Validation of first speech-specific questionnaire for English-speaking head and neck cancer (HNC) patients.

Abstract

9081 Background: Although there are many voice-specific scales, surprisingly there is no speech-specific questionnaire for English-speaking HNC patients. The aim of this study is to validate the Speech Handicap Index (SHI) as the first speech-specific questionnaire in the English language. Methods: Sixty-three consecutive English-speaking patients in follow-up for oral or oropharyngeal cancers at The Royal Marsden Hospital, London, UK were recruited for this study. English version of Speech Handicap Index (SHI) is based on the widely used voice-specific scale the “Voice Handicap Index” (VHI). It consists of 30 well-constructed questions to evaluate the patient's speech and psycho-social functions. Patients were given both the questionnaires (SHI and UWQOL) in the outpatient for returning via post. A randomly selected subset of thirty-two patients was asked to complete both the questionnaires again after four weeks in order to assess test-retest reliability. Internal consistency and test-retest reliability were assessed using Cronbach's alpha and Spearman's correlation coefficient, respectively. Construct (by UWQOL V.04) and group validity were determined using the Mann-Whitney U-test. Results: The internal consistency reliability for Total SHI and SHI speech domain as calculated by Cronbach's alpha coefficient was 0.98 and 0.95, respectively. For SHI psycho-social domain alpha coefficient was 0.98. Test-retest reliability of Total SHI and SHI speech domain as calculated by Spearman's rank correlation coefficients were 0.92 and 0.88, respectively. For SHI psycho-social domain the coefficient was 0.89. The correlation coefficients between Total SHI score, the SHI speech domain, the SHI psycho-social domain and overall SHI speech assessment question, and speech domain of UWQOL were 0.72, 0.72, 0.71 and 0.68, respectively. The correlation coefficients between Total SHI score, the SHI speech domain, the SHI psycho-social domain and overall SHI speech assessment question, and social domain of the UWQOL were 0.44, 0.44, 0.43 and 0.35, respectively. Conclusions: The SHI is a precise, highly reliable and valid speech assessment tool for HNC patients. No significant financial relationships to disclose.