Diagnosis change in voice-disordered patients evaluated by primary care and/or otolaryngology: a longitudinal study.

Published

Journal Article

OBJECTIVE: Accurate diagnosis of a voice disorder is an essential first step toward its appropriate treatment. We examined differences in laryngeal diagnosis over time in outpatients evaluated by primary care physicians (PCPs) and/or otolaryngologists. STUDY DESIGN AND SETTING: Retrospective analysis of data from a large, national administrative US claims database. SUBJECTS AND METHODS: Patients with laryngeal disorders based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004, to December 31, 2008, with at least 2 outpatient visits by a PCP and/or otolaryngologist and continuously enrolled for 12 months were included. The initial and final laryngeal diagnoses were tabulated. RESULTS: Of approximately 55 million individuals, 29,501 met inclusion criteria. More than half the patients in the PCP to otolaryngology group and one-third of the otolaryngology to otolaryngology group had different laryngeal diagnoses over time. Three-fourths of patients with an initial acute laryngitis diagnosis in the PCP to otolaryngology group and half of the otolaryngology to otolaryngology group had a different final laryngeal diagnosis. Of patients with a final laryngeal cancer diagnosis, one-fourth of the otolaryngology to otolaryngology group had an initial diagnosis of nonspecific dysphonia, and one-fifth of the PCP to otolaryngology group had an initial diagnosis of acute laryngitis. CONCLUSION: Differential diagnosis of voice disorders often evolves over time. The impact on treatment and health care utilization are important areas of future study.

Full Text

Duke Authors

Cited Authors

  • Cohen, SM; Dinan, MA; Roy, N; Kim, J; Courey, M

Published Date

  • January 2014

Published In

Volume / Issue

  • 150 / 1

Start / End Page

  • 95 - 102

PubMed ID

  • 24264568

Pubmed Central ID

  • 24264568

Electronic International Standard Serial Number (EISSN)

  • 1097-6817

Digital Object Identifier (DOI)

  • 10.1177/0194599813512982

Language

  • eng

Conference Location

  • England