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一家私人执业社区语音诊所的流行病学模式与治疗结果

Epidemiological Patterns and Treatment Outcomes in a Private Practice Community Voice Clinic.

作者信息

Thijs Zoë, Knickerbocker Kristie, Watts Christopher R

机构信息

Davies School of Communication Sciences & Disorders, Texas Christian University, Fort Worth, Texas.

A Tempo Voice Center, Fort Worth, Texas.

出版信息

J Voice. 2022 May;36(3):437.e11-437.e20. doi: 10.1016/j.jvoice.2020.06.025. Epub 2020 Jul 28.

Abstract

OBJECTIVES

Voice therapy is administered by speech-language pathologists in multiple practice settings, including private practice community voice clinics. However, the evidence for diagnosis patterns and voice treatment outcomes in community voice clinics is very limited. The purpose of this study was to extend knowledge from a previous investigation by assessing the epidemiological patterns of patient referrals to a private practice community voice clinic across a 4-year period (50 months) and to measure the effectiveness of treatment outcomes for patients who were followed up with voice therapy in the same setting.

STUDY DESIGN

Retrospective case series.

METHODS

Consecutive patient records from November 2014 through January 2019 were reviewed. Patients were grouped into seven categories of distinctive diagnoses. Descriptive data for each group were extracted to determine epidemiological patterns of disorder diagnosis, voice handicap, voice quality severity, age, and gender. For patients who completed at least three treatment sessions, pre- and posttreatment measurements of two assessments, the Voice Handicap Index (VHI) and the Acoustic Voice Quality Index (AVQI), were extracted and compared using a multivariate analysis of variance.

RESULTS

Records from 454 consecutive patient referrals over a 50-month time period were reviewed. The most frequent diagnoses were multifactorial etiologies or those with only a few cases, categorized collectively as an "other" diagnosis category. Diagnoses of nonspecific dysphonia and mid-membranous lesions were also common. Consensus Auditory Perceptual Evaluation of Voice-scale scores were not different among disorders; however, group differences were found for VHI and AVQI. Treatment data were available for 292 patients, with 47 of those patients completing at least three treatment sessions and with data for pre- and posttreatment VHI and AVQI. A mixed multivariate analysis of variance showed a significant effect of treatment (Wilks' Lambda = 0.42, F[2] = 27.58, P < 0.001, ƞ² = 0.58), where both AVQI and VHI improved significantly across the pre- to posttreatment measurements.

CONCLUSIONS

Patient characteristics and diagnosis patterns across a 50-month period were similar when compared to a previous study that investigated epidemiological patterns in this clinic across 28 months. Voice therapy administered in this community voice clinic to patients with varied diagnoses was found to be effective based on changes in VHI and AVQI measurements.

摘要

目的

言语治疗师在多种实践环境中提供嗓音治疗,包括私人执业社区嗓音诊所。然而,社区嗓音诊所中诊断模式和嗓音治疗结果的证据非常有限。本研究的目的是通过评估4年(50个月)期间转诊至一家私人执业社区嗓音诊所的患者的流行病学模式,扩展先前一项调查的知识,并衡量在同一环境中接受嗓音治疗随访的患者的治疗效果。

研究设计

回顾性病例系列研究。

方法

回顾了2014年11月至2019年1月期间的连续患者记录。患者被分为七类不同的诊断。提取每组的描述性数据,以确定疾病诊断、嗓音障碍、嗓音质量严重程度、年龄和性别的流行病学模式。对于至少完成三次治疗疗程的患者,提取并使用多因素方差分析比较两项评估(嗓音障碍指数(VHI)和声学嗓音质量指数(AVQI))的治疗前和治疗后测量值。

结果

回顾了50个月期间454例连续患者转诊的记录。最常见的诊断是多因素病因或病例数较少的病因,统称为“其他”诊断类别。非特异性发声障碍和膜中部病变的诊断也很常见。嗓音的一致性听觉感知评估量表评分在不同疾病之间没有差异;然而,在VHI和AVQI方面发现了组间差异。有292例患者的治疗数据可用,其中47例患者至少完成了三次治疗疗程,并提供了治疗前和治疗后VHI和AVQI的数据。混合多因素方差分析显示治疗有显著效果(威尔克斯'λ=0.42,F[2]=27.58,P<0.001,ƞ²=0.58),治疗前到治疗后的测量中,AVQI和VHI均有显著改善。

结论

与之前一项调查该诊所28个月流行病学模式的研究相比,50个月期间的患者特征和诊断模式相似。基于VHI和AVQI测量值的变化,发现该社区嗓音诊所对不同诊断的患者进行的嗓音治疗是有效的。

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