The Cutoff Point and Diagnostic Accuracy of the Voice Handicap Index in Cantonese-Speaking Population.

BACKGROUND

Voice Handicap Index (VHI) has been used extensively in research and clinical settings. It has been suggested to be used as a diagnostic tool in the literature. However, little is known if it could be applied as a diagnostic tool to the Cantonese-speaking population. The study aims to establish cutoff points and the diagnostic accuracy for VHI-30 and VHI-10 to discriminate between Cantonese-speaking dysphonic and nondysphonic individuals.

METHODS

Data from 256 adults from Hong Kong were extracted from a database at a local institution. There were a total of 91 nondysphonic individuals and 165 dysphonic individuals. Receiver operating characteristics curve analysis was conducted to establish cutoff points for VHI-30 and VHI-10. Diagnostic accuracy statistics such as sensitivity, specificity, positive, and negative predicted values (PPV and NPV) and likelihood ratios (LRs) were also reported.

RESULTS

The dysphonic group scored higher than the nondysphonic group on the mean scores of both versions of VHI. Receiver operating characteristics curve analysis revealed a moderate to strong area under curve of 0.89 in both VHI-30 and VHI-10. A cutoff point of 18.5 point was yielded for VHI-30 (Sensitivity = 86.1%, Specificity = 81.3%, PPV = 89.3%, NPV = 76.3%, LR+ = 4.60, LR- = 0.17) and a cutoff point of 7.5 point was yielded for VHI-10 (Sensitivity = 80.6%, Specificity = 87.9%, PPV = 92.4%, NPV = 71.4%, LR+ = 6.66, LR- = 0.22).

CONCLUSIONS

Both the Chinese VHI-30 and VHI-10 for Cantonese speakers showed promising diagnostic accuracy. VHI can be used as adjunct to clinical diagnosis and treatment outcome measures for voice disorders in the Cantonese-speaking population.