Development and Preliminary Validation of a Modified Thyroid Symptom Questionnaire ( TSQ )

BACKGROUND: This study aimed to modify and validate the Thyroidectomy Voice and Symptom Questionnaire (TVSQ) to serve as a symptom screening tool in benign thyroid disease. METHODS: A 32-item modified TVSQ was developed and administered alongside a symptom checklist to outpatients; controls were recruited to determine discriminative validity. Reliability analysis guided item reduction, and principal components analysis (PCA) evaluated subscales. RESULTS: The 102 thyroid patients and 100 controls were recruited. Symptom prevalence was higher when using the questionnaire than the checklist (dyspnoea 58% vs. 24%; dysphonia 42% vs. 30%). Item reduction produced a 20-item instrument termed the "Thyroid Symptom Questionnaire" (TSQ). PCA supported two subscales: "voice change" and "throat and neck discomfort". The TSQ demonstrated excellent internal consistency and higher scores in thyroid patients (p < 0.001). CONCLUSIONS: The TSQ demonstrated feasibility and discriminative validity in the assessment of benign thyroid disease symptoms, extending the use of the TVSQ beyond its post-surgical focus.