The Application and Comparison of the Pediatric Voice Handicap Index and Acoustic Analysis in Pediatric Benign Voice Disorders

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Importance There are many methods for pediatric voice assessment, but each has its own limitations. Currently, there are few studies that have compared the outcomes of subjective and objective evaluation methods in children with voice disorders. Objective To apply and compare the pediatric Voice Handicap Index (pVHI) with acoustic analysis in pediatric benign voice disorders. Design Case-control study. Setting This study was conducted at a single institution. Participants Pediatric participants with and without benign voice disorders were included from August 2021 to April 2023. Intervention or Exposures The questionnaire results for the pVHI were obtained, and acoustic analysis was conducted. Main Outcome Measures The main outcomes included the pVHI scores, acoustic parameters, and the Pearson Correlation Coefficient. Results Out of the 338 participants, 160 children were diagnosed with voice disorders, whereas 178 did not exhibit such conditions. The total scores and those of each subscale were significantly higher in the patient group than in the control group ( P < .05). Significant differences were also observed in the fundamental frequency (228.13 ± 66.78 vs 253.65 ± 47.21), jitter (2.08 ± 2.59 vs 2.42 ± 1.75), shimmer (8.52 ± 5.78 vs 9.44 ± 3.69), harmonic to noise ratio (HNR) (0.50 ± 0.68 vs 0.65 ± 0.19), s/z ratio (1.46 ± 1.89 vs 0.99 ± 0.44), and maximum phonation time (6.08 ± 3.38 vs 7.82 ± 2.50) ( P < .05). When comparing the types of diseases, the physical dimension of the pVHI (17.43 ± 7.02 vs 15.29 ± 6.92 vs 13.32±7.71) and the HNR (0.39 ± 0.16 vs 0.41 ± 0.21 vs 0.75 ± 1.24) were most negatively affected in the vocal fold polyps group. Moderate to strong correlations were shown among the pVHI total and each subscale scores ( P < .05), while the highest r score was shown between the physical and the total scores of the pVHI (r = 0.882). Conclusions and Relevance Pediatric patients with voice disorders exhibit more severe voice handicaps in both pVHI scores and acoustic parameters. The total score of the pVHI is moderately to strongly correlated with each subscale, whereas no strong correlation was presented between different acoustic parameters or between acoustic parameters and pVHI scores. This indicates that the two evaluation methods are not interchangeable; thus, a comprehensive evaluation is essential in clinical practice to prevent bias.

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