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Related Experiment Video

Updated: Feb 21, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
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Published on: March 24, 2023

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Minimal Important Difference in Voice Handicap Index-10.

Stephanie Misono1, Bevan Yueh1, Ali N Stockness1

  • 1Department of Otolaryngology, University of Minnesota, Minneapolis.

JAMA Otolaryngology-- Head & Neck Surgery
|October 4, 2017
PubMed
Summary

A change of 6 points on the Voice Handicap Index-10 (VHI-10) may indicate a meaningful improvement for patients. This minimal important difference (MID) was associated with a moderate change in voice symptoms, but further research is needed.

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Area of Science:

  • Audiology and Speech Sciences
  • Otolaryngology
  • Health Outcomes Research

Background:

  • Patient-reported outcome measures (PROMs) are crucial for assessing treatment efficacy in voice disorders.
  • The minimal important difference (MID) quantifies the smallest change in a PROM that patients perceive as beneficial.
  • Establishing the MID for the Voice Handicap Index-10 (VHI-10) is essential for interpreting changes in voice-related quality of life.

Purpose of the Study:

  • To determine the minimal important difference (MID) for the total score of the Voice Handicap Index-10 (VHI-10).
  • To utilize an anchor-based approach, correlating VHI-10 changes with a global rating of change.
  • To provide a clinically meaningful threshold for interpreting VHI-10 score improvements.

Main Methods:

  • A cohort of 273 adult voice clinic patients completed the VHI-10 at baseline and 2 weeks later.
  • A global rating of change scale was administered concurrently to assess perceived voice improvement.
  • Anchor-based methods (Pearson correlation) and distribution-based methods were employed to estimate the MID.

Main Results:

  • A VHI-10 score change of 6 was associated with a 'moderate' change on the global rating scale.
  • Patients reporting 'no change' or 'small change' had similar mean VHI-10 score changes (1 point).
  • The correlation between global change and VHI-10 change was modest (r=0.32), suggesting VHI-10 change alone may not fully capture perceived voice improvement.

Conclusions:

  • A VHI-10 score difference of 6 is proposed as a potential minimal important difference (MID).
  • This MID corresponds to a moderate perceived improvement in voice symptoms.
  • Further research is recommended due to the modest correlation and lack of clear differentiation between 'no change' and 'small change' categories.