Clinical associations in the diagnosis of vocal cord dysfunction

Li, Rung‐chi; Singh, Umesh; Windom, Hugh Porter; Gorman, Stephen; Bernstein, Jonathan A.

doi:10.1016/j.anai.2016.08.002

Cited by 18 publications

(14 citation statements)

References 24 publications

(23 reference statements)

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“…4 ). Diagnosis can be confirmed with visualization of abnormal vocal cord adduction on laryngoscopy or by videostroboscopy [ 22 ]. Acute management includes reassurance and supportive care until the episode resolves spontaneously.…”

Section: Extrathoracic Mimickers Of Asthmamentioning

confidence: 99%

Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy

Gherasim

Dao

Bernstein

2018

World Allergy Organization Journal

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Asthma can often be challenging to diagnose especially when patients present with atypical symptoms. Therefore, it is important to have a broad differential diagnosis for asthma to ensure that other conditions are not missed. Clinicians must maintain a high index of suspicion for asthma mimickers, especially when patients fail to respond to conventional therapy. The purpose of this review is to briefly review some of the more common causes of asthma mimickers that clinicians should consider when the diagnosis of asthma is unclear.

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Section: Extrathoracic Mimickers Of Asthmamentioning

confidence: 99%

Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy

Gherasim

Dao

Bernstein

2018

World Allergy Organization Journal

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“…EILO is often confused with exercise-induced bronchospasm (EIB), which requires a fall in FEV1 ≥ 10% and > 200 ml from baseline during an exercise challenge test [ 18 ]. These two conditions rarely co-exist [ 19 ] and have distinct clinical features [ 20 ] (Table 2 ).…”

Section: Conundrums Associated With Diagnosing Adolescent Asthmamentioning

confidence: 99%

Keeping Pace with Adolescent Asthma: A Practical Approach to Optimizing Care

et al. 2021

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“…However, it is not always possible to visualize episodes, which further complicates the diagnosis 9 . Therefore, most PVFM diagnoses are diagnoses of exclusion based on history 8 and nonspecific signs such as expiratory posterior glottal gap 10,11 and cannot be definitively confirmed 12 . Lack of understanding of PVFM among clinicians leads to higher healthcare utilization and associated costs.…”

Section: Introductionmentioning

confidence: 99%

Economic Burden Associated With Management of Paradoxical Vocal Fold Motion Disorder

2021

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Objectives Paradoxical vocal fold movement (PVFM) is often misdiagnosed as asthma and tends to have a prolonged time to diagnosis. Study aims were to estimate the time from dyspnea onset to PVFM diagnosis, to estimate associated pre‐ and postdiagnosis direct and indirect healthcare cost, and to compare the cost of postdiagnosis care among patients who did and did not undergo standard‐of‐care speech therapy. Methods Patients diagnosed with PVFM were identified retrospectively. Time from dyspnea symptom onset to diagnosis was measured. Direct costs consisting of office visits, procedures, and prescribed pharmaceuticals before and after diagnosis were calculated. Indirect costs associated with lost wages related to healthcare were also estimated. Costs for patients who initiated versus did not initiate speech therapy and who had successful versus unsuccessful therapy were compared. Results Among 110 patients, median time from dyspnea onset to PVFM diagnosis was 33 months (interquartile range [IQR] 5–60). Direct and indirect prediagnosis median costs were $8,625 (IQR $1,687–$35,812) and $736 (IQR $421–$1,579) while first year following dyspnea symptom onset median direct and indirect costs were $1,706 (IQR $427–$7,118) and $315 (IQR $131–$631). Median direct and indirect costs of care in the postdiagnosis year were $2,062 (IQR $760–$11,496) and $841 (IQR $631–$1,261). Pharmaceuticals were predominant cost drivers in all time periods. Of those who completed speech therapy, 85% had breathing symptom improvement while incurring significant cost savings compared to those whose symptoms persisted. Conclusion Costs of care leading to diagnosis of PVFM are substantial. More efficient methods of identifying patients with PVFM are essential to reduce prolonged time to diagnosis and associated costs. Level of Evidence NA Laryngoscope, 132:142–147, 2022

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Clinical associations in the diagnosis of vocal cord dysfunction

Cited by 18 publications

References 24 publications

Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy

Confounders of severe asthma: diagnoses to consider when asthma symptoms persist despite optimal therapy

Keeping Pace with Adolescent Asthma: A Practical Approach to Optimizing Care

Economic Burden Associated With Management of Paradoxical Vocal Fold Motion Disorder

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