No abstract

Objective. During ambulatory 24-hour dual pH probe monitoring for suspected extraesophageal reflux (EER), patients are responsible for indicating relevant study events. Study interpretation relies on patient accuracy and compliance to test instructions. This study sought to explore patient compliance during pH probe monitoring and evaluated the utility of a Post-Evaluation Questionnaire as a clinical tool. Participants and Methods. Participants were prospectively studied during 24-hour dual pH probe monitoring. Participants used both a food diary and monitor settings to indicate relevant study events. Following pH testing, participants completed a Post-Evaluation Questionnaire regarding test experiences. Results. Eighty-two participants completed the study. Means and standard deviations were calculated for individual responses on the Post-Evaluation Questionnaire. Means indicate high participant accuracy for study events, and adherence to typical activities and diet over the testing period. Factor analysis was performed on the Post-Evaluation Questionnaire items and identified two factors: "typical experiences" and "times forgot." Cronbach's alpha demonstrated acceptable reliability levels for questions related to "typical experiences," but poor reliability for "times forgot" questions. Conclusions. Assessment of participant compliance during pH probe testing can quickly and easily be completed through a Post-Evaluation Questionnaire. Participant compliance can be assessed for improved study interpretation.

The current recommendation for any professional voice user is to drink at least 64 oz of water per day, but the optimal amount is unknown and frequently more is recommended. Body response to fluid adjustment is not well defined. Bioelectrical impedance analysis (BIA) was used to measure body water changes of in young adults (15 males, 21 females) studying acting and communication sciences and disorders at a university. Half had habitually good hydration and half were poorly hydrated. A counter-balanced design was used for two 3-day periods of normal and over-hydration conditions, separated by 1 week. The time of the menstrual cycle was controlled for in one group of females. Participants drank 64 oz of water/day for normal hydration and 112 oz for over-hydration. BIA measurements of total body weight, total body water, and electrical impedance were collected during the first and third day of each hydration condition, and participants provided self-ratings of perceived hydration levels. Manipulating water intake did not change overall total body water levels. Results revealed no significant gains in total body water during the over-hydration condition, even among participants with poor baseline hydration. The homeostatic level may have been influenced by habitual hydration and require more time to change. Participants were inaccurate in their self-assessments of body water levels.

Extraesophageal reflux can be a significant yet elusive issue in the diagnosis and treatment of voice, swallowing, and airway disorders. This paper explores the role of patient compliance during 24-hour dual pH probe monitoring as a confounding factor in the poor agreement amongst current clinical tools. Supporting data from a recent research study are provided.