Aims: To examine the psychometric properties of a Norwegian translation of the Voice Handicap Index (VHI) and test its ability to discriminate between patients and controls. Abbreviated versions of VHI were also studied. Method: Following standard translation, 126 healthy subjects and 126 patients with laryngeal disease answered the Norwegian translation of the VHI-30 [hereafter, VHI-30(N)]. Results: The VHI(N) showed a high Cronbach α. Control/patient scores were as follows: Emotional (E): 0.88/0.90; Functional (F): 0.77/0.91; Physical (P): 0.86/0.83, and total: 0.93/0.94.One three-level question where the subjects rated the level of voice disease correlated well with the VHI(N) scores. The 90th (95th) percentile of the control score was 18 (33), whereas the mean ± SEM patient score was 52.3 ± 2.04 of a maximum of 120 points. Differences between patient and control groups were significant for all questions on the VHI(N). Receiver operating characteristic analyses demonstrate that the F, P, E and total VHI scores discriminated very well between patients and controls. This was also the case when the abbreviated scales were analyzed as published by Nawka et al. [Folia Phoniatr Logop 2009;61:37–48] and Rosen et al. [Laryngoscope 2004;114:1549–1556]. Conclusion: This Norwegian version of the VHI questionnaire seems to be psychometrically sound.

The aim of this study is to determine to what extent the Voice Handicap Index-Norwegian (VHI-N) is scored depending on specific laryngological disease. In a multi-center study, 126 healthy subjects and 355 patients with different voice-related diseases answered the VHI-N. The VHI-N scores showed high Cronbach's alpha. Analyses of variance were performed with VHI-N dependent and specific voice-related disease as independent variable, and showed highly significant dependence by group allocation (F(7,461) = 28.0; p < 0.001). When studying post hoc analyses secondary to this ANOVA analysis, we have shown that the control group scored lower than the entire patient groups (all p < 0.001) except the dysplasia group. Aphonic patients scored higher than all the other groups (all p < 0.001) except those with spasmodic dysphonia. The cancer patient group furthermore scored lower than patient groups with recurrent palsy, dysfunctional disease or spasmodic dysphonia (all p < 0.001). In addition, patients with recurrent palsy scored higher than patients with degenerative/inflammatory disease (p < 0.001). No influences of patient age, gender, or smoking were observed in the VHI-N scores. The VHI-N is a psychometrically well-functioning instrument, also at disease-specific levels and discriminates well between health and voice diseases, as well as between different voice-related diseases. The VHI-N may be recommended to be used when monitoring voice-related disease treatment.