Exploring Patient's Preference of Patient‐Reported Outcome Measures in Laryngeal Movement Disorders

Abstract

Background: Despite many available patient-reported outcome measures (PROMs) for laryngeal movement disorders, there is a lack of patient input regarding which PROM most accurately and conveniently captures aspects related to their vocal disease. This study aimed to assess patients' preferences among a selection of voice-related PROMs (Voice Handicap Index-10 [VHI-10], OMNI-Vocal Effort Scale [OMNI-VES], Communicative Participation Item Bank-General Short Form [CPIB-10], and Visual Analog Scales [VAS]) within the laryngeal movement disorder population and investigate associations between selected instruments.Methods: Prior to botulinum toxin A injection, patients with laryngeal dystonia and/or essential tremor of the vocal tract were administered the VHI-10, OMNI-VES, CPIB-10, and three novel VAS questions in a randomized order. Patients rank ordered the four PROMs based on the PROMs' reflection of their voice problems. Pearson's correlation coefficients evaluated pairwise associations among PROM scores. Fisher's exact test compared the preferred PROM rankings.Results: Seventy patients (53 female, mean age = 60.7 years) participated. The VHI-10 and CPIB-10 were most preferred at 33.9% and 27.4% respectively. The OMNI-VES and VAS scales were less favored (19.4%, each). When analyzed by age ≥60 years, the CPIB-10 was most favored (33.3%), but for age <60 years, VHI-10 was most preferred (42.3%). There was a strong correlation between scores of all administered PROMs (strongest correlation between OMNI-VES and VAS, r = 0.8, p < 0.001; the weakest correlation between OMNI-VES and VHI-10, r = 0.6, p < 0.001).Conclusions: With an increasing trend in PROMs usage and a strong correlation between all evaluated outcome instruments, insight regarding patients' PROM preferences is an area for further consideration.

Adult Normative Data for the OMNI‐Vocal Effort Scale (VES)

“…A recent investigation that sought to explore patient preferences for PROMs in laryngeal movement disorders determined OMNI-VES to be less preferred, citing that the visual analog scale does not provide enough depth to describe communication when compared with measures such as the VHI-10. 41 However, these two scales are not designed to measure the same areas of voice production; therefore, the comparison is arguable. The OMNI-VES was designed to specifically address vocal effort and to be used in conjunction with an outcome measure that more generally assesses vocal function, such as the VHI-10, to provide the patient and clinician greater insight into the presenting vocal symptoms and behaviors.…”

“…A recent investigation that sought to explore patient preferences for PROMs in laryngeal movement disorders determined OMNI‐VES to be less preferred, citing that the visual analog scale does not provide enough depth to describe communication when compared with measures such as the VHI‐10 41 . However, these two scales are not designed to measure the same areas of voice production; therefore, the comparison is arguable.…”