Economic Burden of Induced Laryngeal Obstruction in Adolescents and Children.
induced laryngeal obstruction
paradoxical vocal fold movement
vocal cord dysfunction
Journal
The Laryngoscope
ISSN: 1531-4995
Titre abrégé: Laryngoscope
Pays: United States
ID NLM: 8607378
Informations de publication
Date de publication:
17 Jan 2024
17 Jan 2024
Historique:
revised:
13
11
2023
received:
22
09
2023
accepted:
03
01
2024
medline:
17
1
2024
pubmed:
17
1
2024
entrez:
17
1
2024
Statut:
aheadofprint
Résumé
Diagnosing pediatric induced laryngeal obstruction (ILO) requires equipment typically available in specialist settings, and patients often see multiple providers before a diagnosis is determined. This study examined the financial burden associated with the diagnosis and treatment of ILO in pediatric patients with reference to socioeconomic disadvantage. Adolescents and children (<18 years of age) diagnosed with ILO were identified through the University of Madison Voice and Swallow Outcomes Database. Procedures, office visits, and prescribed medications were collected from the electronic medical record. Expenditures were calculated for two time periods (1) pre-diagnosis (first dyspnea-related visit to diagnosis), and (2) the first year following diagnosis. The Area Deprivation Index (ADI) was used to estimate patient socioeconomic status to determine if costs differed with neighborhood-level disadvantage. A total of 113 patients met inclusion criteria (13.9 years, 79% female). Total pre-diagnosis costs of ILO averaged $6486.93 (SD = $6604.14, median = $3845.66) and post-diagnosis costs averaged $2067.69 (SD = $2322.78; median = $1384.12). Patients underwent a mean of 3.01 (SD = 1.9; median = 2) procedures and 5.8 (SD = 4.7; median = 5) office visits prior to diagnosis. Pharmaceutical, procedure/office visit, and indirect costs significantly decreased following diagnosis. Patients living in neighborhoods with greater socioeconomic disadvantage underwent fewer procedures and were prescribed more medication than those from more affluent areas. However, total expenditures did not differ based on ADI. Pediatric ILO is associated with considerable financial costs. The source of these costs, however, differed according to socioeconomic advantage. Future work should determine how ILO diagnosis and management can be more efficient and equitable across all patients. Laryngoscope, 2024.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NIH HHS
ID : T32-DC009401
Pays : United States
Informations de copyright
© 2024 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.
Références
Patel RR, Venediktov R, Schooling T, Wang B. Evidence-based systematic review: effects of speech-language pathology treatment for individuals with paradoxical vocal fold motion. Am J Speech Lang Pathol. 2015;24(3):566-584. https://doi.org/10.1044/2015_AJSLP-14-0120.
Clemm HH, Olin JT, McIntosh C, et al. Exercise-induced laryngeal obstruction (EILO) in athletes: a narrative review by a subgroup of the IOC consensus on ‘acute respiratory illness in the athlete’. Br J Sports Med. 2022;56(11):622-629. https://doi.org/10.1136/bjsports-2021-104704.
Franca MC. Differential diagnosis in paradoxical vocal fold movement (PVFM): an interdisciplinary task. Int J Pediatr Otorhinolaryngol. 2014;78(12):2169-2173. https://doi.org/10.1016/j.ijporl.2014.10.003.
Sandage MJ, Milstein CF, Nauman E. Inducible laryngeal obstruction differential diagnosis in adolescents and adults: a tutorial. Am J Speech-Language Pathol. 2022;32(1):1-17. https://doi.org/10.1044/2022_AJSLP-22-00187.
Fujiki RB, Olson-Greb B, Thibeault SL. Clinical profiles of children and adolescents with induced laryngeal obstruction (ILO) and exercise induced laryngeal obstruction (EILO). Ann Otol Rhinol Laryngol. 2024;133(2):00034894231190842. https://doi.org/10.1177/00034894231190842.
Halvorsen T, Walsted ES, Bucca C, et al. Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement. Eur Respir J. 2017;50(3):1602221. https://doi.org/10.1183/13993003.02221-2016.
