title: Changing Patterns in Reflux Care: 10-Year Comparison of ABEA Members.
abstract: OBJECTIVE
  To compare patterns of laryngopharyngeal reflux (LPR) diagnosis and management over time by American Broncho-Esophagological Association (ABEA) members.
  
  
  METHODS
  American Broncho-Esophagological Association members completed an online questionnaire focused on LPR evaluation and management in 2012; responses were compared to a 2002 survey.
  
  
  RESULTS
  Four hundred twenty-six members were emailed, of whom 63 (14.8%) responded. In both time periods, throat clearing, heartburn, globus, arytenoid edema, and erythema were considered highly related to LPR. Management in 2012 differed as respondents more commonly treated LPR empirically (82.6% vs 56.3%, P = .036). When adjunctive testing was ordered, dual pH probe were less frequently utilized in 2012 (61.5% vs 78.3%, P = .029). Either esophagogastroduodenoscopy (EGD) or transnasal esophagoscopy (TNE) was used more often in 2012 compared to EGD alone in 2002 (63.8% vs 42.4%, P = .020). Dual pH probe was regarded as the most sensitive and specific evaluation for LPR in both surveys, while the perceived sensitivity/specificity of EGD in 2012 was half that reported in 2002 (28.0% vs 56.3%, P = .003).
  
  
  CONCLUSIONS
  Attitudes of ABEA members toward empiric treatment and adjunctive tests have changed between 2012 and 2002. While pH probe testing remains the test regarded as most sensitive/specific for evaluation of LPR, empiric management has become more common. Meanwhile, EGD use has increased despite a significant decrease in its perceived sensitivity/specificity.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Gooi
authors.affiliation: Divisions of Otolaryngology-Head and Neck Surgery & Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati Ohio, USA.
authors.forename: Stacey L
authors.initials: SL
authors.lastname: Ishman
authors.affiliation: Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Bock
authors.affiliation: Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
authors.forename: Joel H
authors.initials: JH
authors.lastname: Blumin
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, Maryland, USA lakst1@jhmi.edu.
authors.forename: Lee M
authors.initials: LM
authors.lastname: Akst
mesh_terms: D050782:Esophageal pH Monitoring / Q000706:statistics & numerical data; D004945:Esophagoscopy / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis* / Q000628:therapy*; D010036:Otolaryngology / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D054328:Proton Pump Inhibitors / Q000627:therapeutic use; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D012955:Societies, Medical; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D054328:Proton Pump Inhibitors
keywords: diagnosis; gastroesophageal reflux; laryngopharyneal reflux; test; treatment