Delayed Otolaryngology Referral for Voice Disorders Increases Health Care Costs

Cohen, Seth M.; Kim, Jaewhan; Roy, Nelson; Courey, Mark S.

doi:10.1016/j.amjmed.2014.10.040

Cited by 38 publications

(40 citation statements)

References 26 publications

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“…However, increased time from first primary care visit to first otolaryngology evaluation (laryngoscopy) is rather often associated with change of initially diagnosis and treatment, and increased health care costs [4]. Clinical diagnostics of laryngeal/voice disorders is rather complex and based on multidimensional approach including perception of voice changes, video laryngostroboscopy, acoustic voice analysis, measurement of voice aerodynamics, and subjective rating of voice by the patient [5].…”

Section: Introductionmentioning

confidence: 99%

Exploring the feasibility of smart phone microphone for measurement of acoustic voice parameters and voice pathology screening

Uloza

Padervinskis

Vegienė

et al. 2015

Eur Arch Otorhinolaryngol

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The objective of this study is to evaluate the reliability of acoustic voice parameters obtained using smart phone (SP) microphones and investigate the utility of use of SP voice recordings for voice screening. Voice samples of sustained vowel/a/obtained from 118 subjects (34 normal and 84 pathological voices) were recorded simultaneously through two microphones: oral AKG Perception 220 microphone and SP Samsung Galaxy Note3 microphone. Acoustic voice signal data were measured for fundamental frequency, jitter and shimmer, normalized noise energy (NNE), signal to noise ratio and harmonic to noise ratio using Dr. Speech software. Discriminant analysis-based Correct Classification Rate (CCR) and Random Forest Classifier (RFC) based Equal Error Rate (EER) were used to evaluate the feasibility of acoustic voice parameters classifying normal and pathological voice classes. Lithuanian version of Glottal Function Index (LT_GFI) questionnaire was utilized for self-assessment of the severity of voice disorder. The correlations of acoustic voice parameters obtained with two types of microphones were statistically significant and strong (r = 0.73-1.0) for the entire measurements. When classifying into normal/pathological voice classes, the Oral-NNE revealed the CCR of 73.7% and the pair of SP-NNE and SP-shimmer parameters revealed CCR of 79.5%. However, fusion of the results obtained from SP voice recordings and GFI data provided the CCR of 84.60% and RFC revealed the EER of 7.9%, respectively. In conclusion, measurements of acoustic voice parameters using SP microphone were shown to be reliable in clinical settings demonstrating high CCR and low EER when distinguishing normal and pathological voice classes, and validated the suitability of the SP microphone signal for the task of automatic voice analysis and screening.

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Section: Introductionmentioning

confidence: 99%

Exploring the feasibility of smart phone microphone for measurement of acoustic voice parameters and voice pathology screening

Uloza

Padervinskis

Vegienė

et al. 2015

Eur Arch Otorhinolaryngol

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“…Voice disorders affect a significant proportion of adults in the United States, adversely impacting patients' quality of life and contributing substantially to healthcare costs of up to $5 billion annually . There is evidence that costs are increased further by delayed referral to an otolaryngologist for evaluation of these disorders . Racial and socioeconomic disparities likely affect adults suffering from voice disorders and may contribute to quality‐of‐life deficits as well as delayed otolaryngology referrals; however, there are no studies examining health disparities among patients with voice problems.…”

Section: Introductionmentioning

confidence: 99%

Health disparities among adults with voice problems in the United States

et al. 2017

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“…However, an examination of voice-disordered patients who presented to general medicine or primary care physicians and subsequently to otolaryngologists found incremental health care costs as the time to otolaryngology evaluation increased from ≤1 month to ≥3 months. 13 Identification of patients at risk for chronic voice-related health care utilization could potentially improve individual outcomes, avoid unnecessary tests and medication trials, and reduce societal costs. With 80.3% and 68.5% of the ≥30-day group having ≥60 and ≥90 days, respectively, of voice-related health care utilization, 30 days of nonotolaryngology voice-related health care may indicate someone likely to have prolonged voice-related health care utilization and who could benefit from early otolaryngology evaluation or reevaluation.…”

Section: Discussionmentioning

confidence: 99%

Chronicity of Voice‐Related Health Care Utilization in the General Medicine Community

Lee

Roy

Misono

2017

Otolaryngol.--head neck surg.

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Objectives To examine voice-related health care utilization of patients in the general medical community without otolaryngology evaluation and explore factors associated with prolonged voice-related health care. Study Design Retrospective cohort analysis. Setting Large, national administrative US claims database. Subjects and Methods Patients with voice disorders per International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes from January 1, 2010, to December 31, 2012, seen by a general medical physician, and who did not see an otolaryngologist in the subsequent year were included. Voice-related health care utilization, patient demographics, comorbid conditions, and index laryngeal diagnosis were collected. Logistic regression with variable selection was performed to evaluate the association between predictors and ≥30 days of voice-related health care use. Results In total, 46,205 unique voice-disordered patients met inclusion criteria. Of these patients, 8.5%, 10.0%, and 12.5% had voice-related health care use of ≥90, ≥60, and ≥30 respectively. Of the ≥30-day days, subset, 80.3% and 68.5%, respectively, had ≥60 and ≥90 days of voice-related health care utilization. The ≥30-day subset had more general medicine and nonotolaryngology specialty physician visits, more prescriptions and procedures, and 4 times the voice-related health care costs compared with those in the <30-day subset. Age, sex, employment status, initial voice disorder diagnosis, and comorbid conditions were related to ≥30 days of voice-related health care utilization. Conclusions Thirty days of nonotolaryngology-based care for a voice disorder may represent a threshold beyond which patients are more likely to experience prolonged voice-related health care utilization. Specific factors were associated with extended voice-related health care.

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Delayed Otolaryngology Referral for Voice Disorders Increases Health Care Costs

Cited by 38 publications

References 26 publications

Exploring the feasibility of smart phone microphone for measurement of acoustic voice parameters and voice pathology screening

Exploring the feasibility of smart phone microphone for measurement of acoustic voice parameters and voice pathology screening

Health disparities among adults with voice problems in the United States

Chronicity of Voice‐Related Health Care Utilization in the General Medicine Community

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