Relationship between patient-perceived vocal handicap and clinician-rated level of vocal dysfunction

Objectives/Hypothesis The relationship between patient‐reported vocal handicap and clinician‐rated measures of vocal dysfunction is not understood. This study aimed to determine if a correlation exists between the Voice Handicap Index‐10 (VHI‐10) and the Voice Functional Communication Measure rating in the National Outcomes Measurement System (NOMS). Study Design Retrospective case series. Methods Four hundred and nine voice evaluations over 12 months at a tertiary voice center were reviewed. The VHI‐10 and NOMS scores, diagnoses, and potential comorbid factors were collected and analyzed. Results For the study population as a whole, there was a moderate negative correlation between the NOMS rating and the VHI‐10 (Pearson r = −0.57). However, for a given NOMS level, there could be considerable spread in the VHI‐10. In addition, as the NOMS decreased stepwise below level 4, there was a corresponding increase in the VHI‐10. However, a similar trend in VHI‐10 was not observed for NOMS above level 4, indicating the NOMS versus VHI‐10 correlation was not linear. Among diagnostic groups, the strongest correlation was found for subjects with functional dysphonia. The NOMS versus VHI‐10 correlation was not affected by gender or the coexistence of a psychiatric diagnosis. Conclusions A simple relationship between VHI‐10 and NOMS rating does not exist. Patients with mild vocal dysfunction have a less direct relationship between their NOMS ratings and the VHI‐10. These findings provide insight into the interpretation of patient‐perceived and clinician‐rated measures of vocal function and may allow for better management of expectations and patient counseling in the treatment of voice disorders. Level of Evidence 4 Laryngoscope, 125:180–185, 2015