Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan.
Tokyo Voice Center, International University of Health and Welfare, Tokyo, Japan; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, International University of Health and Welfare, Tokyo, Japan; Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Jichi Medical University, Shimotsuke, Japan.
J Voice. 2022 Jan;36(1):144.e1-144.e9. doi: 10.1016/j.jvoice.2020.04.031. Epub 2020 Jun 23.
The Voice Handicap Index (VHI) is recognized as a useful subjective assessment method for dysphonia. The original VHI has been translated into numerous other languages, including Japanese (J-VHI). Although the reliability and validity of the J-VHI have already been established, the cutoff point has not been determined. The aims of this study were to investigate the relationship between the J-VHI and other voice laboratory measurements, and determine the cutoff point.
This study included 167 dysphonic patients and 55 healthy volunteers. All patients and volunteers completed the J-VHI at the initial visit, and the following outcomes were determined: VHI scores of patients with dysphonia and healthy volunteers, VHI scores according to disease, cutoff point, and correlations between VHI scores and other voice laboratory measurements.
Both the total VHI (VHI-T) and individual domain (functional domain [VHI-F], emotional domain [VHI-E], physical domain [VHI-P]) scores were significantly higher in the dysphonia group compared to the healthy volunteer group. VHI-T, VHI-F, and VHI-E scores were significantly lower in the benign mucosal lesion subgroup, compared to the other disease subgroups. The G scale and B scale of the grade-roughness-breathiness-asthenia-strain scale showed a significant association with VHI-T, VHI-F, and VHI-P scores. Similarly, the A scale showed a significant association with VHI-T, VHI-F, and VHI-E scores. The cutoff point (12) for VHI-T was chosen from the receiver operating characteristic curve to maximize sensitivity and specificity. Similarly, the cutoff points for VHI-F (5), VHI-P (5), and VHI-E (3) were also obtained. Significant differences in maximum phonation time, pitch range, G scale, and B scale were observed between the VHI-T negative (VHI ≤ 12) and positive (VHI-T > 13) groups.
These findings suggest that self-evaluation using the VHI could serve as an independent assessment and screening tool for patients with dysphonia.
嗓音障碍指数（VHI）被认为是一种评估嗓音障碍的有用的主观评估方法。原始的 VHI 已被翻译成多种其他语言，包括日语（J-VHI）。尽管 J-VHI 的可靠性和有效性已经得到了证实，但尚未确定其截断值。本研究的目的是研究 J-VHI 与其他嗓音实验室测量值之间的关系，并确定截断值。
本研究纳入了 167 例嗓音障碍患者和 55 名健康志愿者。所有患者和志愿者在初次就诊时均完成了 J-VHI 评估，同时测定了以下结果：嗓音障碍患者和健康志愿者的 VHI 评分、根据疾病分类的 VHI 评分、截断值以及 VHI 评分与其他嗓音实验室测量值之间的相关性。
与健康志愿者组相比，嗓音障碍组的总 VHI（VHI-T）和各单项评分（功能项[VHI-F]、情感项[VHI-E]、生理项[VHI-P]）均显著升高。良性黏膜病变亚组的 VHI-T、VHI-F 和 VHI-E 评分显著低于其他疾病亚组。格拉斯哥嗓音障碍严重程度分级量表的 G 级和 B 级与 VHI-T、VHI-F 和 VHI-P 评分显著相关。同样，A 级与 VHI-T、VHI-F 和 VHI-E 评分显著相关。VHI-T 的截断值（12）是通过受试者工作特征曲线选择的，以最大程度地提高灵敏度和特异性。同样，也获得了 VHI-F（5）、VHI-P（5）和 VHI-E（3）的截断值。VHI-T 阴性（VHI≤12）和阳性（VHI-T＞13）组之间的最大发声时间、音域、G 级和 B 级评分存在显著差异。
这些发现表明，使用 VHI 进行自我评价可以作为评估嗓音障碍患者的独立评估和筛查工具。
