Creation and Validation of the Singing Voice Handicap Index

Abstract

Objectives: We developed and validated a disorder-specific health status instrument (Singing Voice Handicap Index; SVHI) for use in patients with singing problems. Methods: Prospective instrument validation was performed. Of 81 original items, those with poor statistical validity were eliminated, resulting in 36 items. The ability to discriminate dysphonic from normal singers, test-retest reliability, internal consistency, and construct validity were assessed. Results: We included 112 dysphonic and 129 normal singers, professional and nonprofessional, of classical, country, rock, choral, and gospel repertoire. Dysphonic singers had worse SVHI scores than normal singers (p ≤ .001, rank sum test). Test-retest reliability was high (Spearman correlation, 0.92; p ≤ .001). Internal consistency demonstrated a Cronbach's α of 97, and the correlation between the SVHI and self-rated singing voice impairment was .63 (p ≤ .001, Spearman correlation). Conclusions: The SVHI is a reliable and valid tool for assessing self-perceived handicap associated with singing problems.