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Demirci AN, İncebay Ö, Köse A. Readability of Patient-Reported Outcome Measures Used in Voice Disorders. J Voice 2024:S0892-1997(24)00305-9. [PMID: 39448277 DOI: 10.1016/j.jvoice.2024.09.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2024] [Revised: 09/10/2024] [Accepted: 09/10/2024] [Indexed: 10/26/2024]
Abstract
OBJECTIVES This study aims to evaluate Turkish patient-reported outcome measures (PROM) used in voice disorders using different readability formulas and to examine the relationship between text-based features and readability values. STUDY DESIGN A search was conducted to identify published Turkish PRO questionnaires related to dysphonia that are completed by patients. METHODS A search was conducted to identify published PROM related to dysphonia that are completed by patients in a self-administered format. Reading grade levels were analyzed for voice-related PROM using the Ateşman readability and the Bezirci-Yılmaz new readability formulas as computed by a readability calculations software package. Text-based quantitative features are obtained. Descriptive statistics were also computed across the questionnaires. RESULTS A total of 14 PROMs were found. In the analysis, the mean of the Ateşman readability values of the PROM was calculated as 70.66 (±5.55). This value is defined as "easy," according to the Ateşman readability measures. The average Bezirci-Yılmaz new readability value is 6.03 (±1.07). This value corresponds to the sixth-grade reading level in the Turkish education system. CONCLUSIONS Results show that more than half of the PROMs in the Turkish language have the recommended reading level. PROMs allow health care professionals to objectively understand the patient's symptoms, both qualitatively and quantitatively. Therefore, it is critical that patients accurately understand and respond to these outcome measures. This is why developers should consider reading as a testable structure. Speech and language therapists should consider the reading level required to understand a specific PROM to obtain the most useful information for treatment planning and outcome assessments.
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Affiliation(s)
- Ayşe Nur Demirci
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey.
| | - Önal İncebay
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Ayşen Köse
- Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Turkey
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Hozeili E, Azimi T, Ahmadi A, Khoramshahi H, Tahmasebi N, Dastoorpoor M. Psychometric properties of the Persian version of the stuttering generalization self-measure tool in adults who stutter. JOURNAL OF FLUENCY DISORDERS 2024; 80:106056. [PMID: 38503058 DOI: 10.1016/j.jfludis.2024.106056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 01/15/2024] [Accepted: 03/08/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE Our study aimed to translate the Stuttering Generalization Self-Measure (SGSM) into Persian and investigate its validity, reliability, and internal responsiveness in the Iranian population. METHOD This study was conducted on 30 adults who stutter (AWS) and 30 adults who do not stutter (AWNS). The International Quality of Life Assessment protocol (IQOLA) was applied to translate SGSM into Persian. The face and content validity were determined. Also, the discriminant validity was evaluated by comparing the scores of two groups. In addition, the internal consistency test-retest, and inter-judge reliability were assessed with Cronbach's alpha and intra-class correlation coefficients (ICC). Moreover, the mean standardized response (MSR) and the standardized effect size were measured to determine the internal responsiveness using pre- and post-treatment data. RESULTS All the items were comprehensible and clear. The content validity ratio (CVR) and content validity index (CVI) for all nine questions were obtained higher than.62 and.9, respectively. The internal consistency value was high (Cronbach's alpha =.98). For the test-retest reliability, ICC values were excellent, ranging from.93 to.99. The discriminant validity results revealed a significant difference between AWS and AWNS (p < .001). Pre- and post-treatment results indicated high internal responsiveness to changes for percentage of syllable stuttered (SS%) (MSR = 1.09). CONCLUSION The Persian version of SGSM (P-SGSM) benefits from the high values for validity and reliability. Furthermore, it distinguishes the AWS and AWNS and reflects the treatment changes significantly.
