Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population.

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Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population.

J Voice. 2016 Mar 4;

Authors: Moore J, Greenberg C, Thibeault SL

Abstract
OBJECTIVE: To evaluate predictors of longitudinal change in patient-perceived voice impact as determined by the Voice Handicap Index (VHI).
STUDY DESIGN: Prospective, survey study.
METHODS: Patients consented to the University of Wisconsin Voice and Swallow Clinics Outcomes Database with voice, concerns with a baseline clinic visit from November 2012 to January 2014 were eligible for the study. The VHI was sent to patients 6 months post clinic visit to determine change in voice handicap from baseline. General health was screened using the 12-item Short Form Health Survey, using physical component summary and mental component summary scores. Predictor variables included treatment (medical and/or behavioral); dysphonia sub-diagnosis; grade, roughness, breathiness, asthenia, and strain rating; age; sex; socioeconomic factors; smoking history; and comorbidity score.
RESULTS: Two hundred thirty-seven patients met study criteria and were followed longitudinally. Eighty-two patients returned 6-month surveys. The VHI was significantly correlated with mental component summary scores. Patients with a higher grade in baseline grade, roughness, breathiness, asthenia, and strain score were more likely to receive voice intervention (P = 0.04). Six-month improvement in VHI score was associated with both higher initial VHI score and higher educational level in both univariate (P < 0.01, P = 0.04) and multivariate analyses (P < 0.01, P = 0.02). Voice treatment (medical and/or behavioral) was not a significant factor for improvement in VHI score.
CONCLUSIONS: Our results suggest that it is important to consider baseline self-perceived voice impact measures and educational level in setting expectations for voice treatment. Future studies examining the relationship between treatment patterns and voice-related patient outcomes are warranted.

PMID: 26952321 [PubMed - as supplied by publisher]

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