Journal of voice : official journal of the Voice Foundation · 2026
Determining Minimal Clinically Important Difference in Malay Version of Voice Handicap Index-10 (mVHI-10).
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Chandran Sobhashinni, Baki Marina Mat, Shakri Nadhirah, Azman Mawaddah, Mohd Zawawi Nor Shahrina
Аннотация
BACKGROUND: Minimal Clinically Important Difference (MCID) values are widely reported across health-related outcomes; however, evidence specific to voice disorders remains limited. The Voice Handicap Index-10 (VHI-10) is a widely used patient-reported outcome measure for assessing voice-related quality of life. While previous literature has suggested specific MCID thresholds for the VHI-10, these established benchmarks lack generalizability when applied to Malaysian-speaking cohorts. Therefore, this study aimed to determine the MCID for the Malay version of VHI-10 (mVHI-10).
METHODS: A total of 163 patients with voice disorders were recruited via convenience sampling, comprising Malay, Chinese, and Indian participants with a mean age of 52 ± 15.94 years. Patients with neurodegenerative diseases or cognitive impairment were excluded. The mVHI-10 was administered at baseline and at a follow-up visit within three months of the baseline assessment. At follow-up, patients also completed the Global Rating of Change Questionnaire (GRCQ). Changes in mVHI-10 scores were compared across GRCQ categories using Spearman's correlation and the Kruskal-Wallis test. Pearson's correlation was performed to examine the relationship between changes in mVHI-10 and Maximum Phonation Time (MPT). The receiver operating characteristic (ROC) was used to determine the MCID cutoff.
RESULTS: The mean change of the mVHI-10 score was -4.73. Based on GRCQ, 117 participants reported improvement, 26 reported no change, and 20 reported worsening. Changes in mVHI-10 were strongly correlated with GRCQ scores (r = -0.65, P < 0.001) and moderately correlated with change in MPT (r = -0.301, P < 0.001). The MCID cutoff value for the mVHI-10 was determined as a 4-point reduction.
CONCLUSION: A reduction of 4 points in mVHI-10 represents a clinically meaningful improvement among Malaysian patients with voice disorders. Further studies are warranted to determine disorder-specific MCID values, as clinical significance may vary across different voice disorders.
METHODS: A total of 163 patients with voice disorders were recruited via convenience sampling, comprising Malay, Chinese, and Indian participants with a mean age of 52 ± 15.94 years. Patients with neurodegenerative diseases or cognitive impairment were excluded. The mVHI-10 was administered at baseline and at a follow-up visit within three months of the baseline assessment. At follow-up, patients also completed the Global Rating of Change Questionnaire (GRCQ). Changes in mVHI-10 scores were compared across GRCQ categories using Spearman's correlation and the Kruskal-Wallis test. Pearson's correlation was performed to examine the relationship between changes in mVHI-10 and Maximum Phonation Time (MPT). The receiver operating characteristic (ROC) was used to determine the MCID cutoff.
RESULTS: The mean change of the mVHI-10 score was -4.73. Based on GRCQ, 117 participants reported improvement, 26 reported no change, and 20 reported worsening. Changes in mVHI-10 were strongly correlated with GRCQ scores (r = -0.65, P < 0.001) and moderately correlated with change in MPT (r = -0.301, P < 0.001). The MCID cutoff value for the mVHI-10 was determined as a 4-point reduction.
CONCLUSION: A reduction of 4 points in mVHI-10 represents a clinically meaningful improvement among Malaysian patients with voice disorders. Further studies are warranted to determine disorder-specific MCID values, as clinical significance may vary across different voice disorders.