Assessing outcomes for dysphonic patients

This study was designed to evaluate a disease-specific outcome measure for patients with selected voice disorders and to relate this instrument to a s tandardized quality of life measurement. In addition, the study attempts to document the degree of handicap for dysphonia patients globally, between d ifferent vocal pathologies, and in comparison to other chronic diseases. In this prospective, observational study, 260 adult patients evaluated for al terations of voice completed a general quality of life measure (the Medical Outcomes Trust Short Form 36-Item[SF-36]) and a voice-specific instrument (Voice Handicap Index [VHI]) pretreatment. The highest correlation was between the social functioning score of the SF- 36 and the total score of the VHI and the physical, emotional, and function al subscales (p < 0.001) of the VHI. Significant correlation was also obtai ned for the SF-36 domains mental health (p < 0.01). general health (p < 0.0 1), and role functioning emotional (p < 0.017) with the three VHI domains a nd the total VHI score. Patients had significantly lower scores than the ge neral U.S. population in five of the eight domains of SF-36. Patients with vocal fold paralysis had the highest level of pretreatment disability as me asured on both the VHI and SF-36 among voice patients. The patients with dy sphonia had a lower level of physical functioning than the patients with ch ronic sinusitis (p < 0.01), reflecting a greater handicap. In addition, the dysphonia group had lower levels of social functioning than the angina (p < 0.01) and sciatica (p < 0.01) groups and a lower score for mental health than the angina group (p < 0.01). The SF-36 correlates with the VHI in the domains of social functioning, men tal health, and role functioning emotional. The baseline handicap for voice disorders represents a significant disability even in comparison to condit ions such as angina pectoris, sciatica, and chronic sinusitis.