Role of Psychological Processes on Symptom Burden in Laryngopharyngeal Reflux

项目摘要/摘要 喉咽反流(LPR)是一种常见的异质性综合征 哪些喉部症状可归因于胃食道反流，导致健康状况不佳， 不适当的资源利用，以及巨大的医疗成本。职业生涯的长期目标是发现 LPR的表型导向护理范式，侧重于不同的疾病机制。我们的初步调查结果 产生了一个中心假设，即识别不同的LPR表型是可行的，并且 过度警惕、焦虑等心理过程影响LPR的症状负担。因此，总体上， 这项提案的目标是建立一种有效的方法来衡量高度警惕和焦虑的水平 并了解不同的LPR表型是否报告不同水平的喉部症状 高度警惕和焦虑。这个项目的基本原理是它将突出认知-情感的影响 关于LPR症状负担的过程，并生成围绕行为干预作用的假设 在LPR中。因此，我们将追求两个具体的目标：1)验证喉部过度警戒和焦虑量表 [LHAS]自我报告工具，以及2)衡量不同LPR的高度警惕和焦虑水平 表型。在第一个目标下，200名有症状的患者和40名健康志愿者将完成LHAS 以及一套经过验证的测量心理痛苦和与健康相关的生活质量的工具。 将评估左翼的心理测量学特性，并初步确定左翼的截止值 下定决心。在第二个目标下，200名有症状的患者将被归类为lpr表型。 从主成分判别分析中利用我们的先验模型。喉咙高度警戒的水平 焦虑将在LPR表型以及健康志愿者中进行测量和比较。这个 拟议中的研究具有重要意义，因为它有望填补关于心力衰竭相互作用的关键证据空白 心理压力源对LPR症状负担的影响。这项研究具有创新性，因为它将提供一种新的临床 一种评估LPR患者认知情感过程的工具，并提供第一次评估的框架 ITS类表型分层随机对照试验评估行为干预效果的比较 与传统的抗反流治疗，如质子泵抑制剂，在LPR患者。

PROJECT SUMMARY/ABSTRACT Generalized approaches for laryngopharyngeal reflux (LPR), a prevalent and heterogeneous syndrome in which laryngeal symptoms are attributed to gastroesophageal reflux, have led to poor health outcomes, inappropriate resource utilization, and tremendous healthcare costs. The long-term career goal is to discover phenotype guided care paradigms for LPR, focused on distinct disease mechanism. Our preliminary findings have generated the central hypothesis that identification of distinct LPR phenotypes is feasible and that psychological processes such as hypervigilance and anxiety impact symptom burden in LPR. Thus, the overall objectives in this proposal are to establish a validated method to measure levels of hypervigilance and anxiety surrounding laryngeal symptoms and understand whether distinct LPR phenotypes report differing levels of hypervigilance and anxiety. The rationale for this project is that it will highlight the impact of cognitive-affective processes on LPR symptom burden and generate hypotheses surrounding the role of behavioral interventions in LPR. Thus, two specific aims will be pursued: 1) validate the laryngeal hypervigilance and anxiety scale [LHAS] self-report instrument, and 2) measure levels of hypervigilance and anxiety across distinct LPR phenotypes. Under the first aim, 200 symptomatic patients and 40 healthy volunteers will complete the LHAS and a set of validated instruments measuring psychological distress and health related quality of life. Psychometric properties of the LHAS will be assessed and a preliminary cutoff for the LHAS will be determined. Under the second aim, the 200 symptomatic patients will be categorized into LPR phenotypes utilizing our prior model from discriminant analysis of principal components. Levels of laryngeal hypervigilance and anxiety will be measured and compared across LPR phenotypes, as well as the healthy volunteers. The proposed research is significant as it is expected to fill a key evidence gap about the interplay of psychological stressors on LPR symptom burden. This research is innovative as it will provide a novel clinical tool to evaluate cognitive affective processes in patients with LPR as well as inform the framework of a first-of- its-kind phenotype stratified randomized controlled trial to assess efficacy of behavioral interventions compared to traditional anti-reflux therapy such as proton pump inhibitors in patients with LPR.