Development of the voice risk calculator

Abstract

Reducing or eliminating risk factors associated with a disease is an important concept in disease prevention (World Health Organization, 2002). The present study developed and validated a 16-item questionnaire that assesses the risks associated with the development of phonotraumatic voice problem. The questionnaire has 3 subscales which covered (1) vocal health, (2) behaviours related to increasing voice risks, and (3) psycho-emotional status. The questionnaire provided an aggregated score that reflected the total degree of risk out of a total score of 64. This questionnaire is called the Voice Risk Calculator (VRC). Seventy-seven Chinese-speaking subjects (42 dysphonic and 35 non-dysphonic subjects) participated in this study. Good 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 differentiated between subjects with phonotraumatic voice disorders (≥ 20) and non-dysphonic subjects (< 20). The sensitivity of the VRC was 76% with specificity 63%. The VRC has satisfactory reliability and validity that would serve as a useful clinical instrument for assessing risks related to the development of phonotraumatic voice problem.