title: Validation of a voice prosthesis questionnaire to assess valved speech and its related issues in patients following total laryngectomy.
abstract: OBJECTIVE
  To establish the reliability and validity of a new self-administered questionnaire to assess valved speech and its related issues in patients who have undergone a total laryngectomy operation.
  
  
  METHODS
  Cross-sectional psychometric validation study.
  
  
  METHODS
  Tertiary cancer care centre.
  
  
  METHODS
  We identified sixty-one total laryngectomy patients with no sign of recurrent disease and using voice prosthesis from the speech and language therapy database of the Royal Marsden Hospital. The patients were assessed using a postal self-administered voice prosthesis questionnaire concerning the voice valve and it's related issues. Patients were also asked to complete the University of Michigan voice related quality of life and University of Washington head and neck quality of life (version 4) questionnaires.
  
  
  METHODS
  Test-retest and internal consistency reliability; content; criterion and construct validity.
  
  
  RESULTS
  We received completed questionnaires from fifty-one of the sixty-one total laryngectomy patients identified for the study providing a response rate of 84%. The median age of the group was 65 years (range: 40-85) with thirty-seven males and fourteen females. The internal consistency reliability using the Cronbach's alpha coefficient was 0.87 (range: 0.85 to 0.89). Test-retest reliability showed that more than 75% of patients had a score on re-test that was within 1 point of their original score. Content validity was ensured during the design process. The median Spearman correlation coefficient was 0.25 for convergent construct validity with the University of Washington head and neck quality of life questionnaire and 0.64 for criterion validity on comparison with the University of Michigan voice related quality of life scale.
  
  
  CONCLUSIONS
  The voice prosthesis questionnaire is the first validated and reliable self-administered questionnaire designed specifically for evaluating valved speech and its related issues in patients who have undergone total laryngectomy. The voice prosthesis questionnaire has significant utility for audit, outcomes research and monitoring in this unique group of patients.
authors.affiliation: Head and Neck Unit, Royal Marsden Hospital, London, UK. rehan.kazi@rmh.nhs.uk
authors.forename: R
authors.initials: R
authors.lastname: Kazi
authors.forename: A
authors.initials: A
authors.lastname: Singh
authors.forename: J
authors.initials: J
authors.lastname: De Cordova
authors.forename: A
authors.initials: A
authors.lastname: Al-Mutairy
authors.forename: P
authors.initials: P
authors.lastname: Clarke
authors.forename: C
authors.initials: C
authors.lastname: Nutting
authors.forename: P
authors.initials: P
authors.lastname: Rhys-Evans
authors.forename: K
authors.initials: K
authors.lastname: Harrington
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery; D007825:Laryngectomy; D007831:Larynx, Artificial; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013060:Speech; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014833:Voice Quality