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Clinical Validation of the Hebrew Voice Symptom Scale (VoiSS-Heb)
Daniel Hilewitz1, Osnat Kandelshine-Waldman2, Ofer Amir2
1Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel; Department of Otolaryngology, Head & Neck Surgery, Sheba Medical Center, Tel Hashomer, Israel.
Journal of Voice : Official Journal of the Voice Foundation
|December 9, 2025
Summary
The Hebrew Voice Symptom Scale (VoiSS-Heb) is a validated, reliable tool for assessing dysphonia in adults. It accurately measures voice symptoms and correlates with voice quality and anxiety, aiding patient-centered care.
Area of Science:
- Otolaryngology
- Speech-Language Pathology
- Psychometrics
Background:
- Dysphonia significantly impacts adults' quality of life.
- Existing voice assessment tools may lack cultural adaptation for specific populations.
- A validated Hebrew version of the Voice Symptom Scale (VoiSS) is needed for clinical use.
Purpose of the Study:
- To translate and culturally adapt the Voice Symptom Scale (VoiSS) into Hebrew (VoiSS-Heb).
- To validate the VoiSS-Heb for assessing Hebrew-speaking adults with dysphonia.
- To evaluate its psychometric properties and associations with perceptual voice quality (GRBAS) and anxiety (GAD-7).
Main Methods:
- Cross-sectional validation study conducted at a tertiary Voice Clinic.
- Seventy-eight dysphonic patients and 140 controls completed VoiSS-Heb, Hebrew Voice Handicap Index (VHI-Heb), and GAD-7.
- Clinicians provided GRBAS ratings; psychometric properties (internal consistency, validity, discriminative ability) were examined.
Main Results:
- VoiSS-Heb showed excellent internal consistency (Cronbach's α = 0.932) and distinguished dysphonic from healthy individuals.
- Strong correlations with VHI-Heb confirmed convergent validity; correlations with GRBAS and GAD-7 indicated sensitivity to perceptual and emotional aspects.
- Receiver operating characteristic (ROC) analysis identified a cutoff of 32.5 points (sensitivity 87.2%, specificity 92.9%).
Conclusions:
- The VoiSS-Heb is a valid, reliable, and clinically meaningful tool for assessing dysphonia in Hebrew-speaking adults.
- Its availability supports precise assessment and patient-centered treatment planning.
- Facilitates improved access to culturally appropriate voice care.
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