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Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion.
Respir Med. 2015 Dec; 109(12):1516-20.RM

Abstract

BACKGROUND

Ongoing contention surrounding typical demographic and clinical attributes of chronic cough (CC) and paradoxical vocal fold motion (PVFM) impedes timely diagnosis and optimum patient care. Designed to reduce preventable patient morbidity through improved recognition and differentiation, the current study aimed to determine representative clinical profiles for CC and PVFM, with identification of distinctive attributes from the general population and risk factors associated with each diagnosis.

METHODS

Self-reported medical questionnaires, demographic and lifestyle attributes of CC and PVFM cases from a disease-specific outcomes database were compared to US population data and published normative values. Univariate comparison and multivariate regression modelling of age, sex, alcohol intake, smoking, Reflux Symptom Index (RSI), Voice Handicap Index (VHI), and Generalized Anxiety Disorder 7-item Scale (GAD-7) determined distinguishing features between the clinical groups, including odds ratios for presenting with CC versus PVFM.

RESULTS

Clinical profiles developed from 283 (128 CC, 155 PVFM) adults (18-91 years) were significantly different from the general population across each demographic, lifestyle and clinical variable (all p < .01), with the exception of obesity. Age (55.39 ± 13.54 vs 45.07 ± 16.51 years, p < .01) and mean RSI score (21.5 ± 9.02 vs 18.1 ± 9.08, p < .01) most reliably distinguished CC from PVFM, with those aged 60-69 years (OR = 9.45) most likely to be diagnosed with CC.

CONCLUSIONS

Standard clinical profiles of CC and PVFM are distinct from the general population, aiding determination of relative probabilities and risk factors in the differential diagnostic process. Variations between CC and PVFM were subtle, reliably distinguished by age and relative severity of laryngopharyngeal reflux symptomatology.

Authors+Show Affiliations

Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, United States.Emory Voice Center, Department of Otolaryngology, Emory University, Atlanta, GA, United States.Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, United States.Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, United States. Electronic address: thibeault@surgery.wisc.edu.

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26507903

Citation

Hartley, Naomi A., et al. "Comparative Analysis of Clinical Profile: Chronic Cough Vs Paradoxical Vocal Fold Motion." Respiratory Medicine, vol. 109, no. 12, 2015, pp. 1516-20.
Hartley NA, Petty BE, Johnson B, et al. Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion. Respir Med. 2015;109(12):1516-20.
Hartley, N. A., Petty, B. E., Johnson, B., & Thibeault, S. L. (2015). Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion. Respiratory Medicine, 109(12), 1516-20. https://doi.org/10.1016/j.rmed.2015.10.007
Hartley NA, et al. Comparative Analysis of Clinical Profile: Chronic Cough Vs Paradoxical Vocal Fold Motion. Respir Med. 2015;109(12):1516-20. PubMed PMID: 26507903.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion. AU - Hartley,Naomi A, AU - Petty,Brian E, AU - Johnson,Bethany, AU - Thibeault,Susan L, Y1 - 2015/10/22/ PY - 2015/07/04/received PY - 2015/10/06/revised PY - 2015/10/10/accepted PY - 2015/10/29/entrez PY - 2015/10/29/pubmed PY - 2016/9/20/medline KW - Cough KW - Epidemiology KW - Larynx KW - PVFM SP - 1516 EP - 20 JF - Respiratory medicine JO - Respir Med VL - 109 IS - 12 N2 - BACKGROUND: Ongoing contention surrounding typical demographic and clinical attributes of chronic cough (CC) and paradoxical vocal fold motion (PVFM) impedes timely diagnosis and optimum patient care. Designed to reduce preventable patient morbidity through improved recognition and differentiation, the current study aimed to determine representative clinical profiles for CC and PVFM, with identification of distinctive attributes from the general population and risk factors associated with each diagnosis. METHODS: Self-reported medical questionnaires, demographic and lifestyle attributes of CC and PVFM cases from a disease-specific outcomes database were compared to US population data and published normative values. Univariate comparison and multivariate regression modelling of age, sex, alcohol intake, smoking, Reflux Symptom Index (RSI), Voice Handicap Index (VHI), and Generalized Anxiety Disorder 7-item Scale (GAD-7) determined distinguishing features between the clinical groups, including odds ratios for presenting with CC versus PVFM. RESULTS: Clinical profiles developed from 283 (128 CC, 155 PVFM) adults (18-91 years) were significantly different from the general population across each demographic, lifestyle and clinical variable (all p < .01), with the exception of obesity. Age (55.39 ± 13.54 vs 45.07 ± 16.51 years, p < .01) and mean RSI score (21.5 ± 9.02 vs 18.1 ± 9.08, p < .01) most reliably distinguished CC from PVFM, with those aged 60-69 years (OR = 9.45) most likely to be diagnosed with CC. CONCLUSIONS: Standard clinical profiles of CC and PVFM are distinct from the general population, aiding determination of relative probabilities and risk factors in the differential diagnostic process. Variations between CC and PVFM were subtle, reliably distinguished by age and relative severity of laryngopharyngeal reflux symptomatology. SN - 1532-3064 UR - https://www.unboundmedicine.com/medline/citation/26507903/Comparative_analysis_of_clinical_profile:_Chronic_cough_vs_paradoxical_vocal_fold_motion_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0954-6111(15)30071-8 DB - PRIME DP - Unbound Medicine ER -