Checking for voice disorders without clinical intervention: The Greek and global VHI thresholds for voice disordered patients

Dionysios Tafiadis,Meropi E Helidoni,George A Velegrakis,Periklis Papadopoulos,Louiza Voniati,Nafsika Ziavra,Spyridon K Chronopoulos,Thomas Murry,Evangelia I Kosma

doi:10.1038/s41598-019-45758-z

Abstract

Voice disorders often remain undiagnosed. Many self-perceived questionnaires exist for various medical conditions. Here, we used the Greek Voice Handicap Index (VHI) to address the aforementioned problem. Everyone can fill in the VHI questionnaire and rate their symptoms easily. The innovative feature of this research is the global cut-off score calculated for the VHI. Therefore, the VHI is now capable of helping clinicians establish a more customizable treatment plan with the cut-off point identifying patients without normal phonation. For the purpose of finding the global cut-off point, a group of 180 participants was recruited in Greece (90 non-dysphonic participants and 90 with different types of dysphonia). The voice disordered group had higher VHI scores than those of the control group. In contrast to previous studies, we provided and validated for the first time the cut-off points for all VHI domains and, finally, a global cut-off point through ROC and precision-recall analysis in a voice disordered population. In practice, a score higher than the well-estimated global score indicates (without intervention) a possible voice disorder. Nevertheless, if the score is near the threshold, then the patient should definitely follow preventive measures.

Highlights

The subjective voice evaluation using self-perceived questionnaires has been proven to effectively record the patients’ experience of their voice disorder, which has an impact on their quality of life (QOL)[1,2,3]
The sample consisted of 180 participants (90 controls and 90 voice disordered People - VDP)
For VDP, the Voice Handicap Index (VHI)-T median and mean scores were estimated to be 35.50 and 37.82, respectively, which is similar to many results from studies of the cross-cultural adaptation of VHI to dysphonic populations[1,21,23,24,25,26,27,28,29,30,31,32,33]

Summary

Introduction

The subjective voice evaluation using self-perceived questionnaires has been proven to effectively record the patients’ experience of their voice disorder, which has an impact on their quality of life (QOL)[1,2,3]. To obtain the opinions of patients regarding the psychosocial effects of their voice disorders on their daily lives[1], recent studies have reported its discriminatory ability[40,41,42,43,44,45,46] The latter is a very important finding, as it demonstrates that this questionnaire is a very important tool in the hands of specialists and every person who wishes to preliminarily check his/her vocal-voice status for potential abnormalities before the use of interventional actions (e.g., endoscopy). The second purpose of this study was to determine the correlations between various populations, while the third purpose was to estimate a global cut-off point (for voice disordered patients). The latter could be a true innovation in global voice screening procedures

Methods

Results

Discussion

Conclusion