Use of the Polish Adaptation of the Pediatric Voice Handicap Index in Predicting Severe Voice Disorders in Children

The pediatric Voice Handicap Index (pVHI) score is known to be associated with the severity of dysphonia, assessed by the GRBAS perceptual voice rating scale or by the acoustic analysis. However, there is no consensus regarding pVHI scoring for clinical applications. The aim of this study was to determine the relevance of parental voice assessment, aided by the pVHI questionnaire, for the identification of cases of severe pediatric voice disorders. The prospective cohort study was conducted at the audiology and phoniatrics outpatient clinic. Children aged 4.5 to 14 years were enrolled in the study. The pVHI questionnaire was filled in by the adult accompanying the child during the appointment. Voice was rated by the physician using the GRBAS scale and Yanagihara scale. The group included in the analysis consisted of 93 children. There was no significant difference in the diagnosis of severe cases regarded as patients with the GRBAS and Yanagihara scales scores above the third quartile of them. The risk of having a severe voice disorder was statistically greater along with the increase in the pVHI (OR 1.08 per 1 point, 95% CI 1.03-1.13, P = 0.002) and its components. For the primary outcome (GRBAS total score ≥ 6) both the minimum distance from the cut point to the ideal diagnosis (sensitivity of 1.00 and 1-specificity of 0.00) and minimum absolute difference between sensitivity and specificity were achieved for pVHI total score of 27 points. Parental assessment of voice impairment using pVHI is useful for identification children with severe pediatric voice disorders with a threshold established at 27 points.