Duke Voice Care Center, Division of Otolaryngology-Head and Neck Surgery, Duke University Medical Center, Durham, North Carolina, USA.
Laryngoscope. 2012 Feb;122(2):343-8. doi: 10.1002/lary.22426.
OBJECTIVES/HYPOTHESIS: To determine the prevalence and common causes of dysphonia as diagnosed by primary care physicians (PCPs) and otolaryngologists and to evaluate differences in etiologies offered by these providers.
Retrospective analysis of data from a large, nationally representative administrative U.S. claims database.
Patients were identified as dysphonic based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004, to December 31, 2008. Data regarding age, sex, geographic location, and type of physician providing the dysphonia diagnosis were collected. Overall and age-related prevalence rates, as well as frequency of specific etiologies by provider type, were calculated.
Of the almost 55 million individuals in the database, 536,943 patients (ages 0 to >65 years) were given a dysphonia diagnosis (point prevalence rate of 0.98%). The prevalence rate was higher among females as compared to males (1.2% vs. 0.7%) and among those >70 years of age (2.5%). The most frequent diagnoses overall were acute laryngitis, nonspecific dysphonia, benign vocal fold lesions, and chronic laryngitis. PCPs more commonly diagnosed acute laryngitis, whereas otolaryngologists more commonly diagnosed nonspecific dysphonia and laryngeal pathology. Gastroesophageal reflux was more commonly diagnosed as a comorbid condition by otolaryngologists than by PCPs. Overall laryngeal cancer prevalence in this treatment-seeking population was 2.2% and was greatest among males >70 years of age.
This analysis of insurance claims data from a nationally representative database represents the largest study of its kind. Important differences in dysphonia prevalence related to age, sex, diagnosis, and physician type were identified.
目的/假设：确定初级保健医生（PCP）和耳鼻喉科医生诊断的声音障碍的患病率和常见原因，并评估这些提供者提供的病因差异。
对来自美国大型全国代表性行政索赔数据库的回顾性数据分析。
根据国际疾病分类，第九修订版，临床修正，从 2004 年 1 月 1 日至 2008 年 12 月 31 日的代码，确定患者为声音障碍。收集有关年龄，性别，地理位置和提供声音障碍诊断的医生类型的数据。计算了总体和与年龄相关的患病率以及按提供者类型划分的特定病因的频率。
在数据库中近 5500 万人中，有 536943 名患者（0 至> 65 岁）被诊断为声音障碍（点患病率为 0.98％）。与男性相比，女性的患病率更高（1.2％对 0.7％），年龄> 70 岁的人群更高（2.5％）。总体而言，最常见的诊断是急性喉炎，非特异性声音障碍，良性声带病变和慢性喉炎。PCP 更常诊断为急性喉炎，而耳鼻喉科医生更常诊断为非特异性声音障碍和喉病理学。与 PCP 相比，耳鼻喉科医生更常将胃食管反流诊断为合并症。在这种寻求治疗的人群中，喉癌的总体患病率为 2.2％，年龄> 70 岁的男性中患病率最高。
对来自全国代表性数据库的保险索赔数据的这种分析代表了此类研究中规模最大的一次。根据年龄，性别，诊断和医生类型，确定了声音障碍患病率的重要差异。
