Preliminary Receiver Operating Characteristic Analysis on Voice Handicap Index of Laryngeal Inflammation in Greek Patients

Objective(s): Laryngeal inflammations lead to voice disorders. Medical conditions such as chronic laryngitis, gastroesophageal reflux, laryngopharyngeal reflux, Reinke edema and/or vocal folds hemorrhage, result in diverse symptoms including chronic cough, throat cleaning and dysphonia (e.g. hoarseness). In turn, the dysphonic symptoms can be evaluated via subjective and objective procedures. The objective procedures usually include self-perceived questionnaires like the Voice Handicap Index (VHI). Studies reported that VHI can distinguish objectively dysphonic and non-dysphonic populations using the cut-off points of Receiver Operating Characteristic Curves. The purpose of this study was to calculate the cut-off points for individuals exhibiting voice symptoms which had been developed from laryngeal inflammatory diseases in Greece. Methods: One hundred and twelve participants (90 non-dysphonic and 22 dysphonic) filled in the Hellenic Voice Handicap Index (VHI) and the Greek translated version of Voice Evaluation Template (VEF) were administrated. All subjects were evaluated by an Otolaryngologist and a Speech-Language Pathologist. Results: The group with voice disorders exhibited higher VHI scores (in total and in its 3 subdomains) compared to non-dysphonic subgroup. Statistical significant differences were found for all VHI’s total cut-off point of 19.50 (sensitivity: 0.882, 1-specificity: 0.011) and for its three subdomains [functional 6.50 (sensitivity = 0.636, and 1-specificity = 0.022); physical 9.50 (sensitivity = 0.636, and 1-specificity = 0.000); emotional 6.50 (sensitivity = 0.455, and 1-specificity = 0.133)]. Conclusion: The preliminary results showed that VHI could discriminate individuals having voice disorders from laryngeal inflammations. The Voice Handicap Index can be used as a primary health care tool and a self-monitoring procedure in acute and sub-acute phases of the laryngeal inflammation.