Validity and Responsiveness of VELO

Abstract

Objective

Test the Velopharyngeal Insufficiency (VPI) Effects on Life Outcomes (VELO) instrument for validity, reliability, and responsiveness.

Study Design

Observational cohort.

Setting

Academic tertiary medical center.

Subjects

Children with VPI (n = 59) and their parents (n = 84) were prospectively enrolled from a pediatric VPI clinic.

Methods

Pediatric speech language pathologists diagnosed VPI using perceptual speech analysis and rated VPI severity and speech intelligibility deficit (each as minimal, mild, moderate, or severe). All parents and youth 8+ years old (n = 24) completed the VELO instrument and other quality-of-life questionnaires at baseline; the first 40 subjects completed the VELO instrument again 2 weeks later. Treatments included Furlow palatoplasty (n = 20), sphincter pharyngoplasty (n = 14), or an obturator (n = 2), and 29 of 36 (81%) subjects completed the questionnaires 3 months posttreatment. VELO was tested with correlations for criterion validity against VPI severity, construct validity against speech intelligibility and velopharyngeal gap size, and concurrent validity against other quality-of-life measures (r > .40 demonstrating validity); for test-retest reliability using intraclass correlation (>.6 demonstrating reliability); and for responsiveness with the 3-month posttreatment measure using the paired t test.

Results

Parental responses are reported; youth responses showed similar results. The VELO instrument did not meet criterion validity (r = –.18, P = .10), or functional construct validity (r = –.37, P = .001), but did meet anatomic construct and concurrent validity (each r > .50, P < .01). VELO scores demonstrated excellent test-retest reliability (r = .85, P < .001) and responsiveness (baseline 54 ± 14 to posttreatment 70 ± 18, P < .001).

Conclusion

VELO provides a VPI-specific quality-of-life instrument that demonstrates concurrent validity, test-retest reliability, and responsiveness to change in quality of life with treatment.

Keywords

velopharyngeal insufficiency quality of life validation reliability responsiveness

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References

Patrick

Deyo

. Generic and disease-specific measures in assessing health status and quality of life. Med Care. 1989;27(suppl 3):S217-232.

Skirko

Weaver

Perkins

. Modification and evaluation of a Velopharyngeal Insufficiency Quality-of-Life Instrument. Arch Otolaryngol Head Neck Surg. 2012;138:929-935.

Barr

Thibeault

Muntz

de Serres

. Quality of life in children with velopharyngeal insufficiency. Arch Otolaryngol Head Neck Surg. 2007;133:224-229.

Lam

Starr

Perkins

. A comparison of nasendoscopy and multiview videofluoroscopy in assessing velopharyngeal insufficiency. Otolaryngol Head Neck Surg. 2006;134:394-402.

Health outcomes methodology. Med Care. 2000;38(suppl 9):II7-13.

Liang

. Longitudinal construct validity: establishment of clinical meaning in patient evaluative instruments. Med Care. 2000;38(suppl 9):II84-90.

Hartnick

. Validation of a pediatric voice quality-of-life instrument: the pediatric voice outcome survey. Arch Otolaryngol Head Neck Surg. 2002;128:919-922.

Boseley

Hartnick

. Assessing the outcome of surgery to correct velopharyngeal insufficiency with the pediatric voice outcomes survey. Int J Pediatr Otorhinolaryngol. 2004;68:1429-1433.

Boseley

Cunningham

Volk

Hartnick

. Validation of the Pediatric Voice-Related Quality-of-Life survey. Arch Otolaryngol Head Neck Surg. 2006;132:717-720.

10.

Huskisson

. Measurement of pain. Lancet. 1974;2:1127-1131.

11.

Scott

Huskisson

. Graphic representation of pain. Pain. 1976;2:175-184.

12.

Sie

. Cleft palate speech and velopharyngeal insufficiency: surgical approach. B-ENT. 2006;2(suppl 4):85-94.

13.

Yoon

Starr

Perkins

Bloom

Sie

. Interrater and intrarater reliability in the evaluation of velopharyngeal insufficiency within a single institution. Arch Otolaryngol Head Neck Surg. 2006;132:947-951.

14.

Sie

Chen

. Management of velopharyngeal insufficiency: development of a protocol and modifications of sphincter pharyngoplasty. Facial Plast Surg. 2007;23:128-139.

15.

Landis

Koch

. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-174.

16.

Terwee

Bot

de Boer

. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60:34-42.

17.

Cohen

. A power primer. Psychol Bull. 1992;112:155-159.

18.

Kazis

Anderson

Meenan

. Effect sizes for interpreting changes in health status. Med Care. 1989;27(suppl 3):S178-189.

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