Predictors of Six-month Change in the Voice Handicap Index in a Treatment-seeking Population.
Jaime Moore, Caprice Greenberg, Susan L Thibeault
PMID 26952321WHAT IT FOUND
Recorded voice treatment, medication, or surgery after evaluation did not predict six-month change in patient-reported voice handicap.
Higher initial voice handicap and higher education did predict greater improvement.
Key findings
01Recorded treatment after evaluation was not a significant predictor of six-month change in patient-reported voice handicap.
02Baseline Voice Handicap Index severity was significantly associated with six-month percent change, with greater improvement described for higher severity but percent change reported higher in mild than moderate.
03Higher education level was significantly associated with greater six-month percent improvement in Voice Handicap Index scores.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 82 of 237 eligible patients returned six-month surveys, so 65% did not respond and the results may not represent all voice patients. The study used existing clinic records, not random assignment, so it cannot show that treatment caused change. It did not know whether patients in the non-treatment group received voice care elsewhere or had trial therapy during evaluation. Education and income were partly derived from census data tied to zip code, not individual patient information. Smoking history was patient-reported and may be unreliable. Race was not considered. Data came from multiple clinicians, which can weaken consistency. Six patients with baseline Voice Handicap Index score of zero were excluded from percent-change analysis.
The easy way to misread this
Do not conclude that voice treatment does not help. The study only tested whether recorded treatment predicted change in a small follow-up group, and it could not account for treatment received elsewhere or trial therapy during evaluation.