[en] [en] BACKGROUND: Laryngopharyngeal reflux (LPR) is a common otolaryngologic diagnosis. Treatment of presumed LPR remains challenging, and limited frameworks exist to guide treatment.
METHODS: Using RAND/University of California, Los Angeles (UCLA) Appropriateness Methods, a modified Delphi approach identified consensus statements to guide LPR treatment. Experts independently and blindly scored proposed statements on importance, scientific acceptability, usability, and feasibility in a four-round iterative process. Accepted measures reached scores with ≥ 80% agreement in the 7-9 range (on a 9-point Likert scale) across all four categories.
RESULTS: Fifteen experts rated 36 proposed initial statements. In round one, 10 (27.8%) statements were rated as valid. In round two, 8 statements were modified based on panel suggestions, and experts subsequently rated 5 of these statements as valid. Round three's discussion refined statements not yet accepted, and in round four, additional voting identified 2 additional statements as valid. In total, 17 (47.2%) best practice statements reached consensus, touching on topics as varied as role of empiric treatment, medication use, lifestyle modifications, and indications for laryngoscopy.
CONCLUSION: Using a well-tested methodology, best practice statements in the treatment of LPR were identified. The statements serve to guide physicians on LPR treatment considerations.
Disciplines :
Otolaryngology
Author, co-author :
Kamal, Afrin N ; Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Redwood City, CA, USA. kamala@stanford.edu
Dhar, Shumon I; Department of Otolaryngology, Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA
Bock, Jonathan M; Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
Clarke, John O; Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University, Redwood City, CA, USA
Lechien, Jérome ; Université de Mons - UMONS > Faculté de Psychologie et des Sciences de l'Education > Service de Métrologie et Sciences du langage
Allen, Jacqueline; Department of Otolaryngology, Head and Neck Surgery, University of Auckland, Auckland, New Zealand
Belafsky, Peter C; Department of Otolaryngology/Head and Neck Surgery, Davis School of Medicine, University of California, Sacramento, CA, USA
Blumin, Joel H; Department of Otolaryngology & Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
Chan, Walter W; Division of Gastroenterology, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
Fass, Ronnie; Division of Gastroenterology, Department of Medicine, MetroHealth, Cleveland, OH, USA
Fisichella, P Marco; Abbvie Inc., Chicago, IL, USA
Marohn, Michael; Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
O'Rourke, Ashli K; Department of Otolaryngology, Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
Postma, Gregory; Department of Otolaryngology, Head and Neck Surgery, Augusta University, Augusta, GA, USA
Savarino, Edoardo V; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
Vaezi, Michael F; Division of Gastroenterology, Department of Medicine, Vanderbilt University, Nashville, TN, USA
Carroll, Thomas L; Division of Otolaryngology and Harvard Medical School, Department of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Boston, MA, USA
Akst, Lee M; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
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