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Affiliation(s)
- Ebtesam Hozeili
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Tabassom Azimi
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Akram Ahmadi
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Hassan Khoramshahi
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran; Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
| | - Neda Tahmasebi
- Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Chan HF, Rosen CA, Schneider SL. An investigation of the cutoff point of the English version of speech handicap index in the American total laryngectomees. LOGOP PHONIATR VOCO 2024; 49:34-40. [PMID: 35895076 DOI: 10.1080/14015439.2022.2102206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 05/24/2022] [Accepted: 07/08/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES The present article aims to identify the optimal cutoff score and the diagnostic accuracy for the English version of Speech Handicap Index (SHI) to screen out individuals with and without speech disorders in daily life. MATERIALS AND METHODS In this cross-sectional cohort study, a volunteer sample of 104 adult patients after total laryngectomy and 99 healthy controls in the United States completed the English version of SHI online questionnaire. Sensitivity and specificity were computed for a range of cut-off values using the Receiving Operating Characteristics (ROC) analysis to establish an optimal cutoff point for the SHI. Other measures of diagnostic accuracy, such as likelihood ratios (LR), positive predictive values (PPV), and negative predictive values (NPV) were also computed. RESULTS Patients after total laryngectomy obtained a higher score than the healthy controls on the mean scores of SHI. According to the ROC analysis, an optimal cutoff score of 17 points determined by Youden index was identified on the head and neck cancer population with a sensitivity of 92.31%, specificity of 92.31%, PPV of 90.60%, NPV of 91.75%, LR + of 9.14, and LR- of 0.09. CONCLUSIONS The cutoff score of the English version of SHI applied on the English-speaking population in the United States demonstrated promising diagnostic accuracy.
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Affiliation(s)
- Hiu Fung Chan
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA
| | - Clark A Rosen
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA
| | - Sarah L Schneider
- Department of Otolaryngology - Head and Neck Surgery, University of California - San Francisco, San Francisco, CA, USA
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Işık EE, Atalar MS, Alioğlu T, Sağlam T, Cangi ME. Special Education Teachers' Self-Assessed Voice Health Regarding Voice Use Habits. J Voice 2024:S0892-1997(24)00008-0. [PMID: 38395654 DOI: 10.1016/j.jvoice.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 01/17/2024] [Accepted: 01/17/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVES Special education teachers (SETs) work with students with disabilities. To get and keep these students' attention during the lesson, they may use their voices with high loudness and frequent pitch changes. These situations can be tiring for their voices and affect their vocal health. This study aimed to compare SETs' voice fatigue, reflux symptoms, and self-assessments according to their voice use habits in their work and social lives. METHODS A total of 208 SETs were included. A Teacher Voice Use Habits Questionnaire was developed by considering the literature, taking expert opinion, and conducting a pilot study. In addition, the Vocal Fatigue Index (VFI), Voice Handicap Index-30 (VHI-30), and Reflux Symptom Index (RSI) were used. One-way ANOVA, Mann-Whitney U, Kruskal Wallis-H, and Pearson correlation analyses were performed. RESULTS Of SETs, 37.5% reported frequent hoarseness, and 65.4% reported voice fatigue during/at the end of the day. Those who answered "yes" to the questions about talking loudly at home, having the television on at home, feeling stressed in the work environment, eating and drinking before going to bed at night, smoking, having frequent colds, talking loudly during the day, and voice fatigue during/at the end of the day had significantly higher scores in all scales. Those who used their voice for more than 6hours were found to have significantly higher scores on the VFI and RSI. In all scales, the scores of those who made very frequent long phone calls were significantly higher. CONCLUSION According to the SETs' reports, it was concluded that they did not comply with the rules of vocal hygiene, although they used their voices for a long time. This situation should be considered an occupational health problem in schools, and it may be helpful to screen this group's voice disorders and design preventive programs.
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Affiliation(s)
- Elif Ezgi Işık
- University of Health Sciences, Hamidiye Faculty of Health Science, Department of Speech and Language Therapy, İstanbul, Turkey
| | - Merve Sapmaz Atalar
- University of Health Sciences, Hamidiye Faculty of Health Science, Department of Speech and Language Therapy, İstanbul, Turkey; Üsküdar University, Faculty of Health Science, Department of Speech and Language Therapy, İstanbul, Turkey
| | - Tuğberk Alioğlu
- Üsküdar University, Faculty of Health Science, Department of Speech and Language Therapy, İstanbul, Turkey
| | | | - Mehmet Emrah Cangi
- University of Health Sciences, Hamidiye Faculty of Health Science, Department of Speech and Language Therapy, İstanbul, Turkey.
