title: Relationship between patient-perceived vocal handicap and clinician-rated level of vocal dysfunction.
abstract: OBJECTIVE
  The relationship between patient-reported vocal handicap and clinician-rated measures of vocal dysfunction is not understood. This study aimed to determine if a correlation exists between the Voice Handicap Index-10 (VHI-10) and the Voice Functional Communication Measure rating in the National Outcomes Measurement System (NOMS).
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Four hundred and nine voice evaluations over 12 months at a tertiary voice center were reviewed. The VHI-10 and NOMS scores, diagnoses, and potential comorbid factors were collected and analyzed.
  
  
  RESULTS
  For the study population as a whole, there was a moderate negative correlation between the NOMS rating and the VHI-10 (Pearson r = -0.57). However, for a given NOMS level, there could be considerable spread in the VHI-10. In addition, as the NOMS decreased stepwise below level 4, there was a corresponding increase in the VHI-10. However, a similar trend in VHI-10 was not observed for NOMS above level 4, indicating the NOMS versus VHI-10 correlation was not linear. Among diagnostic groups, the strongest correlation was found for subjects with functional dysphonia. The NOMS versus VHI-10 correlation was not affected by gender or the coexistence of a psychiatric diagnosis.
  
  
  CONCLUSIONS
  A simple relationship between VHI-10 and NOMS rating does not exist. Patients with mild vocal dysfunction have a less direct relationship between their NOMS ratings and the VHI-10. These findings provide insight into the interpretation of patient-perceived and clinician-rated measures of vocal function and may allow for better management of expectations and patient counseling in the treatment of voice disorders.
authors.affiliation: Clinical Center for Voice Care, Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Childs
authors.forename: Clifford
authors.initials: C
authors.lastname: Bielinski
authors.forename: Laura
authors.initials: L
authors.lastname: Toles
authors.forename: Amy
authors.initials: A
authors.lastname: Hamilton
authors.forename: Janis
authors.initials: J
authors.lastname: Deane
authors.forename: Ted
authors.initials: T
authors.lastname: Mau
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D015897:Comorbidity; D059026:Diagnostic Self Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology; D017063:Outcome Assessment, Health Care; D012907:Smoking / Q000009:adverse effects; D013001:Somatoform Disorders / Q000175:diagnosis / Q000523:psychology; D013070:Speech Therapy; D013223:Statistics as Topic; D062606:Tertiary Care Centers; D014832:Voice Disorders / Q000145:classification / Q000175:diagnosis* / Q000523:psychology; D055815:Young Adult
keywords: Dysphonia; Voice Handicap Index; patient perception; quality of life; vocal function; voice assessment; voice handicap