Comparative analysis of clinical profile: Chronic cough vs paradoxical vocal fold motion.
BACKGROUND
Ongoing contention surrounding typical demographic and clinical attributes of chronic cough (CC) and paradoxical vocal fold motion (PVFM) impedes timely diagnosis and optimum patient care. Designed to reduce preventable patient morbidity through improved recognition and differentiation, the current study aimed to determine representative clinical profiles for CC and PVFM, with identification of distinctive attributes from the general population and risk factors associated with each diagnosis.


METHODS
Self-reported medical questionnaires, demographic and lifestyle attributes of CC and PVFM cases from a disease-specific outcomes database were compared to US population data and published normative values. Univariate comparison and multivariate regression modelling of age, sex, alcohol intake, smoking, Reflux Symptom Index (RSI), Voice Handicap Index (VHI), and Generalized Anxiety Disorder 7-item Scale (GAD-7) determined distinguishing features between the clinical groups, including odds ratios for presenting with CC versus PVFM.


RESULTS
Clinical profiles developed from 283 (128 CC, 155 PVFM) adults (18-91 years) were significantly different from the general population across each demographic, lifestyle and clinical variable (all p < .01), with the exception of obesity. Age (55.39 ± 13.54 vs 45.07 ± 16.51 years, p < .01) and mean RSI score (21.5 ± 9.02 vs 18.1 ± 9.08, p < .01) most reliably distinguished CC from PVFM, with those aged 60-69 years (OR = 9.45) most likely to be diagnosed with CC.


CONCLUSIONS
Standard clinical profiles of CC and PVFM are distinct from the general population, aiding determination of relative probabilities and risk factors in the differential diagnostic process. Variations between CC and PVFM were subtle, reliably distinguished by age and relative severity of laryngopharyngeal reflux symptomatology.
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, United States.
Naomi A
NA
Hartley
Emory Voice Center, Department of Otolaryngology, Emory University, Atlanta, GA, United States.
Brian E
BE
Petty
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, United States.
Bethany
B
Johnson
Division of Otolaryngology, Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, United States. Electronic address: thibeault@surgery.wisc.edu.
Susan L
SL
Thibeault
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000209:etiology; D002908:Chronic Disease; D003371:Cough / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis / Q000523:psychology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D064706:Vocal Cord Dysfunction / Q000175:diagnosis* / Q000523:psychology; D055815:Young Adult
Cough; Epidemiology; Larynx; PVFM