An investigation of the cutoff point of the English version of speech handicap index in the American total laryngectomees

Abstract

Objectives

The present article aims to identify the optimal cutoff score and the diagnostic accuracy for the English version of Speech Handicap Index (SHI) to screen out individuals with and without speech disorders in daily life.

Materials and methods

In this cross-sectional cohort study, a volunteer sample of 104 adult patients after total laryngectomy and 99 healthy controls in the United States completed the English version of SHI online questionnaire. Sensitivity and specificity were computed for a range of cut-off values using the Receiving Operating Characteristics (ROC) analysis to establish an optimal cutoff point for the SHI. Other measures of diagnostic accuracy, such as likelihood ratios (LR), positive predictive values (PPV), and negative predictive values (NPV) were also computed.

Results

Patients after total laryngectomy obtained a higher score than the healthy controls on the mean scores of SHI. According to the ROC analysis, an optimal cutoff score of 17 points determined by Youden index was identified on the head and neck cancer population with a sensitivity of 92.31%, specificity of 92.31%, PPV of 90.60%, NPV of 91.75%, LR + of 9.14, and LR- of 0.09.

Conclusions

The cutoff score of the English version of SHI applied on the English-speaking population in the United States demonstrated promising diagnostic accuracy.

Keywords:

• Speech disorders
• speech handicap index
• clinical cutoff score
• speech-related quality of life
• total laryngectomy
• alaryngeal speech

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Notes on contributors

Hiu Fung Chan

Hiu Fung (Kammy) Chan is a researcher and a Speech-Language pathologist. She earned her graduate degree at Yonsei University in Korea. She completed her Fulbright fellowship at the University of California, San Francisco (UCSF) Department of Otolaryngology-Head and Neck Surgery. She is passionate about advocating for the needs of patients in a human-centered approach.

Clark A. Rosen

Dr. Clark Rosen is the Director of the UCSF Voice and Swallowing Center, Chief of the Division of Laryngology, Professor of Otolaryngology-Head and Neck Surgery. He has had amazing productivity as a clinician scientist. He has trained over 15 fellows in Larynogology and numerous visiting Otolaryngologists from around the world.

Sarah L. Schneider

Sarah L. Schneider is the Co-Director of the UCSF Voice and Swallowing Center, Speech Language Pathology Director and Health Sciences Assistant Clinical Professor in the Department of Otolaryngology – Head and Neck Surgery. She is active in several research projects within the department and acts as a research consultant in the area of voice.