Psychometric evaluation of disease specific quality of life instruments in voice disorders

The objective of this study was to compare the psychometric properties of voice disordered quality of life (VQOL) instruments. Nine VQOL instruments were identified through a comprehensive literature search. Based on specific criteria, four were selected for comprehensive review: Voice Handicap Index (VHI), Voice Activity and Participation Profile (VAPP), Voice-Related Quality of Life (V-RQOL) and Voice Outcome Survey (VOS). Selected instruments were evaluated based on 11 measurement standards related to item information, versatility, practicality, breadth and depth of health measure, reliability, validity, and responsiveness. VHI and V-RQOL each met 7 of 11 criteria, with VHI showing additional preferable item information, practicality, and reliability over V-RQOL and V-RQOL showing preferable responsiveness properties over VHI. These study results do not support the Social Security Administration's recent conclusion that the VHI meets reliability and validity standards for individual decision making. Nevertheless, the present results do support the use of VHI total scores for clinical use with individual patients, and the use of V-RQOL total scores or individual dimension scores for use with groups of patients.