Development and validation of the Exercise-Induced Laryngeal Obstruction Dyspnea Index (EILODI) - 05/04/22
, Monica Shaffer, CCC-SLP c, Emily Nauman, CCC-SLP c, Catherine S. Durso, PhD d, Elizabeth M. Fan, PA-C a, Herman Staudenmayer, PhD e, Kent L. Christopher, MD f, Jackie Gartner-Schmidt, CCC-SLP gAbstract |
Background |
Exercise-induced laryngeal obstruction (EILO) causes exertional dyspnea and is important for its effect on quality of life, diagnostic confusion with exercise-induced asthma, and health care resource utilization. There is no validated patient-reported outcome measure specific to EILO.
Objective |
We sought to develop, validate, and define a minimal clinically important difference for a patient-reported outcome measure to be used with adolescents and young adults with EILO.
Methods |
A multidisciplinary group created a preliminary measure, modified by a 10-member participant focus group, with 20 items scored along a 5-point Likert scale. A subsequent cohort of participants recruited from a clinic, aged 12 to 21 years, with confirmed EILO by continuous laryngoscopy during exercise testing (1) completed the measure at 3 points in time over 28 days and (2) provided anchoring data in the form of a daily exercise log and categorical self-assessments of clinical improvement. Thirty additional participants without exertional dyspnea served as controls.
Results |
Two hundred nineteen subjects with mild to severe EILO participated in the exploratory factor analysis, which identified 7 factors within the preliminary outcome measure. After a process of item reduction, a 12-item metric with a total score ranging from 0 to 48 was developed. Mean scores of patients with EILO and healthy controls at baseline were 28.8 ± 7.4 and 4.5 ± 7.4, respectively. A minimal clinically important difference of 6 was determined by comparison of index change with changes in categorical self-assessments of improvement.
Conclusions |
This is the first patient-reported outcome measure specifically designed for adolescents and young adults with EILO.
Le texte complet de cet article est disponible en PDF.Key words : Exercise-induced laryngeal obstruction, EILO, Exercise-Induced Laryngeal Obstruction Dyspnea Index, EILODI, continuous laryngoscopy during exercise, CLE, vocal cord dysfunction, VCD, paradoxical vocal fold motion, patient-reported outcome measure, questionnaire
Abbreviations used : CLE, EFA, EILO, EILODI, MCID, PROM
Plan
| This study was not externally funded. |
|
| Disclosure of potential conflict of interest: Outside of institutional affiliation, J. T. Olin is a respiratory consultant for the United States Olympic and Paralympic Committee and USA Swimming and has also received honoraria from speaking at conferences for the American College of Sports Medicine and the Indiana Speech-Language and Hearing Association. The rest of the authors declare that they have no relevant conflicts of interest. |
Vol 149 - N° 4
P. 1437-1444 - avril 2022 Retour au numéro
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