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Optimising outcome assessment of voice interventions, I: Reliability and validity of three self-reported scales

Lookup NU author(s): Alison Webb, Professor Paul Carding, Dr Nick Steen, Emerita Professor Janet WilsonORCiD


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Background: There is an increasing choice of voice outcome research tools, but good comparative data are lacking. Objective: To evaluate the reliability and validity of three voice-specific, self-reported scales. Design: Longitudinal, cohort comparison study. Setting: Two UK voice clinics: the Freeman Hospital, Newcastle upon Tyne, and the Glasgow Royal Infirmary. Participants: One hundred and eighty-one patients presenting with dysphonia. Main outcome measures: All patients completed the vocal performance questionnaire, the voice handicap index and the voice symptom scale. For comparison, each patient's voice was recorded and assessed perceptually using the grade-roughness-breathiness-aesthenia-strain scale. The reliability and validity of the three self-reported vocal performance measures were assessed in all subjects, while 50 completed the questionnaires again to assess repeatability. Results: The results of the 170 participants with completed data sets showed that all three questionnaires had high levels of internal consistency (Cronbach's alpha = 0.81-0.95) and repeatability (voice handicap index = 0.83; vocal performance questionnaire = 0.75; voice symptom scale = 0.63). Concurrent and criterion validity were also good, although, of the grade-roughness-breathiness-aesthenia-strain subscales, roughness was the least well correlated with the self-reported measures. Conclusion: The vocal performance questionnaire, the voice handicap index and the voice symptom scale are all reliable and valid instruments for measuring the patient-perceived impact of a voice disorder. © 2007 JLO (1984) Limited.

Publication metadata

Author(s): Webb A, Carding P, Deary I, MacKenzie K, Steen IN, Wilson JA

Publication type: Article

Publication status: Published

Journal: Journal of Laryngology and Otology

Year: 2007

Volume: 121

Issue: 8

Pages: 763-767

ISSN (print): 0022-2151

ISSN (electronic): 1748-5460

Publisher: Cambridge University Press


DOI: 10.1017/S0022215107007177


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