title: Validation of a pediatric voice quality-of-life instrument: the pediatric voice outcome survey.
abstract: OBJECTIVE
  To validate a parent proxy instrument to study the voice-related quality of life (VR-QOL) for the pediatric population.
  
  
  METHODS
  The voice outcome survey (VOS) was administered to 108 caregivers of children aged 2 to 18 years, who either had a tracheotomy or had achieved surgical decannulation. The VOS was altered so that each item was addressed to the parent proxy as opposed to the child. A scoring paradigm was developed to report the scores on a range of 0 to 100. Structural properties of the instrument examined include validity, reliability, and principal component analysis. The VOS was then revised to suit the results of this analysis.
  
  
  RESULTS
  The mean +/- SD (range) score for the pediatric VOS was 49.8 +/- 27.1 (0-100). Reliability analysis and principal component analysis supported the reduction of 1 item from the final pediatric VOS. The revised instrument demonstrated an overall Cronbach alpha value of.86. Substratification by age revealed robust Cronbach alpha values from ages 2 to 18 years. Construct validity analysis also supported statistical significance (P =.004). Principal component analysis of the revised instrument supports its internal structure and design.
  
  
  CONCLUSIONS
  The pediatric VOS is a simple, short, health status instrument designed to measure the VR-QOL in the pediatric population. Cross-sectional analysis suggests that children and adolescents with tracheotomies have a poorer VR-QOL than do those who have achieved decannulation.
authors.affiliation: Harvard Medical School, Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA 02114, USA. christopher_hartnick@meei.harvard.edu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Hartnick
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002404:Catheterization; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D025341:Principal Component Analysis; D011788:Quality of Life; D015203:Reproducibility of Results; D014133:Tracheal Diseases / Q000601:surgery*; D014140:Tracheotomy; D014831:Voice