{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T06:32:58Z","timestamp":1773037978120,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T00:00:00Z","timestamp":1675036800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>A key outcome measure in the clinical evaluation of dysphonia is the Voice Handicap Index (VHI\u201010). The clinical validity of the VHI\u201010 was established from surveys administered in the physician's office. We aim to understand whether VHI\u201010 responses remain reliable when the questionnaire is completed in settings other than the physician's office.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective observational study conducted over a 3\u2010month period in the outpatient laryngology setting. Thirty\u2010five adult patients presenting with a complaint of dysphonia, which was symptomatically stable for the preceding 3\u00a0months, were identified. Each patient completed a VHI\u201010 survey during the initial office visit, followed by three weekly out\u2010of\u2010office (termed \u201cambulatory\u201d) VHI\u201010 surveys, over the course of 12\u2009weeks. The specific setting in which the patient completed the survey was recorded (social, home, or work). The Minimal Clinically Important Difference (MCID) is defined as 6 points based on existing literature. T\u2010tests and a test of one proportion were used for analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 553 responses were collected. Of these, 347 ambulatory scores (63%) differed from the Office score by at least the MCID. Specifically, 94 (27%) were higher than the in\u2010office score by 6 or more points while 253 (73%) were lower.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The setting in which the VHI\u201010 is completed affects how the patient answers the questions. The score is dynamic, reflecting effects of the patients' environment during completion. Utilization of VHI\u201010 scores to measure clinical treatment response is only valid if each response is obtained in the same setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4<\/jats:p><\/jats:sec>","DOI":"10.1002\/lio2.1016","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T10:54:40Z","timestamp":1675076080000},"page":"150-155","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Patient reported outcome measures: The impact of environment on <scp>VHI<\/scp>\u201010 responses"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5954-0237","authenticated-orcid":false,"given":"Eliezer C.","family":"Kinberg","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4960-9709","authenticated-orcid":false,"given":"Amir","family":"Taree","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1146-9942","authenticated-orcid":false,"given":"Mingyang","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6898-6633","authenticated-orcid":false,"given":"Peter","family":"Filip","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6885-2929","authenticated-orcid":false,"given":"Mark","family":"Courey","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,1,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1044\/2016_JSLHR\u2010S\u201016\u20100022"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817731759"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.63.0830"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.5334\/egems.227"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41687\u2010018\u20100061\u20106"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010200409000\u201000009"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27900"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2017.1621"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599819852604"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.01126"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X677851"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp14X680029"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.1016","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lio2.1016","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.1016","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T15:58:54Z","timestamp":1692287934000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.1016"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,30]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["10.1002\/lio2.1016"],"URL":"https:\/\/doi.org\/10.1002\/lio2.1016","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1,30]]},"assertion":[{"value":"2022-10-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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