title: Frequency and factors associated with use of videolaryngostroboscopy in voice disorder assessment.
abstract: OBJECTIVE
  Videolaryngostroboscopy (VLS) is considered an important diagnostic tool in the evaluation of patients with laryngeal/voice disorders. We evaluated the frequency of, diagnoses associated with, and factors related to VLS use in the evaluation of outpatients with laryngeal/voice disorders.
  
  
  METHODS
  Retrospective analysis of a large, national administrative U.S. claims database.
  
  
  METHODS
  Patients with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from January 1, 2004, to December 31, 2008, seen by an otolaryngologist were included. Patient age, gender, geographic region, laryngeal diagnosis, comorbid conditions, and whether laryngoscopy or VLS was performed during the outpatient otolaryngology visit were collected.
  
  
  RESULTS
  A total of 168,444 unique patients saw an otolaryngologist for 272,112 outpatient visits. Of those, 6.2% of outpatient otolaryngology visits had a VLS performed. Patient age was related to VLS use, with lower odds in the elderly (≥ 65 years of age) and those 0 to 17 years of age. Geographic variation was noted, with higher odds of VLS use in urban versus rural areas and greater odds in the Northeast versus the South. Laryngeal diagnosis was associated with VLS use with greatest odds for patients with multiple diagnoses, vocal fold paralysis, and paresis-followed by nonspecific dysphonia and benign vocal fold/laryngeal pathology and followed by acute and chronic laryngitis and laryngeal cancer. Patients with gastro-esophageal reflux (GER) had greater odds of VLS use than patients without GER.
  
  
  CONCLUSIONS
  VLS was used in 6.2% of outpatient otolaryngology outpatient visits; and its use was influenced by multiple factors.
authors.affiliation: Duke Voice Care Center, Division of Otolaryngology-Head & Neck Surgery, Duke University Medical Center, Durham, North Carolina.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Cohen
authors.forename: Steven
authors.initials: S
authors.lastname: Thomas
authors.forename: Nelson
authors.initials: N
authors.lastname: Roy
authors.forename: Jaewhan
authors.initials: J
authors.lastname: Kim
authors.forename: Mark
authors.initials: M
authors.lastname: Courey
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis*; D007828:Laryngoscopy / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D049489:Stroboscopy / Q000706:statistics & numerical data; D014741:Video Recording / Q000706:statistics & numerical data; D014832:Voice Disorders / Q000175:diagnosis*; D055815:Young Adult
keywords: Laryngeal/voice disorders; Marketscan; dysphonia; videolaryngostroboscopy; voice