Guimarães Isabel, Torrejano Gabriela, Aires Raquel, Caetano Mariana, Fernandes António, Martins Paulo, Luís Leonel
Clinical and Therapeutics Pharmacological Unit, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal; Speech Therapy Department, Alcoitão Health School of Sciences, Faculty of Medicine, Instituto de Medicina Molecular, University of Lisbon, Lisbon, Portugal.
ENT Department, Centro Hospitalar Universitário Lisboa Norte, EPE, Lisboa, Portugal.
J Voice. 2023 Oct 5. doi: 10.1016/j.jvoice.2023.08.018.
To determine cut-off values of the Voice Handicap Index (VHI) and the shortened version (VHI-10) for European Portuguese (EP) with voice disorders. In addition, to analyze the discriminatory power of individual items of the VHI-10 and the ability to detect differences in various Ear Nose and Throat (ENT) diagnoses.
Cross-sectional cohort study.
All participants completed the EP VHI and a 4-point self-assessment of voice disorder severity. The case group (subjects with voice disorders) underwent assessment through strobovideolaryngoscopy examinations by ENT surgeons and perceptual analyses by speech-language pathologists (SLPs). In contrast, the control group was evaluated solely by SLPs. Data were analyzed using a receiver-operating characteristic curve to determine the accuracy and cut-off values of the VHI and VHI-10.
The study involved a sample of 350 adults (171 cases and 179 controls), predominantly women aged 18-88 years. The area under curve (AUC) for VHI and VHI-10 was 0.997 [95% confidence interval (CI): 0.992-1] and 0.998 [95% CI: 0.995-0.999], respectively. Optimal cut-off values were identified as 13.5 for VHI (0.994 sensitivity and 0.989 specificity) and 5.5 for VHI-10 (0.977 sensitivity and 0.955 specificity). Each individual item within the VHI-10 significantly contributed to the overall assessment, exhibiting varying discriminatory power ranging from excellent (AUC = 0.937) to poor (AUC = 0.637). Significant differences were found in the case group between neurogenic disorders and healthy larynx (P = 0.014), structural and physiologic minor laryngeal abnormalities (P = 0.006), and inflammatory disorders (P = 0.043).
The VHI and the VHI-10 exhibited accurate screening properties for predicting EP speakers with voice disorders.
确定欧洲葡萄牙语（EP）嗓音障碍患者的嗓音障碍指数（VHI）及其简化版（VHI-10）的临界值。此外，分析VHI-10各单项的鉴别力以及检测不同耳鼻喉（ENT）诊断差异的能力。
横断面队列研究。
所有参与者均完成了EP VHI及嗓音障碍严重程度的4级自我评估。病例组（嗓音障碍患者）接受了耳鼻喉外科医生的频闪喉镜检查和言语病理学家（SLP）的感知分析。相比之下，对照组仅由SLP进行评估。使用受试者操作特征曲线分析数据，以确定VHI和VHI-10的准确性和临界值。
该研究纳入了350名成年人样本（171例病例和179名对照），主要为18至88岁的女性。VHI和VHI-10的曲线下面积（AUC）分别为0.997 [95%置信区间（CI）：0.992 - 1]和0.998 [95% CI：0.995 - 0.999]。VHI的最佳临界值确定为13.5（灵敏度0.994，特异度0.989），VHI-10的最佳临界值为5.5（灵敏度0.977，特异度0.955）。VHI-10中的每个单项对整体评估均有显著贡献，其鉴别力从优秀（AUC = 0.937）到较差（AUC = 0.637）不等。病例组中神经源性疾病与健康喉部（P = 0.014）、结构和生理性轻度喉部异常（P = 0.006）以及炎症性疾病（P = 0.043）之间存在显著差异。
VHI和VHI-10在预测EP嗓音障碍患者方面表现出准确的筛查特性。
