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

Lesley F. Childs, Clifford Bielinski, Laura Toles, Amy Hamilton, Janis Deane, Ted Mau

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


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 r520.57). 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.

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).

Original languageEnglish (US)
Pages (from-to)180-185
Number of pages6
Issue number1
StatePublished - Jan 1 2015


  • Dysphonia
  • Patient perception
  • Quality of life
  • Vocal function
  • Voice Handicap Index
  • Voice assessment
  • Voice handicap

ASJC Scopus subject areas

  • Otorhinolaryngology


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