Quality of Life Research

, Volume 28, Issue 2, pp 283–296 | Cite as

Measurement properties of self-report questionnaires on health-related quality of life and functional health status in dysphonia: a systematic review using the COSMIN taxonomy

  • Renée SpeyerEmail author
  • Jae-Hyun Kim
  • Kenji Doma
  • Yu-Wei Chen
  • Deborah Denman
  • Debra Phyland
  • Lauren Parsons
  • Reinie Cordier



The current review was conducted to identify all self-report questionnaires on functional health status (FHS) and/or health-related quality-of-life (HR-QoL) in adult populations with dysphonia (voice problems), and to evaluate the psychometric properties of the retrieved questionnaires.


A systematic review was performed in the electronic literature databases PubMed and Embase. The psychometric properties of the questionnaires were determined using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) taxonomy and checklist. Responsiveness was outside the scope of this review and as no agreed ‘gold standard’ measures are available in the field of FHS and HR-QoL in dysphonia, criterion validity was not assessed. Only questionnaires developed and published in English were included.


Forty-eight studies reported on the psychometric properties of 15 identified questionnaires. As many psychometric data were missing or resulted from biased study designs or statistical analyses, only preliminary conclusions can be drawn. Based on the current available psychometric evidence in the literature, the Voice Handicap Index seems to be the most promising questionnaire, followed by the Vocal Performance Questionnaire.


More research is needed to complete missing data on psychometric properties of existing questionnaires in FHS and/or HR-QoL. Further, when developing new questionnaires, the use of item response theory is preferred above classical testing theory, as well as international consensus-based psychometric definitions and criteria to avoid bias in outcome data on measurement properties.


Dysphonia Voice Reliability Validity Assessment 



Consensus-based standards for the selection of health measurement instruments


Evaluation of the ability to sing easily


Functional health status


Glottal Function Index


Health-related quality of life


Singing Voice Handicap Index


Singing Voice Handicap Index-10


Transgender Self-Evaluation Questionnaire


Transsexual Voice Questionnaire—Male to Female


Voice Capabilities Questionnaire


Voice Disability Coping Questionnaire


Vocal Fatigue Index

VHI or VHI-30

Voice Handicap Index


Voice Handicap Index-10


Voice and Symptom Scale


Vocal Performance Questionnaire


Voice-related quality of life


Voice Rating Scale



The authors express their gratitude to Jessica Powell, Grace Martin and Melinda Licciardello for providing support during the start-up of this review.

Compliance with ethical standards

Conflict of interest

DP authored one of the instruments included in this review (EASE); however, DP was not involved in COSMIN scorings or quality ratings of measurement properties of questionnaires; raters were blinded to the involvement of DP in the paper. All other authors declare that they have no competing interests.

Research involving human and animal participants

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

11136_2018_2001_MOESM1_ESM.docx (81 kb)
Supplementary material 1 (DOCX 80 KB)


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Department of Special Needs EducationUniversity of OsloOsloNorway
  2. 2.Department of Otorhinolaryngology and Head and Neck SurgeryLeiden University Medical CenterLeidenThe Netherlands
  3. 3.School of Occupational Therapy, Social Work and Speech PathologyCurtin UniversityPerthAustralia
  4. 4.Department of LinguisticsMacquarie UniversitySydneyAustralia
  5. 5.College of Healthcare SciencesJames Cook UniversityTownsvilleAustralia
  6. 6.Faculty of Health SciencesThe University of SydneySydneyAustralia
  7. 7.Department of Surgery, Faculty of Medicine, Nursing and Health SciencesMonash UniversityMelbourneAustralia

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