A Meta-Analytic Reliability Generalization Study of the Pediatric Voice Handicap Index

The pediatric voice handicap index (pVHI) is a widely used proxy-reported outcome measure. However, its reliability values are subject to variability across studies. Accordingly, the objective of this study is to analyze the mean reliability estimation and stratified alpha coefficient of the pVHI. Another aim of the study is to determine if differences in reliability values can be linked to the specific research characteristics.

This is a meta-analytic reliability generalization study.

Two researchers used Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria to review five databases (Scopus, Web of Science, YÖKTEZ, Ulakbim, and PUBMED) for publications published between 2007 and 2022 that used pVHI. A meta-analysis was then conducted on 12 papers that fit the predetermined inclusion criteria to ascertain the total effect size of the Cronbach's alpha coefficient of pVHI scores. The reliability coefficients of pVHI were computed utilizing Cochran Q, I², and the lower and upper bounds of mean reliability. Additionally, moderator analyses were employed to examine the heterogeneity among studies.

The computed mean reliability value was approximately 0.916 [0.8840, 0.9401] which is within the acceptable range (>0.70). Furthermore, the mean stratified Cronbach's alpha coefficient was found to be roughly 0.95. The heterogeneity statistics indicated that the reliability estimations for each study varied significantly (Q ∼ (df = 11) ∼ = 163.6172, P < 0.0001; I² = 93.90%).

Results indicate that pVHI yields sufficiently reliable outcomes. Furthermore, the reliability of the pVHI remained consistent regardless of index language, participant group (healthy, dysphonic, or both), or continent of origin. These results improve the clinical value and utility of pVHI by providing further evidence of its reliability.