Voice Handicap Index-10 and Voice-Related Quality of Life: Determination of Cutoff Points in Turkish Language for Screening of Voice Disorders

Emel Tahir; Özlem Cangökçe Yaşar; İbrahim Erensoy; Özgür Kemal

doi:10.1016/j.jvoice.2025.03.019

Voice Handicap Index-10 and Voice-Related Quality of Life: Determination of Cutoff Points in Turkish Language for Screening of Voice Disorders

J Voice. 2025 Apr 15:S0892-1997(25)00112-2. doi: 10.1016/j.jvoice.2025.03.019. Online ahead of print.

Authors

Emel Tahir¹, Özlem Cangökçe Yaşar², İbrahim Erensoy³, Özgür Kemal⁴

Affiliations

¹ Department of Otolaryngology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. Electronic address: emeltahir@hotmail.com.
² Department of Speech and Language Therapy, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey. Electronic address: ozlemc@omu.edu.tr.
³ Department of Speech and Language Therapy, Faculty of Health Sciences, Ondokuz Mayıs University, Samsun, Turkey. Electronic address: ibrahim.erensoy8@gmail.com.
⁴ Department of Otolaryngology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey. Electronic address: drozgurkemal@gmail.com.

PMID: 40240248
DOI: 10.1016/j.jvoice.2025.03.019

Abstract

Objectives: To determine the cutoff values of the Turkish Voice Handicap Index-10 (TVHI-10) and Turkish Voice-Related Quality of Life (TVRQoL) questionnaires and to determine the diagnostic accuracy and discriminatory capacity of these patient-reported outcome measurements.

Study design: Cross-sectional cohort study.

Participants and methods: This study includes patients with dysphonia and healthy controls without voice issues. Participants with previous voice disease, laryngeal surgery, and tobacco or alcohol use were all excluded-evaluations performed by otolaryngologists and speech-language therapists. After comprehensive voice assessment, including videolaryngostroboscopy, all subjects completed the TVHI-10 and TVRQoL questionnaires. The study group includes a wide range of voice diseases. The cutoff scores were obtained using a receiver-operating characteristic (ROC) analysis.

Results: The optimal cutoff value for the TVHI-10 was determined to be 7, with a sensitivity of 94% (AUC = 0.973), indicating excellent diagnostic accuracy. For the TVRQoL, a cutoff value of 75 was identified, with a sensitivity of 86.7% (AUC = 0.912). Compared with the physical functioning subdomain (0.915), the social-emotional subdomain showed a lower AUC (0.997), indicating low diagnostic accuracy.

Conclusion: Cutoff values vary across languages and cultures, so defining them during transcultural adaptation and validation is essential. The TVHI-10 showed better diagnostic accuracy than TVRQoL and is recommended for early detection of voice disorders in Turkish-speaking populations.

Data transparency statement: The authors are dedicated to guaranteeing the clarity and replicability of the research data reported in this study. The dataset that provides evidence for the results of this paper can be found in the Mendeley Data repository. You can access it by clicking on the following link: xxx, xxx (2024), "VHI-10,VRQoL cut off," Mendeley Data, V1, doi: 10.17632/w966wy7422.1 If any researcher needs access to the dataset for verification, replication, or further analysis, they should contact the editorial office of the journal. The writers will swiftly assist in the dissemination of data through the editing team. All statistical analysis results are uploaded as Supplementary Material.

Keywords: Voice Handicap Index—Voice-Related Quality of Life—Dysphonia—Receiver-operating characteristic analysis—Cutoff point—Voice—Patient-reported outcome measure.