Assessing Risk Factors for Voice Problems (Voice Risk Calculator)

Abstract

OBJECTIVE: Reducing or eliminating risk factors associated with voice problems is an important concept in the prevention of dysphonia. The present study developed and validated a 16-item questionnaire (Voice Risk Calculator) that assesses the risks associated with the development of phonotraumatic voice problem. METHODS: The Voice Risk Calculator covers three areas (2 items related to vocal health, 8 items related to voice-related behaviors, and 6 items related to psycho-emotional status) and used a five-point categorical scale (0 to 4) for each item. A total of 77 subjects (42 dysphonic speakers with phonotraumatic origins and 35 with normal voices) recruited from a major hospital in Beijing completed the Voice Risk Calculator. RESULTS: High test-retest reliability (rs = .97, p < .0001) and internal consistency (α = .88) were found. The concurrent validity of the VRC was supported by its moderate correlations (rs = .62, p < .0001) with the Voice Handicap Index (VHI-10). A cut off score of 20 was found which could differentiate between subjects with phonotraumatic voice disorders (≥ 20) and non-dysphonic subjects (< 20). The Voice Risk Calculator has a sensitivity of 76% and a specificity of 63%. CONCLUSION: The Voice Risk Calculator is of satisfactory reliability and validity that would serve as a useful clinical instrument for assessing risks related to the development of phonotraumatic voice problem. Using this to predict the risk in developing voice problems would help voice clinicians to develop prevention strategies appropriately.