Liu Vicki, Smith Dori, Yip Helena
College of Medicine-Tucson University of Arizona Tucson Arizona USA.
Department of Otolaryngology-Head and Neck Surgery, College of Medicine-Tucson University of Arizona Tucson Arizona USA.
Laryngoscope Investig Otolaryngol. 2025 May 14;10(3):e70149. doi: 10.1002/lio2.70149. eCollection 2025 Jun.
Around 89% of individuals with Parkinson's disease (PD) present with speech and voice disorders, but only 3%-4% receive speech treatment. Using the NIH All of Us Research Program, this study aims to report the prevalence of dysphonia, the incidence of speech evaluations and treatments, and potential disparities in PD patients on a national scale.
ICD-9 and ICD-10 codes were used to identify individuals with PD and dysphonia in the All of Us database. Diagnostic voice care was determined using CPT codes for flexible laryngoscopy and speech evaluation, while treatment was based on CPT codes for vocal fold augmentation and speech therapy. Unadjusted and adjusted logistic regression analyses were conducted to evaluate the association between voice care access and demographic and socioeconomic factors.
Of 1968 PD patients, 257 (13.1%) had a concomitant diagnosis of dysphonia. 1683 patients (85.5%) received no voice care. Among those with voice care, 264 (13.4%) underwent a diagnostic evaluation and 124 (6.3%) received treatment. Based on adjusted logistic regression models, factors associated with decreased odds of voice care were female sex (aOR = 0.62, 95% CI = 0.45-0.85, = 0.004) and Hispanic ethnicity (aOR = 0.44, 95% CI = 0.22-0.90, = 0.02).
PD commonly presents with voice disorders. Using a national database, only 13.1% of PD patients had a formal dysphonia diagnosis, and only 6.3% received speech treatment. Female sex and Hispanic ethnicity correlated with decreased voice care. This study suggests the underdiagnosis and undertreatment of dysphonia in PD.Level of Evidence: 3.
约89%的帕金森病（PD）患者存在言语和嗓音障碍，但只有3%-4%的患者接受言语治疗。本研究利用美国国立卫生研究院的“我们所有人”研究项目，旨在报告全国范围内PD患者中发声障碍的患病率、言语评估和治疗的发生率以及潜在差异。
使用国际疾病分类第九版（ICD-9）和第十版（ICD-10）编码在“我们所有人”数据库中识别PD和发声障碍患者。通过用于柔性喉镜检查和言语评估的现行程序编码（CPT）确定诊断性嗓音护理，而治疗则基于用于声带增强和言语治疗的CPT编码。进行未调整和调整后的逻辑回归分析，以评估获得嗓音护理与人口统计学和社会经济因素之间的关联。
在1968例PD患者中，257例（13.1%）同时诊断为发声障碍。1683例患者（85.5%）未接受嗓音护理。在接受嗓音护理的患者中，264例（13.4%）接受了诊断性评估，124例（6.3%）接受了治疗。基于调整后的逻辑回归模型，与获得嗓音护理几率降低相关的因素为女性（调整后比值比[aOR]=0.62，95%置信区间[CI]=0.45-0.85，P=0.004）和西班牙裔（aOR=0.44，95%CI=0.22-0.90，P=0.02）。
PD常伴有嗓音障碍。利用全国性数据库，只有13.1%的PD患者得到正式的发声障碍诊断，只有6.3%的患者接受了言语治疗。女性和西班牙裔与获得的嗓音护理减少相关。本研究提示PD患者中发声障碍的诊断不足和治疗不足。证据级别：3级。