Christensen PM, Heimdal JH, Christopher KL, et al. ERS/ELS/ACCP 2013 international consensus conference nomenclature on inducible laryngeal obstructions. Eur Respir Rev. 2015;24(137):445-450. https://doi.org/10.1183/16000617.00006513.
Al-Alwan A, Kaminsky D. Vocal cord dysfunction in athletes: clinical presentation and review of the literature. Phys Sportsmed. 2012;40(2):22-27. https://doi.org/10.3810/psm.2012.05.1961.
Altman KW, Mirza N, Ruiz C, Sataloff RT. Paradoxical vocal fold motion: presentation and treatment options. J Voice. 2000;14(1):99-103. https://doi.org/10.1016/S0892-1997(00)80099-5.
Chiang T, Marcinow AM, de Silva BW, Ence BN, Lindsey SE, Forrest LA. Exercise-induced paradoxical vocal fold motion disorder. Laryngoscope. 2013;123(3):727-731. https://doi.org/10.1002/lary.23654.
Deckert J, Deckert L. Vocal cord dysfunction. AFP. 2010;81(2):156-159. Accessed July 13, 2021. https://www.aafp.org/afp/2010/0115/p156.html.
Hseu A, Sandler M, Ericson D, Ayele N, Kawai K, Nuss R. Paradoxical vocal fold motion in children presenting with exercise induced dyspnea. Int J Pediatr Otorhinolaryngol. 2016;90:165-169. https://doi.org/10.1016/j.ijporl.2016.09.007.
Vance D, Heyd C, Pier M, Alnouri G, Sataloff RT. Paradoxical vocal fold movement: a retrospective analysis. J Voice. 2021;35(6):927-929. https://doi.org/10.1016/j.jvoice.2020.04.007.
Yi JS, Davis AC, Pietsch K, et al. Demographic differences in clinical presentation of pediatric paradoxical vocal fold motion (PVFM). J Voice. 2021. https://doi.org/10.1016/j.jvoice.2021.08.017.
Fujiki RB, Fujiki AE, Thibeault SL. Factors impacting therapy duration in children and adolescents with paradoxical vocal fold movement (PVFM). Int J Pediatr Otorhinolaryngol. 2022;158:111182. https://doi.org/10.1016/j.ijporl.2022.111182.
Walsted ES, Famokunwa B, Andersen L, et al. Characteristics and impact of exercise-induced laryngeal obstruction: an international perspective. ERJ Open Res. 2021;7(2). https://doi.org/10.1183/23120541.00195-2021.
Liyanagedera S, McLeod R, Elhassan HA. Exercise induced laryngeal obstruction: a review of diagnosis and management. Eur Arch Otorhinolaryngol. 2017;274(4):1781-1789. https://doi.org/10.1007/s00405-016-4338-1.
Shay EO, Sayad E, Milstein CF. Exercise-induced laryngeal obstruction (EILO) in children and young adults: from referral to diagnosis. Laryngoscope. 2020;130(6):E400-E406. https://doi.org/10.1002/lary.28276.
Johansson H, Norlander K, Berglund L, et al. Prevalence of exercise-induced bronchoconstriction and exercise-induced laryngeal obstruction in a general adolescent population. Thorax. 2015;70(1):57-63. https://doi.org/10.1136/thoraxjnl-2014-205738.
Christensen PM, Thomsen SF, Rasmussen N, Backer V. Exercise-induced laryngeal obstructions: prevalence and symptoms in the general public. Eur Arch Otorhinolaryngol. 2011;268(9):1313-1319. https://doi.org/10.1007/s00405-011-1612-0.
Ersson K, Mallmin E, Malinovschi A, Norlander K, Johansson H, Nordang L. Prevalence of exercise-induced bronchoconstriction and laryngeal obstruction in adolescent athletes. Pediatr Pulmonol. 2020;55(12):3509-3516. https://doi.org/10.1002/ppul.25104.
Kenn K, Hess MM. Vocal cord dysfunction. Dtsch Arztebl Int. 2008;105(41):699-704. https://doi.org/10.3238/arztebl.2008.0699.
Lunga T, Thibeault SL, Francis DO. Economic burden associated with management of paradoxical vocal fold motion disorder. Laryngoscope. 2022;132(1):142-147. https://doi.org/10.1002/lary.29754.
