voice Handicap Index change following treatment of voice disorders. J Voice 2000;14:619–23CrossRefGoogle ScholarPubMed
15Courey, MS, Garrett, CG, Billante, CR, Stove, RE, Portell, MD, Smith, TL et al. Outcomes assessment following treatment of spasmodic dysphonia with botulinum toxin. Ann Otol Rhinol Laryngol 2000;109:819–22CrossRefGoogle ScholarPubMed
16Benninger, MS, Gardner, G, Grywalski, C. Outcomes of botulinum toxin treatment for patients with spasmodic dysphonia. Arch Otolaryngol Head Neck Surg 2001;127:1083–5CrossRefGoogle ScholarPubMed
17Fung, K, Yoo, J. Vocal function following radiation for non laryngeal versus laryngeal tumours of the head and neck. Laryngoscope 2001;111:1920–3CrossRefGoogle ScholarPubMed
18Hirano, M. Clinical Examination of Voice. Vienna: Springer-Verlag, 1981Google Scholar
19Dejonckere, PH, Obbens, C, Leeper, HA, Hawkins, S, Heeneman, H, Doyle, PC et al. Perceptual evaluation of dysphonia: reliability and relevance. Folia Phoniatrica 1993;45:76–83CrossRefGoogle ScholarPubMed
20De Bodt, M, Wuyts, FL, Van de Heyning, PH, Croux, C. Test-retest of the GRBAS Scale: influence of experience and professional background on perceptual ratings of voice quality. J Voice 1997;11:74–80CrossRefGoogle ScholarPubMed
21Wuyts, FL, De Bodt, MS, Van de Heyning, PH. Is the reliability of a visual analog scale higher than an ordinal scale? An experiment with the GRBAS Scale for the perceptual evaluation of dysphonia. J Voice 1999;13:508–17CrossRefGoogle ScholarPubMed
22Webb, A, Carding, P, Deary, IJ, Mackenzie, K, Steen, IN, Wilson, JA. A study of the reliability of three auditory perceptual scales for dysphonia. Eur Arch Otorhinolaryngol 2004;261:429–34CrossRefGoogle ScholarPubMed
23Fairbanks, G. Voice and Articulation Drillbook. New York: Harper Row, 1960Google Scholar
24Cronbach, L. Essentials of Psychological Testing. London, Harper & Row, 1970Google Scholar
25Hays, R, Anderson, R, Revicki, D. Psychometric considerations in evaluating health-related quality of life measures. Qual Life Res 1993;2:441–9CrossRefGoogle ScholarPubMed
26Shrout, P, Fleiss, J. Intraclass correlations: uses in assessing rater reliability. Psychol Bull 1979;86:420–8CrossRefGoogle ScholarPubMed
27Nunally, J. Introduction to Psychological Measurement. New York: McGraw-Hill, 1970Google Scholar
28Schuavetti, N, Metz, D. Evaluating Research in Communicative Disorders. Boston: Allyn and Bacon, 1997Google Scholar