title: Cross-Cultural Adaptation and Validation of the Italian Version of the Voice Symptom Scale (I-VoiSS).
abstract: OBJECTIVE
  To evaluate the reliability and validity of the Italian Voice Symptom Scale (I-VoiSS).
  
  
  METHODS
  Cross-sectional, nonrandomized, prospective study with controls.
  
  
  METHODS
  The study consisted of five phases: item generation, reliability analysis, normative data generation, validity and responsiveness analysis. A group of 113 dysphonic patients was enrolled for the internal consistency analysis. Seventy-three of them completed the I-VoiSS twice, 2 weeks apart, for test-retest reliability analysis. A group of 150 vocally healthy participants completed the I-VoiSS for normative data generation. I-VoiSS scores obtained by dysphonic and vocally healthy participants were compared for validity analysis. I-VoiSS scores were correlated with those of the Italian version of the Voice Handicap Index (I-VHI) in 49 dysphonic patients for criterion validity analysis. I-VoiSS scores obtained in a group of 37 nonsmoker dysphonic patients before and after surgical treatment for vocal fold polyps were compared for responsiveness analysis. Finally, the cutoff value of the I-VoiSS was calculated.
  
  
  RESULTS
  All the enrolled participants managed to complete the I-VoiSS autonomously. Internal consistency and test-retest were satisfactory (α = 0.92 and r = 0.91). A significant difference in the I-VoiSS scores between the dysphonic and vocally healthy participants was found (p = 0.001). Positive significant correlations were found between I-VoiSS and I-VHI scores (r = 0.85). I-VoiSS scores obtained in the pretreatment condition were significantly higher than those obtained after surgery (p = 0.001). The cutoff value of I-VoiSS was 15.5.
  
  
  CONCLUSIONS
  I-VoiSS is reliable, valid, responsive to changes, and recommended for clinical practice and outcome research.
authors.affiliation: Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy. Electronic address: francesco.mozzanica@gmail.com.
authors.forename: F
authors.initials: F
authors.lastname: Mozzanica
authors.affiliation: Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Robotti
authors.affiliation: Audiology Unit, Department of Clinical Sciences and Community, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico,University of Milan, Milan, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Ginocchio
authors.affiliation: Division of Otorhinolaryngology, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Milan, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Bulgheroni
authors.affiliation: Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Lorusso
authors.affiliation: Centro de Estudos da Voz-CEV, Sao Paulo, Brazil.
authors.forename: M
authors.initials: M
authors.lastname: Behlau
authors.affiliation: Department of Biochemical and Clinical Science "Luigi Sacco", University of Milan, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Schindler
authors.affiliation: Division of Otorhinolaryngology, San Giuseppe Hospital, IRCCS Multimedica, University of Milan, Milan, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Ottaviani
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D003466:Cultural Characteristics; D004185:Disability Evaluation; D055154:Dysphonia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology / Q000601:surgery; D004644:Emotions; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014175:Translating; D014827:Vocal Cords / Q000503:physiopathology* / Q000601:surgery; D014833:Voice Quality; D055815:Young Adult
keywords: Dysphonia; Quality of life; Self-assessment; VoiSS; Voice