Cohen SM, Bellucci E. Healthcare utilization among patients with vocal cord dysfunction. Nurs Forum. 2011;46(3):177-185. https://doi.org/10.1111/j.1744-6198.2011.00224.x.
Bahrainwala AH, Simon MR. Wheezing and vocal cord dysfunction mimicking asthma. Curr Opin Pulm Med. 2001;7(1):8-13.
Benninger C, Parsons JP, Mastronarde JG. Vocal cord dysfunction and asthma. Curr Opin Pulm Med. 2011;17(1):45-49. https://doi.org/10.1097/MCP.0b013e32834130ee.
Bisdorff B, Kenn K, Nowak D, et al. Asthma and vocal cord dysfunction related symptoms in the general population-a pilot study. Ann Allergy Asthma Immunol. 2014;113(5):576-577. https://doi.org/10.1016/j.anai.2014.08.009.
Fretzayas A, Moustaki M, Loukou I, Douros K. Differentiating vocal cord dysfunction from asthma. J Asthma Allergy. 2017;10:277-283. https://doi.org/10.2147/JAA.S146007.
Yelken K, Yilmaz A, Guven M, Eyibilen A, Aladag I. Paradoxical vocal fold motion dysfunction in asthma patients. Respirology. 2009;14(5):729-733. https://doi.org/10.1111/j.1440-1843.2009.01568.x.
Jansrud Hammer I, Halvorsen T, Vollsaeter M, et al. Conundrums in the breathless athlete; exercise-induced laryngeal obstruction or asthma? Scand J Med Sci Sports. 2022;32(6):1041-1049. https://doi.org/10.1111/sms.14137.
Lee JH, An J, Won HK, et al. Prevalence and impact of comorbid laryngeal dysfunction in asthma: a systematic review and meta-analysis. J Allergy Clin Immunol. 2020;145(4):1165-1173. https://doi.org/10.1016/j.jaci.2019.12.906.
Leong P, Gibson PG, Vertigan AE, Hew M, McDonald VM, Bardin PG. Vocal cord dysfunction/inducible laryngeal obstruction-2022 Melbourne Roundtable Report. Respirology. 2023;28:615-626. https://doi.org/10.1111/resp.14518.
Olin JT, Deardorff EH, Fan EM, et al. Therapeutic laryngoscopy during exercise: a novel non-surgical therapy for refractory EILO. Pediatr Pulmonol. 2017;52(6):813-819. https://doi.org/10.1002/ppul.23634.
Hu J, Kind AJH, Nerenz D. Area deprivation index predicts readmission risk at an urban teaching hospital. Am J Med Qual. 2018;33(5):493-501. https://doi.org/10.1177/1062860617753063.
Mahoney J, Hew M, Vertigan A, Oates J. Treatment effectiveness for vocal cord dysfunction in adults and adolescents: a systematic review. Clin Exp Allergy. 2022;52(3):387-404. https://doi.org/10.1111/cea.14036.
Gallena SK, Johnson AT, Vossoughi J. Short-term intensive therapy and outcomes for athletes with paradoxical vocal fold motion disorder. Am J Speech Lang Pathol. 2019;28(1):83-95. https://doi.org/10.1044/2018_AJSLP-17-0223.
Slinger C, Vyas A, Slinger RJ, Blakemore J. Can patient factors predict response to speech and language therapy for inducible laryngeal obstruction? Thorax. 2018;73(Suppl 4):A178. https://doi.org/10.1136/thorax-2018-212555.298.
Drake K, Palmer AD, Schindler JS, Tilles SA. Functional outcomes after behavioral treatment of paradoxical vocal fold motion in adults. Folia Phoniatr Logop. 2017;69(4):154-168. https://doi.org/10.1159/000484716.
Maturo S, Hill C, Bunting G, et al. Pediatric paradoxical vocal-fold motion: presentation and natural history. Pediatrics. 2011;128(6):e1443-e1449. https://doi.org/10.1542/peds.2011-1003.
Nacci A, Fattori B, Segnini G, et al. Respiratory retraining therapy in long-term treatment of paradoxical vocal fold dysfunction. Folia Phoniatr Logop. 2011;63(3):134-141. https://doi.org/10.1159/000316405.
