title: The Ability of Patient-Symptom Questionnaires to Differentiate PVFMD From Asthma.
abstract: OBJECTIVE
  Goals of the current study were to (1) conduct initial validation of a new Paradoxical Vocal Fold Movement Disorder Screening Questionnaire (PVFMD-SQ); (2) determine if symptom-based questionnaires can discriminate between patients with confirmed PVFMD and those with diagnosed uncontrolled asthma without clinical suspicion for PVFMD; and (3) determine if a new questionnaire with diagnostic specificity could be created from a combination of significant items on previously validated questionnaires.
  
  
  METHODS
  This is a prospective, case-controlled study of patients with PVFMD only and asthma only, who completed five questionnaires: Dyspnea Index, Reflux Symptom Index, Voice Handicap Index-10, Sino-Nasal Questionnaire, and PVFMD-SQ. Factor analysis was completed on the new PVFMD-SQ, and the discrimination ability of selected factors was assessed by receiver operating characteristics curve. The factor with the greatest discriminatory ability was selected to create one diagnostic questionnaire, and scores for each participant were calculated to estimate how well the factor correlated with a PVFMD or asthma diagnosis. Mean scores on all questionnaires were compared to test their discriminatory ability.
  
  
  RESULTS
  Patients with PVFMD showed greater voice handicap and reflux symptoms than patients with asthma. A 15-item one-factor questionnaire was developed from the original PVFMD-SQ, with a sensitivity of 89% and specificity of 73% for diagnosing asthma versus PVFMD. The combined questionnaires resulted in four factors, none of which showed discriminatory ability between PVFMD and asthma.
  
  
  CONCLUSIONS
  This study represents the first time that a patient symptom-based screening tool has shown diagnostic sensitivity to differentiate PVFMD from asthma in a cohort of symptomatic patients.
authors.affiliation: University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
authors.forename: Jinny
authors.initials: J
authors.lastname: Ye
authors.affiliation: Department of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Nouraie
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Asthma Institute, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Fernando
authors.initials: F
authors.lastname: Holguin
authors.affiliation: Department of Otolaryngology, University of Pittsburgh Voice Center, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: gillespieai@upmc.edu.
authors.forename: Amanda I
authors.initials: AI
authors.lastname: Gillespie
mesh_terms: D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D015897:Comorbidity; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D016002:Discriminant Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D011795:Surveys and Questionnaires; D064706:Vocal Cord Dysfunction / Q000175:diagnosis* / Q000503:physiopathology; D014833:Voice Quality
keywords: Asthma; Paradoxical vocal fold movement disorder; Screening; Vocal cord dysfunction; Voice