{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:44:53Z","timestamp":1791906293772,"version":"4.3.4"},"reference-count":46,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T00:00:00Z","timestamp":1512691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives\/Hypothesis<\/jats:title>\n                    <jats:p>The Voice Handicap Index\u201010 (VHI\u201010) is commonly used to measure patients' perception of vocal handicap. Clinical consensus has previously defined clinically meaningful improvement as a decrease \u22655. This study determines the minimal clinically important difference (MCID) for VHI\u201010 in patients with unilateral vocal fold paralysis (UVFP) using anchor\u2010based methodology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective cohort questionnaire analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Two hundred eighty\u2010one UVFP patients completed the VHI\u201010 on two consecutive visits (within 3 months). At the follow\u2010up visit, patients answered an 11\u2010point Global Rating of Change Questionnaire (GRCQ) scored from \u22125 to +5. Relationship between the GRCQ and change in VHI\u201010 was quantified using analysis of variance, and MCID for the VHI\u201010 was determined using receiver operating characteristic (ROC) curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall mean VHI\u201010 change was \u22123.71 (standard deviation [SD] = 8.89) and mean GRCQ was 1.37 (SD = 2.51). Average interval between measurements was 1.73 months (SD = 0.83). Mean changes in VHI\u201010 scores were \u22127.45, \u22120.53, and +4.40 for patients whose GRCQ scores indicated improvement, no change, and worsening, respectively. Differences between mean scores were statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Area under the ROC curve was 0.80, demonstrating the classification accuracy of VHI\u201010 change scores. A VHI\u201010 change of \u22124 was determined to be the optimal threshold that discriminated between improvement and no improvement (sensitivity and specificity 0.62 and 0.88, respectively).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The MCID for improvement in VHI\u201010 in UVFP patients is a decrease of 4. This information improves understanding of patients' response to treatment and allows comparison between different treatments. Future research should determine MCID for VHI\u201010 across all voice disorders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      4.\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 128:1419\u20131424, 2018\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.27001","type":"journal-article","created":{"date-parts":[[2017,12,8]],"date-time":"2017-12-08T06:42:40Z","timestamp":1512715360000},"page":"1419-1424","source":"Crossref","is-referenced-by-count":76,"title":["Minimal clinically important difference of voice handicap index\u201010 in vocal fold paralysis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3095-8290","authenticated-orcid":false,"given":"VyVy N.","family":"Young","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, University of Pittsburgh Voice Center University of Pittsburgh School of Medicine Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kwonho","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Medicine Center for Research on Health Care Data Center University of Pittsburgh School of Medicine Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott D.","family":"Rothenberger","sequence":"additional","affiliation":[{"name":"Department of Medicine Center for Research on Health Care Data Center University of Pittsburgh School of Medicine Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda I.","family":"Gillespie","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, University of Pittsburgh Voice Center University of Pittsburgh School of Medicine Pittsburgh Pennsylvania 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