Translation and Validation of the Dizziness Handicap Inventory into Thai Language

Abstract

Objective: To translate and evaluate psychometric properties of Thai version of the Dizziness Handicap Inventory (DHI-TH). Study Design: A cross-sectional study. Setting: Ambulatory. Patients: Fifty patients with dizziness at a vestibular clinic. Main Outcome Measures: Translation and cross-cultural adaptation of the original English version of the DHI was performed according to published guidelines. Psychometric evaluation included internal consistency, content validity, test-retest reliability, convergent validity, discriminant ability, and responsiveness. Responsiveness was examined in 28 patients with vestibular dysfunction who received vestibular rehabilitation for 6 to 8 weeks. Results: There were no floor and ceiling effects. The Cronbach's alpha was good for the total score (0.87) and subscale scores (0.70 physical, 0.73 emotional, and 0.71 functional). Excellent test-retest reliability was demonstrated for the total and subscales (ICC ranged from 0.91 to 0.97, p < 0.001). The SEM was 3.50 and the MDC was 9.68. The total and subscales of DHI-TH were moderately correlated with the SF-36-TH scores (r ranged from À0.40 to À0.63). An optimal cut-off point for detection of dizziness was 21 points (98% sensitivity, 94% specificity). Responsiveness of the DHI-TH was excellent. The ES and SRM were large (1.25 and 1.59, respectively). The DHI-TH discriminated well between patients with self-perceived improved dizziness versus unchanged dizziness (AUC ¼ 0.87). The MCID was 17 points (82.0% sensitivity, 82.0% specificity). Conclusion:The DHI-TH demonstrated good psychometric properties for patients with dizziness. The DHI-TH is a valid and reliable instrument recommended as a measure of disability and quality of life in Thai patients with dizziness.

Variability in Minimal Clinically Important Difference Calculation and Reporting in the Otolaryngology Literature

“…Five studies (Table I and Table II, top) reported MCID of objective outcome measurements/tests (vestibuloocular reflex gain, 14 peak nasal expiratory flow, 15 peak nasal inspiratory flow, 15,16 Brief Smell Identification Test, 17 and laryngotracheal stenosis 18 ). In comparison, 30 studies reported 45 PROM MCID values (Table I and Table II, bottom) 19–48 . While all studies reported the MCID for improvement in an outcome, only five studies (17.2%) also reported an MCID for worsening in an outcome 24,33,39,41,45 …”

“…Of the included studies, 29 (82.9%) used at least 1 anchor‐based method (20 used 1 and 9 used 2 anchor‐based methods) in the calculation of MCID (Table III). 14,16–20,23–31,33–43,45,46,48 Of the studies that used anchor‐based methods, 19 studies used an anchor that was an explicit global rating of change, 19,24–29,33–40,43,46,48 seven studies used an anchor that was based on change in a PROM score, 16–18,20,31,41,42 and four studies used anchors that were considered clinical anchors (based on clinical status or findings) 14,23,30,45 . One study used one anchor that was a global rating of change and one anchor that was based on change in a PROM score 16 .…”

“…Of all included studies, eight studies (22.9%) reported the predictive ability—sensitivity and specificity in all cases—of the reported MCIDs to detect patients experiencing clinically meaningful change in the corresponding outcome (Table II). 14,27–29,35,36,43,46 The mean sensitivity of reported MCIDs was 65.7% (SD: 15.4%) and median sensitivity of reported MCIDs was 60.8% (range: 40.5%–86.7%). The mean specificity of reported MCIDs was 77.6% (SD: 7.7%) and the median specificity was 80.4% (range: 63.5%–88.0%).…”

“…24,33,39,41,45 Methods for MCID Calculation Of the included studies, 29 (82.9%) used at least 1 anchor-based method (20 used 1 and 9 used 2 anchorbased methods) in the calculation of MCID (Table III). 14,[16][17][18][19][20][23][24][25][26][27][28][29][30][31][33][34][35][36][37][38][39][40][41][42][43]45,46,48 Of the studies that used anchor-based methods, 19 studies used an anchor that was an explicit global rating of change, 19,[24][25][26][27][28][29][33][34][35][36][37][38][39][40]…”

Anterior cervical discectomy and fusion to treat cervical instability with vertigo and dizziness: A single center, retrospective, observational study

“…However, there is no consensus on the MCID value for VSS and DHI. Emasithi A has reported 17 as the MCID of DHI-TH (Thai version of the Dizziness Handicap Inventory) (18). The MCID of VSS and DHI used in this study were obtained numerically by using anchor- based method.…”