Validation of Malayalam Version of the Voice Handicap Index

JOURNAL TITLE: International Journal of Phonosurgery & Laryngology

1. Unnikrishnan Menon
2. VS Sheejamol
3. Meera P Cherian
Publishing Year
Author Affiliations
    1. Department of Medical Biostatistics, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
    1. Department of ENT, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India
  • Article keywords



    It is important to have a subjective measure of hoarseness. This can be best achieved if the questionnaire is in the patient's own language.


    To translate the voice handicap index (VHI) into the Malayalam language, and to evaluate its clinical validity and internal consistency.

    Materials and methods

    One hundred and six patients with dysphonia and 20 asymptomatic subjects were included in the study. Internal consistency was analyzed through Cronbach's alpha coefficient. For the clinical validity assessment, the scores obtained in the patient group were compared with those found in asymptomatic individuals through the Mann-Whitney U-test. Also, comparison between the VHI scores before and after phonomicrosurgery on 14 out of the studied 106 patients was done using the nonparametric Wilcoxon signed ranks test. Spearman rank correlation was used to find the effect of patient's age on VHI scores. Finally, the gender-wise average VHI score and its three subsets was analyzed using Wilcoxon signed ranks test.


    The internal consistency was found to be excellent (α = 0.946). The control group scored significantly lower than the patients group (p < 0.001). Similarly, significant improvement was seen in the postoperative average VHI scores (p < 0.004). All of the preceding proves the validity of the translated questionnaire. Age showed a significant negative correlation for the overall VHI and their three domains (p < 0.001) in the dysphonic patients. There was no such correlation between male and female patient groups.


    This Malayalam language version of the VHI questionnaire is a valid instrument for use in the voice clinic. Clinical implication: Encouragement to all voice clinicians in India to develop and use the VHI in their native tongues.

    How to cite this article

    Menon U, Sheejamol VS, Cherian MP. Validation of Malayalam Version of the Voice Handicap Index. Int J Phonosurg Laryngol 2012;2(1):1-4.

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