Validation of the Algerian Arabic Voice Handicap Index 10 (VHI-10-AA)

This study aimed to validate the Voice Handicap Index-10 adapted into Algerian Arabic (VHI-10-AA) and to evaluate its psychometric properties. A secondary objective was to determine the optimal cutoff score for distinguishing dysphonic patients from healthy controls.

This was a cross-sectional validation study.

A total of 150 Algerian Arabic-speaking participants were recruited, comprising 90 healthy controls and 60 patients diagnosed with dysphonia of various etiologies and severity. The VHI-10-AA items were derived from the previously validated VHI-30-Algerian Arabic (Kaddour et al, 2025).¹⁷ Test-retest reliability was assessed using the intraclass correlation coefficient (ICC [2,1]). Discriminant validity was evaluated through the Mann-Whitney U test and receiver operating characteristic (ROC) curve analysis.

The VHI-10-AA demonstrated excellent test-retest reliability, with ICC values of 0.94 for controls, 0.96 for dysphonic patients, and 0.95 for the combined sample. A highly significant difference was found between groups (U = 345.5, P < 0.001), with median scores of 4.0 for controls versus 24.0 for dysphonic patients. ROC curve analysis yielded an area under the curve of 0.94 (95% CI: 0.91-0.97). The optimal cutoff score of 12.5 provided a sensitivity of 88.3% and a specificity of 91.1%. Finally, the internal consistency of the VHI-10-AA was excellent for the total sample (α = 0.95) and dysphonic patients (α = 0.91), and good for controls (α = 0.84).

The VHI-10-AA is a valid, reliable, and clinically useful instrument for assessing voice-related handicap in Algerian Arabic-speaking individuals. The established cutoff score of 12.5 offers an evidence-based threshold for screening dysphonia in clinical and research settings.