A visual analog scale for patient-reported voice outcomes: The VAS voice

Matthew R. Naunheim, Jennifer B. Dai, Benjamin J. Rubinstein, Leanne Goldberg, Alan Weinberg, Mark S. Courey

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objectives: Although patient-reported outcome measures (PROMs) can be useful for assessing quality of life, they can be complex and cognitively burdensome. In this study, we prospectively evaluated a simple patient-reported voice assessment measure on a visual analog scale (VAS voice) and compared it with the Voice Handicap Index (VHI-10). Study design: Prospective survey. Methods: An abbreviated voice measure was designed by a team of otolaryngologists, speech pathologists, and patients that consisted of four VAS questions related to (a) a global question of voice disturbance, (b) physical function of voice, (c) functional issues, and (d) emotional handicap. All English-speaking patients presenting to an academic laryngology clinic for a voice complaint were included. Internal consistency and validity were assessed with comparison to the VHI-10. Results: A total of 209 patients were enrolled. Ninety-two percent of patients reported understanding the survey. The four-item VAS survey was highly correlated with VHI-10 score (Pearson correlation.81, P <.0001), and the Cronbach's alpha between all four VAS questions was.94. Age, gender, and diagnosis were not associated with either the global VAS or VHI-10 tool. Conclusion: Reducing the complexity of instruments assessing voice-related quality of life is feasible, and the VAS voice correlated with existing measures. Simplified assessments may offer advantages compared to more cumbersome PROMs. Level of Evidence: 2c.

Original languageEnglish
Pages (from-to)90-95
Number of pages6
JournalLaryngoscope investigative otolaryngology
Issue number1
StatePublished - 1 Feb 2020


  • dysphonia
  • hoarseness
  • outcomes
  • patient-reported outcome measures
  • visual analog scale
  • voice


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