Outcomes research in laryngology

Voice quality of life outcomes research is in its infancy, with its definitions and applications still rapidly evolving. Several voice outcomes instruments have been developed and validated recently. Such instruments include the Voice Handicap Index, the Voice Outcomes Survey, and the Voice-Related Quality of Life. The Voice Handicap Index and the Voice-Related Quality of Life are both applicable to a wide variety of voice disorders, whereas the Voice Outcomes Survey applies only to unilateral vocal cord paralysis. The Voice Handicap Index and the Voice-Related Quality of Life provide slightly different foci (handicap vs. quality of life) and also differ in questionnaire length (30 vs. 10 items). The Voice Handicap Index was developed and validated before the Voice-Related Quality of Life, and more studies have established its applicability to voice outcomes research. Some Voice Handicap Index studies suggest that patients with specific vocal demands, such as singers, may benefit from the development of more specific instruments to focus on their unique impairments or handicaps. Although more studies are needed to determine the use of these instruments, those currently available suggest a wide range of applications.