Diagnostic Delays in Spasmodic Dysphonia: A Call for Clinician Education.
Diagnostic Delays in Spasmodic Dysphonia: A Call for Clinician Education.
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DOI：
10.1016/j.jvoice.2013.10.022
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发表时间：
2015-09
期刊：
影响因子：
--
通讯作者：
Johns MM
中科院分区：
文献类型：
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作者：
Creighton FX;Hapner E;Klein A;Rosen A;Jinnah HA;Johns MM
痉挛性发声困难是一种罕见但常使人衰弱的疾病。由于从业人员缺乏认识，缺乏明确的诊断标准，SD患者很难接受诊断和后续治疗。目前还没有文献记录医学界在识别和诊断这种疾病方面的疗效。我们的目的是量化患者获得SD诊断的经验。107名连续的SD患者完成了关于他们的SD经历的问卷调查。患者在喉科门诊就诊期间或在参与国立卫生研究院资助的研究SD期间招募。患者在第一次因声音症状去看医生后平均需要4.43年（53.21个月）才被诊断为SD。患者平均需要看3.95名医生才能被诊断为SD。患者（31.4%）曾接受肉毒杆菌毒素以外的药物治疗。患者（30%）尝试替代疗法治疗SD，如脊椎按摩师或饮食调整。尽管医学诊断模式取得了进展，但SD的诊断仍然难以捉摸。SD诊断的客观标准和增加临床医生的教育是必要的，以解决这种诊断延迟。
Spasmodic dysphonia (SD) is a rare but often debilitating disease. Due to lack of awareness among practitioners and lack of well-defined diagnostic criteria, it can be difficult for patients with SD to receive a diagnosis and subsequent treatment. There is currently no literature documenting the efficacy of the medical community in recognizing and diagnosing this disorder. We aimed to quantify the patients’ experiences with obtaining a diagnosis of SD. One hundred seven consecutive patients with SD completed questionnaires about their experiences with SD. Patients were recruited either during outpatient laryngology visits or during participation in a National Institutes of Health funded study investigating SD. It took patients an average of 4.43 years (53.21 months) to be diagnosed with SD after first going to a physician with vocal symptoms. Patients had to see an average of 3.95 physicians to receive a diagnosis of SD. Patients (31.4%) had been prescribed medications other than botulinum toxin to treat their symptoms. Patients (30%) attempted alternative therapies for treatment of SD, such as chiropractor or dietary modification. Despite advances in diagnostic modalities in medicine, the diagnosis of SD still remains elusive. Objective criteria for the diagnosis of SD and increased clinician education are warranted to address this diagnostic delay.