Schonman I, Mudd PA, Wiet GJ, et al. Multi-institutional study of patient-reported outcomes of paradoxical vocal fold motion. Laryngoscope. 2022;133:970-976. https://doi.org/10.1002/lary.30256.
Doshi DR, Weinberger MM. Long-term outcome of vocal cord dysfunction. Ann Allergy Asthma Immunol. 2006;96(6):794-799. https://doi.org/10.1016/S1081-1206(10)61341-5.
Sullivan MD, Heywood BM, Beukelman DR. A treatment for vocal cord dysfunction in female athletes: an outcome study. Laryngoscope. 2001;111(10):1751-1755. https://doi.org/10.1097/00005537-200110000-00016.
Ivancic R, Matrka L, Wiet G, Puckett A, Haney J, de Silva B. Reduced asthma medication use after treatment of pediatric paradoxical vocal fold motion disorder. Laryngoscope. 2021;131(7):1639-1646. https://doi.org/10.1002/lary.29283.
Smith AF, Waycaster C. Estimate of the direct and indirect annual cost of bacterial conjunctivitis in the United States. BMC Ophthalmol. 2009;9(1):13. https://doi.org/10.1186/1471-2415-9-13.
Kind AJH, Buckingham WR. Making neighborhood-disadvantage metrics accessible-the neighborhood atlas. N Engl J Med. 2018;378(26):2456-2458. https://doi.org/10.1056/NEJMp1802313.
Kind AJH, Jencks S, Brock J, et al. Neighborhood socioeconomic disadvantage and 30-day rehospitalization: a retrospective cohort study. Ann Intern Med. 2014;161(11):765-774. https://doi.org/10.7326/M13-2946.
Thompson SG, Barber JA. How should cost data in pragmatic randomised trials be analysed? Br Med J. 2000;320(7243):1197-1200. https://doi.org/10.1136/bmj.320.7243.1197.
Schielzeth H, Dingemanse NJ, Nakagawa S, et al. Robustness of linear mixed-effects models to violations of distributional assumptions. Methods Ecol Evol. 2020;11(9):1141-1152. https://doi.org/10.1111/2041-210X.13434.
Mirasola KL, Braun N, Blumin JH, Kerschner JE, Merati AL. Self-reported voice-related quality of life in adolescents with paradoxical vocal fold dysfunction. J Voice. 2008;22(3):373-378. https://doi.org/10.1016/j.jvoice.2006.11.003.
Fujiki RB, Johnson R, Fujiki AE, Thibeault SL. The effects of exercise induced laryngeal obstruction (EILO) in adolescents: a qualitative study. Am J Speech-Language Pathol. Submitted.
Fujiki RB, Olson-Greb B, Braden M, Thibeault SL. Therapy outcomes for teenage athletes with exercise-induced laryngeal obstruction. Am J Speech Lang Pathol. 2023;32(4):1517-1531. https://doi.org/10.1044/2023_AJSLP-22-00359.
Benestad MR, Drageset J, Clemm H, et al. Self-reported health in adolescents with exercise-induced laryngeal obstruction; a cross-sectional study. Front Pediatr. 2021;9:617759. https://doi.org/10.3389/fped.2021.617759.
Reitz JR, Gorman S, Kegyes J. Behavioral management of paradoxical vocal fold motion. Perspect Voice Voice Disord. 2014;24(2):64-70. https://doi.org/10.1044/vvd24.2.64.
Shaffer M, Litts JK, Nauman E, Haines J. Speech-language pathology as a primary treatment for exercise-induced laryngeal obstruction. Immunol Allergy Clin. 2018;38(2):293-302. https://doi.org/10.1016/j.iac.2018.01.003.
Fujiki RB, Fujiki AE, Thibeault SL. Examining therapy duration in adults with induced laryngeal obstruction (ILO). Am J Otolaryngol. 2024;45(1):104094. https://doi.org/10.1016/j.amjoto.2023.104094.
Traister RS, Fajt ML, Petrov AA. The morbidity and cost of vocal cord dysfunction misdiagnosed as asthma. Allergy Asthma Proc. 2016;37(2):25-31. https://doi.org/10.2500/aap.2016.37.3936.