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Barmak E, Altan E, Yılmaz Z, Korkmaz MH, Çadallı Tatar E. Impact of the Severity of Reinke's Edema on the Parameters of Voice. Turk Arch Otorhinolaryngol 2023; 61:166-174. [PMID: 38784955 PMCID: PMC11110086 DOI: 10.4274/tao.2023.2023-8-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/11/2023] [Indexed: 05/25/2024] Open
Abstract
Objective This study aimed to classify the degree of edema in patients with Reinke's edema (RE) and examine its impact on their voice parameters using both objective and subjective assessment methods. Methods Objective and subjective voice data of 104 patients diagnosed with RE between 2018 and 2021 were evaluated retrospectively. RE is classified into 4 groups (types 1, 2, 3, and 4). The evaluation included videolaryngostroboscopic examination, acoustic voice analysis, and aerodynamic measurements, GRBAS, Voice Handicap Index-10 (VHI-10), Voice-Related Quality of Life Scale (V-RQOL), and Reflux Septum Index (RSI). Results Patients with type 1 RE had a significantly lower mean age than those with types 3-4. Although there were no significant differences in acoustic and aerodynamic parameters between the groups, it was observed that F0 and the maximum phonation time decreased as the degree of edema increased. The GRBASTotal, G, and R scores of types 1 and 2 were significantly lower than those of types 3 and 4, as were the scores of type 1 S. There were no statistically significant differences between the RE groups in terms of VHI-10, V-RQOL, and RSI scores. Conclusion It has been observed that as the severity of RE increases, voice perception and quality (especially types 3 and 4) are negatively affected. Determining the degree of edema will guide the clinician in both the planning of the intervention phase and the follow-up phase.
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Affiliation(s)
- Elife Barmak
- Department of Speech and Language Therapy, Ankara Yıldırım Beyazıt University Faculty of Health Sciences, Ankara, Turkey
| | - Esma Altan
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
| | - Zeynep Yılmaz
- Department of Audiology and Speech Disorders, Institute of Health Sciences, Ankara Yıldırım Beyazıt University, Ankara, Turkey
| | - Mehmet Hakan Korkmaz
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara Yıldırım Beyazıt University Faculty of Medicine, Ankara, Turkey
| | - Emel Çadallı Tatar
- Department of Otorhinolaryngology, University of Health Sciences Turkey, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
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Bulut F, Tetiker AT, Çelikkol A, Yılmaz A, Ballica B. Low Antioxidant Enzyme Levels and Oxidative Stress in Laryngopharyngeal Reflux (LPR) Patients. J Voice 2023; 37:924-931. [PMID: 34253427 DOI: 10.1016/j.jvoice.2021.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/11/2021] [Accepted: 05/18/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Laryngopharyngeal reflux disease (LPR) is a characterized by symptoms different from gastroesophageal reflux disease (GERD). LPR can causes chronic mucosal inflammation which may lead to an increase in cytokine production, and a systemic decrease in antioxidant enzyme levels. Our aim in this study is to evaluate antioxidant enzyme levels in patients with LPR. METHODS Reflux Symptom Index (RSI) questionnaire, extraesophageal symptom questionnaire which is included in RSI and Reflux Finding Score (RFS) evaluation with 70° rigid laryngoscope were performed to patients who applied to the otolaryngology clinic with a typical LPR complaint, and 60 patients who had an RSI score above 13 and an RFS score above 7 were included in the study. Thirty people consisting of healthy volunteers were included in the control group. Antioxidant enzyme SOD, GSH-Px and CAT levels were measured in the blood serum of the patients and compared with the control group. Results obtained from biochemical tests were expressed as mean ± SE. Descriptive statistical methods (mean ± standard error) were used for the independent t test for the control and study group. P < 0.05 was considered statistically significant. RESULTS In the LPR group, 28 (46%) were women, 32 (53%) were men, and age range was 21-60, average age was 36.45 ± 1.147.There was no significant difference between LPR and control group in terms of age, gender and Body Mass Index (BMI). In the LPR group, the lowest score for RSI was 14 and the highest score was 39. The average RSI was 23.67. RFS ranges from 8-22. The mean RFS was 13.50. A highly significant statistical correlation was observed between RSI and total RFS (P < 0.001). There was a significant difference between the antioxidant enzyme levels of the control group and the LPR group. Antioxidant enzyme levels of the control group were SOD 274.10 ± 26.836 U / L, GSH-Px 174.20 ± 20.699 µU / mL and CAT 42.2898 ± 20.699 KU / L. Antioxidant enzyme level results of the LPR group were SOD 147 ± 14.022 U / L (P < 0.01), GSH-Px 88.28 ± 9.113 µU / mL (P < 0.01) and CAT 12.67 ± 0.799 KU / L (P < 0.001). The RSI results ranges from 4 to 39 and the RFS from 8 to 22. Antioxidant enzyme levels demonstrated fairly consistent reliability with individual variables from both RFS and RFS. There was also a highly significant statistical correlation between RSI and RFS. CONCLUSION We found that the antioxidant enzymes SOD, GPX and catalase enzyme levels were significantly lower in LPR patients. Treatment modalities to reduce oxidative stress (OS) in LPR should be investigated.
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Affiliation(s)
- Fuat Bulut
- Otorhinolaryngology, Private Çorlu REYAP Hospital, Istanbul Rumeli University, Istanbul, Turkey.
| | | | - Aliye Çelikkol
- Department of Medical Biochemistry, Faculty of Medicine, Tekirdag Namık Kemal University, Tekirdag, Turkey
| | - Ahsen Yılmaz
- Department of Medical Biochemistry, Faculty of Medicine, Tekirdag Namık Kemal University, Tekirdag, Turkey
| | - Basak Ballica
- Bahcesehir University Medical Faculty, Istanbul, Turkey
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Zhang C, Liu Z, Zhang J, Wang X, Wang J, Zhao J, Li J, Liu L. Comparison of Reflux Symptom Score versus Reflux Symptom Index in screening laryngopharyngeal reflux. Laryngoscope 2023; 133:2104-2109. [PMID: 36453478 DOI: 10.1002/lary.30489] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/06/2022] [Accepted: 11/09/2022] [Indexed: 08/11/2023]
Abstract
OBJECTIVES To compare the screening value of the Reflux Symptom Score (RSS) and the Reflux Symptom Index (RSI) for laryngopharyngeal reflux (LPR). METHODS All included patients attending the Department of Otolaryngology at the Sixth Medical Center of the PLA General Hospital from February 2022 to August 2022, completed the RSS and the RSI and underwent 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH (24 h HEMII-pH) monitoring. The results of 24 h HEMII-pH were used as a diagnostic criterion for LPR, consistency between two questionnaires (RSS, RSI) and 24 h HEMII-pH was compared by the weighted Cohen's kappa statistic and the screening value of RSS and RSI for LPR was compared by receiver operating characteristics analysis. RESULTS A total of 77 patients, 58 males, and 19 females, were included. The Kappa values of between RSS, RSI, and 24 h HEMII-pH were 0.663 (p < 0.001) and 0.213 (p < 0.05), respectively. The sensitivity of RSS and RSI were 92.8% and 48.2%, respectively, the specificity was 71.4% and 80.9%. The negative predictive value and positive predictive value of RSI were 36.9%, 87.1%, and that of RSS were 78.9%, 89.6%. The area under curve of the RSS (0.783; 95% CI = 0.53, 0.75) is significantly higher than RSI (0.633; 95% CI = 0.72, 0.90). CONCLUSION The RSS has a higher consistency and better screening value for LPR compared to RSI. In addition, the RSS includes more reflux symptoms, which may reduce the number of missed diagnoses in patients with LPR to some extent. LEVEL OF EVIDENCE 3 Laryngoscope, 133:2104-2109, 2023.
