1. Diagnosis of vocal cord dysfunction/inducible laryngeal obstruction: An International Delphi Consensus Study.
- Author
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Leong P, Vertigan AE, Hew M, Baxter M, Phyland D, Hull JH, Carroll TL, Gibson PG, McDonald VM, Halvorsen T, Clemm HH, Vollsæter M, Røksund OD, and Bardin PG
- Subjects
- Humans, Delphi Technique, Vocal Cords, Australia, Laryngeal Diseases diagnosis, Vocal Cord Dysfunction diagnosis, Vocal Cord Dysfunction complications, Airway Obstruction diagnosis
- Abstract
Background: Vocal cord dysfunction/inducible laryngeal obstruction (VCD/ILO) is characterized by breathing difficulties in association with excessive supraglottic or glottic laryngeal narrowing. The condition is common and can occur independently; however, it may also be comorbid with other disorders or mimic them. Presentations span multiple specialties and misdiagnosis or delayed diagnosis is commonplace. Group-consensus methods can efficiently generate internationally accepted diagnostic criteria and descriptions to increase clinical recognition, enhance clinical service availability, and catalyze research., Objectives: We sought to establish consensus-based diagnostic criteria and methods for VCD/ILO., Methods: We performed a modified 2-round Delphi study between December 7, 2021, and March 14, 2022. The study was registered at ANZCTR (Australian New Zealand Clinical Trials Registry; ACTRN12621001520820p). In round 1, experts provided open-ended statements that were categorized, deduplicated, and amended for clarity. These were presented to experts for agreement ranking in round 2, with consensus defined as ≥70% agreement., Results: Both rounds were completed by 47 international experts. In round 1, 1102 qualitative responses were received. Of the 200 statements presented to experts across 2 rounds, 130 (65%) reached consensus. Results were discussed at 2 international subject-specific conferences in June 2022. Experts agreed on a diagnostic definition for VCD/ILO and endorsed the concept of VCD/ILO phenotypes and clinical descriptions. The panel agreed that laryngoscopy with provocation is the gold standard for diagnosis and that ≥50% laryngeal closure on inspiration or Maat grade ≥2 define abnormal laryngeal closure indicative of VCD/ILO., Conclusions: This Delphi study reached consensus on multiple aspects of VCD/ILO diagnosis and can inform clinical practice and facilitate research., (Copyright © 2023 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)
- Published
- 2023
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