Are We Using a Multidimensional Voice Evaluation in Patients With Early-Stage Laryngeal Cancer? A Systematic Review

Across the field of voice, evaluation is guided by a multidimensional voice evaluation framework that accounts for the complexity of voice production and its psychological dimensions. However, in the published literature of postradiotherapy (RT) early-stage laryngeal cancer (ESLC) patients with voice disorders, it is hypothesized that a multidimensional voice evaluation is not adhered to. Consequently, in the absence of such evidence, clinicians are unable to draw upon scientific research to support and advocate for evidence-based practice (EBP). The aim of this systematic literature review was to determine the extent to which the various domains of voice are represented in the ESLC postRT literature to identify gaps in research that may influence clinical care.

Systematic literature review.

We searched PubMed, Embase, and CINAHL to highlight the concepts of "RT" and "voice disorders" guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards.

In the 61 included articles, we identified that a multidimensional voice evaluation is rarely employed; only found in 3% of the reviewed articles. Furthermore, the extent to which domains (eg, acoustic, self-assessment, and perceptual) are employed, outcome measures are used, inter-rater and intra-rater reliability is reported, and how data are reported varies across studies impeding meaningful comparisons and synthesis of findings in this population.

There is a lack of methodological consistency in voice evaluation approaches across studies focusing on the ESLC population post RT. This significantly reduces the comparability and clinical application of research findings related to clinical practice for ESLC populations. Moreover, without available evidence, clinicians lack the justification needed to support and promote EBP. We highlight and call for improved adherence to the established guidelines that recommended a multidimensional voice evaluation to be employed in research and clinical practice.