Page 79 - Portuguese Journal - SPORL - Vol 61. Nº2

This is the only instrument that is equivalent to Clinical and scientific utility of the PROM
the versions adapted to other languages and versions in EP
the original (Table 2). The VHI-9i demonstrated The VHI is the only instrument that meets the
13
seven of the 10 clinimetric properties in a target recommended criteria (Table 4).
population of more than 100 individuals, thus
meeting the recommended criterion (≥ 0.70); Discussion
however, there are no data on its reproducibility The adaptations of the four PROMs and one
(Table 3). Proxy to EP are equivalent to their respective
There is only one study on the validation of originals. Of these, the VHI is recommended
the VHI-10, which was conducted in a non- for use in clinical and research settings
representative sample of the target population, because its 10 clinimetric properties have
with regard to the size and condition (laryngeal been analyzed and found to be robust. Our
disease) . The questionnaire was administered data confirm that the VHI is the gold standard
8
by a telephone interview, a strategy that differs instrument because it correlates strongly and
from what is recommended and from what significantly with the abbreviated versions
was used in the original version. Nevertheless, (VHI-9i and VHI-10) and the SVHI, as has
the EP version of the VHI-10 demonstrated five been shown internationally . In addition,
2
of the recommended clinimetric properties it has the advantage of the possibility of
(Table 3). The pVHI shows results for eight using the subscale scores in an independent
clinimetric properties, with all meeting the manner (functional, physical, and emotional)
recommended criteria except for concurrent in addition to the total score, which the
validity (r =0.412, lower than 0.70) (Table 3). abbreviated versions (VH9i and VHI-10) do not
s
The validation study on the SVHI, conducted allow as they are unidimensional scales that
in 75 singers and/or actors, 50 of whom had provide only an overall result . However, it can
5,8
dysphonia, and 324 professionals observed be improved, for example, by determining: (i)
in the ORL clinic of a hospital in Lisbon 11 the cutoff value for individuals with dysphonia,
meets five of the 10 clinimetric properties which could be a useful indicator for screening
because structural validity and sensitivity to cases for subsequent referral for a clinical
change were not analyzed and the criterion evaluation; (ii) the equivalence between its
recommended by COSMIN for predictive use in the paper and digital format, as there
validity (≥ 0.70) was not met (Table 3). are studies on its use in the latter format .
16

Table 4
Clinical and scientific utility of the PROMs in EP

VHI VHI-9i VHI-10 pVHI SVHI

1. Clinimetric properties
Reliability (3) 3 2 2 3 2

Validity (6) 6 4 3 5 3
Sensitivity to change (1) 1 1 X X X

2. Application (other authors - journals) √ X X X X
Classification

Recommended √ X X X X
Recommended with caution X X X X

Potentially recommended √ √ √ √

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