Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation Purpose The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties. Method MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and ... Review Article
Review Article  |   January 01, 2017
Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation
 
Author Affiliations & Notes
  • David O. Francis
    Vanderbilt Voice Center, Department of Otolaryngology, Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, TN
    Center for Surgical Quality and Outcomes Research, Nashville, TN
    Vanderbilt Evidence-Based Practice Center, Nashville, TN
  • James J. Daniero
    Center for Voice and Swallowing, University of Virginia, Charlottesville
  • Kristen L. Hovis
    Vanderbilt University School of Medicine, Nashville, TN
  • Nila Sathe
    Vanderbilt Evidence-Based Practice Center, Nashville, TN
    Vanderbilt University Medical Center, Nashville, TN
    Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
  • Barbara Jacobson
    Department of Hearing and Speech Sciences, Bill Wilkerson Center, Vanderbilt University Medical Center, Nashville, TN
  • David F. Penson
    Center for Surgical Quality and Outcomes Research, Nashville, TN
    Vanderbilt Evidence-Based Practice Center, Nashville, TN
    Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
    Departments of Urology and Medicine, Vanderbilt University Medical Center, Nashville, TN
    Geriatric Research and Education Coordination Center, Veteran's Administration Tennessee Valley Health System, Geriatric Research and Education Coordination Center, Nashville, TN
  • Irene D. Feurer
    Center for Surgical Quality and Outcomes Research, Nashville, TN
    Departments of Surgery and Biostatistics, Vanderbilt University Medical Center, Nashville, TN
  • Melissa L. McPheeters
    Vanderbilt Evidence-Based Practice Center, Nashville, TN
    Department of Health Policy, Vanderbilt University Medical Center, Nashville, TN
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to David O. Francis: david.o.francis@vanderbilt.edu
  • Editor: Julie Liss
    Editor: Julie Liss×
  • Associate Editor: Nelson Roy
    Associate Editor: Nelson Roy×
Article Information
Speech, Voice & Prosodic Disorders / Voice Disorders / Research Issues, Methods & Evidence-Based Practice / Speech, Voice & Prosody / Speech / Review Article
Review Article   |   January 01, 2017
Voice-Related Patient-Reported Outcome Measures: A Systematic Review of Instrument Development and Validation
Journal of Speech, Language, and Hearing Research, January 2017, Vol. 60, 62-88. doi:10.1044/2016_JSLHR-S-16-0022
History: Received January 20, 2016 , Revised April 28, 2016 , Accepted July 20, 2016
 
Journal of Speech, Language, and Hearing Research, January 2017, Vol. 60, 62-88. doi:10.1044/2016_JSLHR-S-16-0022
History: Received January 20, 2016; Revised April 28, 2016; Accepted July 20, 2016

Purpose The purpose of this study was to perform a comprehensive systematic review of the literature on voice-related patient-reported outcome (PRO) measures in adults and to evaluate each instrument for the presence of important measurement properties.

Method MEDLINE, the Cumulative Index of Nursing and Allied Health Literature, and the Health and Psychosocial Instrument databases were searched using relevant vocabulary terms and key terms related to PRO measures and voice. Inclusion and exclusion criteria were developed in consultation with an expert panel. Three independent investigators assessed study methodology using criteria developed a priori. Measurement properties were examined and entered into evidence tables.

Results A total of 3,744 studies assessing voice-related constructs were identified. This list was narrowed to 32 PRO measures on the basis of predetermined inclusion and exclusion criteria. Questionnaire measurement properties varied widely. Important thematic deficiencies were apparent: (a) lack of patient involvement in the item development process, (b) lack of robust construct validity, and (c) lack of clear interpretability and scaling.

Conclusions PRO measures are a principal means of evaluating treatment effectiveness in voice-related conditions. Despite their prominence, available PRO measures have disparate methodological rigor. Care must be taken to understand the psychometric and measurement properties and the applicability of PRO measures before advocating for their use in clinical or research applications.

Acknowledgment
Funding was provided by National Institute on Deafness and Other Communication Disorders Grants K23DC013559 and L30DC012687 to the first author.
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