Laryngology Patient-Reported Outcome Measures and Demographics as Predictors of Dysphonia-Related Procedures

OBJECTIVES: Patient-Reported Outcome Measures (PROMs) are popular in laryngology clinics. We hypothesized that certain PROMs and demographic data might identify which dysphonic patients are more likely to require a procedure by a laryngologist prior to initial examination. METHODS: This study took place at one academic medical center laryngology clinic from September 2021 to October 2023. A prospectively collected new laryngology patient database was queried for a chief complaint inclusive of dysphonia; Vocal Handicap Index-10 (VHI-10), Reflux Symptom Index, and Glottal Function Index (GFI) scores; and a poststroboscopy diagnosis. A retrospective chart review was performed for patient age at presentation, sex, and subsequent dysphonia-related procedures (DRPs) (operating room or office). T tests /Wilcoxon rank sums/ Chi-square tests compared characteristics between patients having a DRP within 1 year of their first visit (DRP+) and patients who did not. Logistic regression models were used to identify predictors of procedure, and accuracy was assessed with receiver operator characteristic curves. RESULTS: Five hundred seventy-seven dysphonic patients were identified; 174 (30.1%) were DRP+. This population was statistically significantly older, more likely to be male, more likely to have a chief complaint of only dysphonia (CCOD), and had greater VHI-10 and GFI scores. Multivariable analysis revealed that the VHI-10 score, the presence (versus absence) of CCOD, and patient sex maximized the area under the curve (0.74; 95% CI: 0.70-0.78). CONCLUSION: Higher VHI-10 scores, CCOD, and male sex may be predictive of the need for subsequent voice-related procedures in new dysphonia patients. These data may be useful for initial visit screening and triage in resource-constrained voice clinics.