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Affiliation(s)
- Chun Zhang
- Department of otolaryngology, School of Medicine, South China University of Technology, Guangzhou, China
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Zhi Liu
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Jinhong Zhang
- Department of otolaryngology, School of Medicine, South China University of Technology, Guangzhou, China
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Xiaoyu Wang
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Jiasen Wang
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Jing Zhao
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - Jinrang Li
- Department of otolaryngology, School of Medicine, South China University of Technology, Guangzhou, China
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
| | - LianLian Liu
- Department of otolaryngology, The Sixth Medical Center of PLA General Hospital of Beijing, Beijing, China
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Yildiz MG, Sagiroglu S, Bilal N, Kara I, Orhan I, Doganer A. Assessment of Subjective and Objective Voice Analysis According to Types of Sulcus Vocalis. J Voice 2023; 37:729-736. [PMID: 34112548 DOI: 10.1016/j.jvoice.2021.04.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/30/2021] [Accepted: 04/08/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Sulcus vocalis (SV) subtypes are difficult to diagnose. Non-invasive techniques are sometimes not feasible in the diagnosis. The study aims to demonstrate the effectiveness and applicability of objective and subjective voice analysis combined with videolaryngostroboscopic examination (VLS) in the diagnosis of SV types. MATERIAL AND METHODS This is a retrospective study that includes patients who presented to Phoniatric outpatient clinic with complaints related to voice and diagnosed with SV on VLS examination between 2017-2020. The SV type was determined based on VLS findings and the patients were categorized into respective groups. Between- and within-group assessment of objective and subjective voice analysis of SV types was conducted. RESULTS 47 patients were included in the study; Type I, Type II, Type III SV patients were 16, 17, and 14 in number, respectively. Fundamental frequency (F0) and Shimmer (%) values were significantly high in Type II and III SV cases, whereas the Maximum Phonation Time (MPT) was significantly low. GRBAS, Voice Handicap Index -10 (VHI-10), Reflux Symptom Index (RSI) scores were statistically significantly high in pathological SV and Voice Related Quality of Life (V-RQOL) scores were low. A moderate correlation between VHI-10 and V-RQOL and between RSI and V-RQOL was detected. CONCLUSIONS Objective and subjective voice analysis in Type II and III SV show a significant difference compared to Type I SV. The use of objective and subjective voice analysis combined with VLS examination can be helpful in the diagnosis of SV types.
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Affiliation(s)
- Muhammed Gazi Yildiz
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY.
| | - Saime Sagiroglu
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Nagihan Bilal
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Irfan Kara
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Israfil Orhan
- The department of ENT, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
| | - Adem Doganer
- The department of biostatistics, Kahramanmaraş Sütcü Imam university faculty of medicine, TURKEY
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Włodarczyk E, Jetka T, Miaśkiewicz B, Skarzynski PH, Skarzynski H. Validation and Reliability of Polish Version of the Reflux Symptoms Index and Reflux Finding Score. Healthcare (Basel) 2022; 10:healthcare10081411. [PMID: 36011068 PMCID: PMC9408310 DOI: 10.3390/healthcare10081411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/21/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
(1) Background: To confirm the credibility, consistency, and replicability of the Polish versions of the Reflux Symptoms Index (PL-RSI) and the Reflux Finding Score (PL-RFS). (2) Methods: The translation followed the WHO recommendations. The study group included 100 volunteers (age 15−87) with hoarseness and pharyngolaryngeal complaints. The control group comprised 55 healthy volunteers (age 20−75). Study participants completed the PL-RSI; then, two independent otolaryngologists completed the PL-RFS based on pharyngeal videostroboscopy. Questionnaires were repeated after 7 days, with no treatment before the second round. Additionally, patients underwent 24 h pH-metry. The control group had a single round of questionnaires followed by pH-metry. (3) Results: The PL-RSI is consistent, reliable (Cronbach’s alpha 0.77−0.83; test−retest reliability 0.83), and significantly correlated with other patient-filled tools (p < 0.001). The PL-RFS intra-rater reliability is 0.84−0.91, and inter-rater is 0.88. Both questionnaires strongly correlate with pH-metry (PL-RSI upright Ryan Score 0.35, PL-RFS—0.60). Both clearly distinguish (i) healthy from persons with voice disorders, but without acid LPR (p < 0.0001), and (ii) within patient group between subjects with and without acid LPR (p = 0.0002). (4) Conclusions: The PL-RSI and PL-RFS are reliable and can be recommended to Polish-speaking otolaryngologists. Our findings confirm the role of country-specific factors in RSI results and that practitioners should always use a proper control group.
