Development and validation of the Dysarthria Impact Scale

Publication date: Jul 04, 2025

Background: Impaired speech due to dysarthria significantly impacts quality of life. Patient-reported outcomes (PROs) offer critical insight into the lived experience of communication disability and are increasingly central to regulatory frameworks for patient-focused drug development. Objectives: To develop and validate the Dysarthria Impact Scale (DIS), a brief PRO designed to assess the impact of motor speech disorders on quality of life across neurological conditions. Methods: A multi-site, cross-sectional study was conducted with 244 participants, including individuals with Huntington’s disease, Parkinson’s disease, hereditary ataxias, and head and neck cancer, along with healthy controls. The 22-item DIS was developed using expert input and patient feedback and evaluated alongside reference tools (Voice Handicap Index and SF-36). Item reduction procedures yielded two shorter versions (DIS-17 and DIS-6). Validity, reliability, and sensitivity/specificity analyses were performed, and minimal clinically important differences (MCIDs) were estimated using distribution-based methods. Results: All DIS versions showed strong convergent validity with the VHI (r = -0.85) and SF-36 (r = 0.72) and were correlated with blinded perceptual speech ratings. DIS-17 and DIS-6 achieved comparable sensitivity (0.93 and 0.88) and specificity (0.84 and 0.86, respectively). Test-retest reliability was high (r = 0.98), with WSSD estimates ranging from 4.0 to 10.6 across groups. Estimated MCIDs ranged from 5 to 15 points. Group differences were observed, with lower DIS scores in ataxia and Parkinson’s disease compared to Huntington’s disease. Conclusions: The DIS is a valid, reliable, and practical PRO for quantifying the impact of dysarthria on quality of life. It is suitable for clinical monitoring and clinical trial use, with sensitivity to disease-related variation and change.

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Concepts Keywords
25330604doi Clinical
Cancer Communication
July Dis
Neurodegenerative Dysarthria
Wellbeing Impairment
Index
Life
Medrxiv
Participants
Patient
Preprint
Reference
Speech
Validity

Semantics

Type Source Name
disease MESH Dysarthria
disease MESH communication disability
disease MESH speech disorders
disease MESH Huntington’s disease
disease MESH disease hereditary
disease MESH ataxias
disease MESH head and neck cancer
disease MESH Parkinson’s disease
disease MESH Neurodegenerative Diseases
pathway REACTOME Neurodegenerative Diseases
disease MESH hereditary ataxias
disease MESH stroke
disease MESH cognitive impairment
disease MESH aphasia
disease MESH apraxia
drug DRUGBANK Methionine
disease MESH Friedreich ataxia
disease MESH Spinocerebellar ataxia
pathway KEGG Spinocerebellar ataxia
disease MESH Cerebellar ataxia
disease MESH vestibular areflexia
disease MESH syndrome
disease MESH Multiple system Atrophy
disease MESH multiple sclerosis
drug DRUGBANK Ethanol
disease MESH drug abuse
disease MESH learning disability
disease MESH voice disorders

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