- Title
- Diagnosis of vocal cord dysfunction/inducible laryngeal obstruction: An International Delphi Consensus Study
- Creator
- Leong, Paul; Vertigan, Anne E.; Clemm, Hege Havstad; Vollsæter, Maria; Røksund, Ola Drange; Bardin, Philip G.; Vocal Cord Dysfunction/Inducible Laryngeal Obstruction Delphi Expert Panel,; Hew, Mark; Baxter, Malcolm; Phyland, Debra; Hull, James H.; Carroll, Thomas L.; Gibson, Peter G.; McDonald, Vanessa M.; Halvorsen, Thomas
- Relation
- Journal of Allergy and Clinical Immunology Vol. 152, Issue 4, p. 899-906
- Publisher Link
- http://dx.doi.org/10.1016/j.jaci.2023.06.007
- Publisher
- Elsevier
- Resource Type
- journal article
- Date
- 2023
- Description
- 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.
- Subject
- vocal cord dysfunction; inducible laryngeal obstruction; paradoxical vocal fold motion; diagnostic criteria; Delphi; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1494902
- Identifier
- uon:53918
- Identifier
- ISSN:0091-6749
- Language
- eng
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