Epidemiological Patterns and Treatment Outcomes in a Private Practice Community Voice Clinic

Objectives: Voice therapy is administered by speech-language pathologists in multiple practice settings, including private practice community voice clinics. However, the evidence for diagnosis patterns and voice treatment outcomes in community voice clinics is very limited. The purpose of this study was to extend knowledge from a previous investigation by assessing the epidemiological patterns of patient referrals to a private practice community voice clinic across a

4 year period (50 months) and to measure the effectiveness of treatment outcomes for patients who were followed up with voice therapy in that setting.

Study Design: Retrospective case series

Methods: Consecutive patient records from November 2014 through January 2019 were reviewed. Patients were grouped into 7 categories of distinctive diagnoses. Descriptive data for each group were extracted to determine epidemiological patterns of disorder diagnosis, voice handicap, voice quality severity, age, and gender. For patients who completed at least 3 treatment

sessions, pre- and post-treatment measurements of two assessments, the Voice Handicap Index (VHI) and the Acoustic Voice Quality Index (AVQI), were extracted and compared using a MANOVA.

Results: Records from 454 consecutive patient referrals over a 50-month time period were reviewed. The most frequent diagnoses were multifactorial etiologies or those with only a few cases, categorized collectively as an “other” diagnosis category. Diagnoses of non-specific dysphonia and mid-membranous lesions were also common. CAPE-V scores were not different among disorders, however, group differences were found for VHI and AVQI. Treatment data were available for 292 patients, with 48 of those patients completing at least 3 treatment sessions and with data for pre- and post-therapy VHI and AVQI. A mixed MANOVA showed a significant effect of treatment (Wilks’ Lamba=0.42, F[2]=27.58, p<0.001, ƞp²=0.58), where both AVQI and VHI improved significantly across the pre-to-post treatment measurements.

Conclusion: Patient characteristics and diagnosis patterns across a 50 month period were similar when compared to a previous study that investigated epidemiological patterns in this clinic across 28 months. Voice therapy administered in this community voice clinic to patients with varied diagnoses was found to be effective based on changes in VHI and AVQI measurements.