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Validation of the voice handicap index using Rasch analysis
H C A Bogaardt1, M M Hakkesteegt, W Grolman
1Department of Phoniatrics and Otolaryngology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. h.c.bogaardt@amc.uva.nl
Summary
Rasch analysis refined the Voice Handicap Index (VHI) into two key dimensions, offering more reliable and interpretable scores for voice disorder assessment and therapy evaluation.
Area of Science:
- Speech and Hearing Sciences
- Psychometrics
- Clinical Measurement
Background:
- The Voice Handicap Index (VHI) assesses psychosocial impacts of voice disorders.
- Traditional VHI evaluation relies on sample-dependent reliability and validity.
- Rasch analysis offers a sample-independent method for psychometric evaluation.
Purpose of the Study:
- To re-examine the VHI's dimensionality using Rasch analysis.
- To generate less sample-dependent item and scale statistics for the VHI.
- To provide interpretable VHI item and person severity estimates on a common logit scale.
Main Methods:
- Rasch analysis was applied to VHI data from 530 dysphonic patients.
- The analysis focused on assessing the VHI's underlying dimensionality and item/person severity.
Main Results:
- Rasch analysis identified two unidimensional constructs: a 20-item psychosocial scale and a 9-item physical-functional scale.
- Item severity ranged from -2.1 to +2.7 logits, and person severity from -4.4 to +4.4 logits.
- Reduced scales demonstrated comparable internal consistency to the original VHI.
Conclusions:
- The VHI comprises two unidimensional constructs, not three as originally proposed.
- Transformed VHI scores provide logit-based severity measures, enhancing therapy evaluation.
- This Rasch-based approach improves the VHI's utility in clinical voice assessment.
