Voice Handicap Index Severity Grading: Do We Need to Recalibrate it for the Indian Population?

Abstract

Ab s t r Ac t Background: The voice handicap index (VHI 30), used to assess patients’ perception of the severity of their voice disorder, is a standard evaluation parameter in dysphonia cases. The score has conventionally set cut-offs to grade the severity. The latter will be effective only if there are appropriate responses from the patient. If not, then there may be a need to re-set the cut-offs. Objective: The objective of this study is to compare and correlate laryngeal findings and voice analysis parameters with the VHI scores, to see if there is a need to recalibrate the normatives. Materials and methods: Document analysis of VHI forms of patients who have visited and undergone treatment at the voice clinic at Amrita Institute of Medical Sciences. The VHI scores were correlated with the laryngeal findings and voice analysis parameters. Results: As much as 64% of patients were in the normal and mild grades of the VHI score. No statistically significant correlation could be found between VHI scores and Jitter and Shimmer, by any of the attempted methods, although there was a clinical correlation in some cases. The validity of the present cut-offs of VHI severity could not be assessed. Conclusion: There is a need to look at VHI scoring patterns in other population groups in India, as also to consider better statistical methods to approach the problem.