Patient-Centered Approach to Assessing Voice Impairment

Area of Science:

• Laryngology
• Psychometrics
• Patient-Reported Outcomes

Background:

• The Voice Handicap Index-10 (VHI-10) is a widely used tool for voice disorder assessment.
• There is a growing emphasis on patient-centered outcomes beyond diagnostic test results.
• Patients' perspectives on the VHI-10 items were previously unknown.

Purpose of the Study:

• To investigate patient perceptions of the VHI-10 items.
• To identify a shorter, patient-centered subset of VHI-10 items for clinical use.

Main Methods:

• Prospective psychometric and patient-centered study design.
• Factor analysis and item response theory (IRT) applied to VHI-10 data from 6048 patients.
• Patient ranking and qualitative feedback on VHI-10 items and proposed shorter subsets.

Main Results:

• Factor analysis confirmed unidimensionality of the VHI-10.
• IRT analysis identified key items with high discrimination parameters (items 4, 3, 6, 1).
• Patients favored a 6-item subset (including items 1, 2, 3, 5, 6, 7) that balanced patient experience and clinical relevance.

Conclusions:

• A shorter, patient-centered VHI-10 version was identified, potentially enhancing clinical assessment.
• This refined VHI-10 subset may offer a more efficient and nuanced evaluation of voice impairments.
• Findings support the development of more patient-centered voice assessment tools.