Seth M Cohen1, Jaewhan Kim2, Nelson Roy3, Amber Wilk4, Steven Thomas4, Mark Courey5. 1. Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina. 2. Division of Public Health and Study Design and Biostatistics Center, University of Utah, Salt Lake City, Utah. 3. Department of Communication Sciences and Disorders, Division of Otolaryngology-Head & Neck Surgery, University of Utah, Salt Lake City, Utah. 4. Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina. 5. Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California, U.S.A.
Abstract
OBJECTIVE: We evaluated the association between specialty voice evaluation and changes in laryngeal diagnosis and treatment in patients with laryngeal/voice disorders. STUDY DESIGN: Retrospective analysis of a large, national administrative U.S. claims database. METHODS: Patients included were identified with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification codes, from January 1, 2004, to December 31, 2008, and had been seen by an otolaryngologist as an outpatient and had a specialty voice evaluation designated by videolaryngostroboscopy (VLS) within 90 days of the last laryngoscopy. Patient diagnosis at the last laryngoscopy visit and the subsequent initial VLS visit were collected. Specific treatment modalities were tabulated for the 30-day period after the last laryngoscopy and for 30 days after the VLS. RESULTS: A total of 168,444 unique patients saw an otolaryngologist for 273,616 outpatient visits. Of those, 6.1% had a VLS performed, of which 4,000 (23.8%) occurred within 90 days of the last laryngoscopy, with a median interval of 30 days (interquartile range 15-50 days). Half of the patient visits had a change in laryngeal diagnosis. Changes in use of antibiotics, proton pump inhibitors, voice therapy, and surgical intervention were seen after specialty voice evaluation. CONCLUSIONS: Specialty voice evaluation was associated with changes in laryngeal diagnosis and treatment. Further study is needed to assess the impact on health care costs and patient outcomes.
OBJECTIVE: We evaluated the association between specialty voice evaluation and changes in laryngeal diagnosis and treatment in patients with laryngeal/voice disorders. STUDY DESIGN: Retrospective analysis of a large, national administrative U.S. claims database. METHODS:Patients included were identified with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification codes, from January 1, 2004, to December 31, 2008, and had been seen by an otolaryngologist as an outpatient and had a specialty voice evaluation designated by videolaryngostroboscopy (VLS) within 90 days of the last laryngoscopy. Patient diagnosis at the last laryngoscopy visit and the subsequent initial VLS visit were collected. Specific treatment modalities were tabulated for the 30-day period after the last laryngoscopy and for 30 days after the VLS. RESULTS: A total of 168,444 unique patients saw an otolaryngologist for 273,616 outpatient visits. Of those, 6.1% had a VLS performed, of which 4,000 (23.8%) occurred within 90 days of the last laryngoscopy, with a median interval of 30 days (interquartile range 15-50 days). Half of the patient visits had a change in laryngeal diagnosis. Changes in use of antibiotics, proton pump inhibitors, voice therapy, and surgical intervention were seen after specialty voice evaluation. CONCLUSIONS: Specialty voice evaluation was associated with changes in laryngeal diagnosis and treatment. Further study is needed to assess the impact on health care costs and patient outcomes.
Authors: Sonali Ramesh; Brennan Ayres; Patrick Ten Eyck; Jeffrey D Dawson; Heather Schacht Reisinger; Hardeep Singh; Loreen A Herwaldt; Christina L Cifra Journal: Diagnosis (Berl) Date: 2022-04-11