학술논문
Best Practices in Treatment of Laryngopharyngeal Reflux Disease: A Multidisciplinary Modified Delphi Study
Document Type
Original Paper
Author
Kamal, Afrin N.; Dhar, Shumon I.; Bock, Jonathan M.; Clarke, John O.; Lechien, Jerome R.; Allen, Jacqueline; Belafsky, Peter C.; Blumin, Joel H.; Chan, Walter W.; Fass, Ronnie; Fisichella, P. Marco; Marohn, Michael; O’Rourke, Ashli K.; Postma, Gregory; Savarino, Edoardo V.; Vaezi, Michael F.; Carroll, Thomas L.; Akst, Lee M.
Source
Digestive Diseases and Sciences. 68(4):1125-1138
Subject
Language
English
ISSN
0163-2116
1573-2568
1573-2568
Abstract
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.