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Affiliation(s)
- Elżbieta Włodarczyk
- Rehabilitation Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland
- Correspondence:
| | - Tomasz Jetka
- World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland;
| | - Beata Miaśkiewicz
- Audiology and Phoniatric Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland;
| | - Piotr Henryk Skarzynski
- Teleaudiology and Screening Department, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland;
- Institute of Sensory Organs, 05-830 Warsaw, Poland
- Heart Failure and Cardiac Rehabilitation Department, Faculty of Medicine, Medical University of Warsaw, 03-242 Warsaw, Poland
| | - Henryk Skarzynski
- Otorhinolaryngology Surgery Clinic, World Hearing Center, Institute of Physiology and Pathology of Hearing, 05-830 Warsaw, Poland;
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Relationship between voice handicap index and reflux symptom index in patients with laryngopharyngeal reflux with dysphonia: A cross-sectional study. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.1055547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wang JY, Peng T, Zhao LL, Feng GJ, Liu YL. Poor consistency between reflux symptom index and laryngopharyngeal pH monitoring in laryngopharyngeal reflux diagnosis in Chinese population. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:25. [PMID: 33553318 PMCID: PMC7859794 DOI: 10.21037/atm-20-4783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background It is unknown whether the reflux symptom index (RSI) can replace pH monitoring as a diagnostic tool for laryngopharyngeal reflux (LPR) in Chinese people. The relationships between reflux parameters and LPR symptoms also require further research. Methods A total of 216 Chinese patients underwent laryngopharyngeal pH monitoring and filled out an RSI questionnaire. Laryngopharyngeal pH monitoring indicated a diagnosis of LPR for patients with 7 or more episodes of reflux or a reflex area index (RAI) of 6.3 or more. The RSI questionnaire indicated a diagnosis of LPR for patients with RSI scores of 14 or higher. Results Of the 216 patients, 85 were diagnosed with LPR as assessed by the RSI, and 72 were diagnosed with LPR through laryngopharyngeal pH monitoring. The Cohen's kappa coefficient comparing LPR diagnosis consistency between RSI score and laryngopharyngeal pH monitoring was 0.133 (P=0.007). This indicated the two diagnostic methods were consistent to a low degree; the total consistency rate was only 59.7% (129/216). The sensitivity of the RSI was 48.6% (35/72), and its specificity was 82.5% (94/114). For convenience, we named the nine symptom groups in the RSI sequentially as P1-P9. P1, P2, P3, P5, P6, and P7 were all correlated with at least one reflux parameter (P<0.05), but P4, P8, and P9 were not correlated with any reflux parameters (P>0.05). A total of 72 patients were diagnosed using pH monitoring, the gold standard for LPR diagnosis. The most common symptoms of LPR were found to be P9, P3, P8, P7, and P2 in these patients. The symptoms that most seriously affected patients were P9, P8, P3, P7, and P2. Conclusions The consistency in diagnosis of LPR between the RSI and laryngopharyngeal pH monitoring was poor, meaning the RSI is not a suitable LPR initial screening tool and cannot replace pH monitoring. Additionally, reflux symptoms P4, P8, and P9 were not correlated with any reflux parameters. The most prevalent LPR symptom was P9, followed by P3, P8, P7, and P2. The most severe symptom was also P9, followed by P8, P3, P7, and P2.
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Affiliation(s)
- Jun-Yao Wang
- Department of Gastroenterology, Peking University People's Hospital, Beijing, China
| | - Tao Peng
- Department of Gastroenterology, Peking University People's Hospital, Beijing, China
| | - Li-Li Zhao
- Department of Gastroenterology, Peking University People's Hospital, Beijing, China
| | - Gui-Jian Feng
- Department of Gastroenterology, Peking University People's Hospital, Beijing, China
| | - Yu-Lan Liu
- Department of Gastroenterology, Peking University People's Hospital, Beijing, China
| |
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