Patient‐Reported Outcome Measures Related to Laryngopharyngeal Reflux

Francis, David O.; Patel, Dhyanesh A.; Sharda, Rohit; Hovis, Kristen L.; Sathe, Nila A; Penson, David F.; Feurer, Irene D.; McPheeters, Melissa L; Vaezi, Michael F.

doi:10.1177/0194599816664330

Cited by 55 publications

(27 citation statements)

References 47 publications

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“…Otolaryngology, which tends to see a large percentage of quality-of-life complaints particularly suited to patient-centric assessment, has likewise had an explosion of PROMs across many different subspecialties and topics, including voice. 8,9,[25][26][27][28][29][30][31][32][33][34] The intention of these patient-centric measures is to capture the patient experience; however, the implementation of these measures remains burdensome for most otolaryngologists and patients. Therefore, considerations prior to using PROMs should include logistical concerns (eg, how to comprehensively capture, record, and store data;…”

Section: Resultsmentioning

confidence: 99%

A visual analog scale for patient‐reported voice outcomes: The VAS voice

Naunheim

Dai

Rubinstein

et al. 2019

Laryngoscope Investig Oto

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Objectives Although patient‐reported outcome measures (PROMs) can be useful for assessing quality of life, they can be complex and cognitively burdensome. In this study, we prospectively evaluated a simple patient‐reported voice assessment measure on a visual analog scale (VAS voice) and compared it with the Voice Handicap Index (VHI‐10). Study design Prospective survey. Methods An abbreviated voice measure was designed by a team of otolaryngologists, speech pathologists, and patients that consisted of four VAS questions related to (a) a global question of voice disturbance, (b) physical function of voice, (c) functional issues, and (d) emotional handicap. All English‐speaking patients presenting to an academic laryngology clinic for a voice complaint were included. Internal consistency and validity were assessed with comparison to the VHI‐10. Results A total of 209 patients were enrolled. Ninety‐two percent of patients reported understanding the survey. The four‐item VAS survey was highly correlated with VHI‐10 score (Pearson correlation .81, P < .0001), and the Cronbach's alpha between all four VAS questions was .94. Age, gender, and diagnosis were not associated with either the global VAS or VHI‐10 tool. Conclusion Reducing the complexity of instruments assessing voice‐related quality of life is feasible, and the VAS voice correlated with existing measures. Simplified assessments may offer advantages compared to more cumbersome PROMs. Level of Evidence 2c

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Section: Resultsmentioning

confidence: 99%

A visual analog scale for patient‐reported voice outcomes: The VAS voice

Naunheim

Dai

Rubinstein

et al. 2019

Laryngoscope Investig Oto

View full text Add to dashboard Cite

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“…Similarly, many digestive complaints associated with LPR are absent, although they predominate in LPR. 30 31 32 …”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Reflux Symptom Index and the Endolaryngeal Findings Scale after Treatment in Individuals with Laryngopharyngeal Reflux

Silva

Duprat

Machado

et al. 2020

Int Arch Otorhinolaryngol

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Introduction Laryngopharyngeal reflux (LPR) is a prevalent condition in outpatients visiting the otorhinolaryngological clinic, with many controversies regarding its diagnosis and follow-up. Therefore, there is a need for clinical instruments that can diagnose individuals and monitor the results of their treatment. Objective To evaluate the applicability of the scores translated and adapted to Brazilian Portuguese: Reflux Symptom Index (RSI) and Endolaryngeal Reflux Findings Scale (ERFS), as instruments for post-treatment follow-up of LPR. Method A total of 35 individuals with atypical symptoms of gastroesophageal reflux disease and with an objective diagnosis of LPR, confirmed by high digestive endoscopy and 24-hour esophageal pH-metry dual probe test were submitted to the RSI and ERFS questionnaires, used in the pre- and post-treatment of 90 days with a Proton Pump Inhibitor. Result The evaluation of RSI and ERFS in the pre- and post-treatment showed a reduction in the results of the two scores, with a higher drop in the RSI (p < 0.001) than in the ERFS (p = 0.014). Although there was an improvement in the values in 23.9% of the individuals in the ERFS, there was no change in the category (p = 0.057), different from the RSI (p < 0.001), where there was a 67.4% improvement in values, as well as change in category (score went from positive to negative). There was a correlation between RSI and ERFS, moderate in the pretreatment and strong in the post-treatment. Conclusion The RSI and ERFS scores, when translated and adapted for Brazilian Portuguese and applied simultaneously, can be considered a good tool for post-treatment LPR follow-up.

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“…However, significant short-comings of the RSI include insufficient development rigor, poor specificity for LPR symptoms, and lack of content validity. 12 As a result, overreliance on the RSI likely contributes to the overdiagnosis of LPRD. This may be one possible explanation for poor outcomes in meta-analyses of randomized controlled trials of PPI therapy, in that many patients thought to have LPRD and treated with PPI therapy do not actually have LPRD.…”

Section: Discussionmentioning

confidence: 99%

Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints

et al. 2018

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Objectives/Hypothesis: Patients with muscle tension dysphonia often demonstrate an elevation in Reflux Symptom Index (RSI) and 10-item Voice Handicap Index (VHI-10) scores, and may be erroneously diagnosed with laryngopharyngeal reflux disease. In this study we assessed the effects of voice therapy on RSI and VHI-10 scores in patients with voice complaints not responsive to antireflux medications. Study Design: Retrospective cohort study. Methods: A study of patients was conducted at a single tertiary-care center over 1 year (January 2012–January 2013). Patients were included if they had dysphonia not responsive to proton pump inhibition, did not have neurologic or neoplastic disease, and participated in at least three voice-therapy sessions in the absence of antireflux therapy. Primary analysis assessed change in RSI scores between the initial and follow-up visits with a laryngologist. Results: A total of 18 patients were included (mean age = 49.9 ± 14.5 years, 89% female, 83% with a primary complaint of dysphonia). From initial to follow-up visit, the median RSI score (18.5 [interquartile range {IQR}, 9.5–22.8] vs. 10.5 [IQR, 4.5–14]; P = .02) and median VHI-10 score (25.5 [IQR, 11.3–30.0] vs. 13.5 [IQR, 9.5–20.8]; P = .03) significantly decreased. A significant inverse correlation was found between the number of voice therapy sessions/month and change in RSI score (r = −0.4; P = .05). Conclusions: In this study of patients with muscle tension dysphonia or vocal hyperfunction not responsive to antireflux therapy, RSI and VHI-10 scores improved following voice therapy. Results suggest that self-reported symptoms typically attributed to laryngopharyngeal reflux disease may actually be secondary to inefficient voice use patterns or anxiety about dysphonia that are responsive to voice therapy.

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Patient‐Reported Outcome Measures Related to Laryngopharyngeal Reflux

Cited by 55 publications

References 47 publications

A visual analog scale for patient‐reported voice outcomes: The VAS voice

A visual analog scale for patient‐reported voice outcomes: The VAS voice

Evaluation of the Reflux Symptom Index and the Endolaryngeal Findings Scale after Treatment in Individuals with Laryngopharyngeal Reflux

Voice therapy associated with a decrease in the reflux symptoms index in patients with voice complaints

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