TY - JOUR
T1 - Can flow-volume loops be used to diagnose exerciseinduced laryngeal obstructions?
T2 - A comparison study examining the accuracy and inter-rater agreement of flowvolume loops as a diagnostic tool
AU - Christensen, Pernille Melia
AU - Maltbæk, Niels
AU - Jørgensen, Inger M
AU - Nielsen, Kim G
PY - 2013/9
Y1 - 2013/9
N2 - Background: Pre-and post-exercise flow-volume loops are often recommended as an easy non-invasive method for diagnosing or excluding exercise-induced laryngeal obstructions in patients with exercise-related respiratory symptoms. However, at present there is no evidence for this recommendation. Aims: To compare physician evaluated pre-and post-exercise flow-volume loops and flow data with laryngoscopic findings during exercise. Methods: Data from 100 consecutive exercise tests with continuous laryngoscopy during the test were analysed. Laryngoscopic images were compared with the corresponding pre-and post-exercise flow-volume loops assessed by four separate physicians and with data from the loops (forced inspiratory flow (FIF) at 25% vs. FIF at 75% of forced inspiratory vital capacity (FIVC), forced expiratory flow at 50% of forced expiratory volume vs. FIF at 50% of FIVC, and FIVC vs. FIF at 50% of FIVC). Results: There was no significant association between the laryngoscopic findings and the flow-volume data. There was no agreement between the four physicians in their assessment of the flow-volume loops (kappa <0.00), and none of the individual physician's assessments were significantly associated with the laryngoscopic findings. Conclusions: Exercise-induced laryngeal obstructions cannot be diagnosed or excluded by physician evaluated pre-and post-exercise flow-volume loops or flow data alone.
AB - Background: Pre-and post-exercise flow-volume loops are often recommended as an easy non-invasive method for diagnosing or excluding exercise-induced laryngeal obstructions in patients with exercise-related respiratory symptoms. However, at present there is no evidence for this recommendation. Aims: To compare physician evaluated pre-and post-exercise flow-volume loops and flow data with laryngoscopic findings during exercise. Methods: Data from 100 consecutive exercise tests with continuous laryngoscopy during the test were analysed. Laryngoscopic images were compared with the corresponding pre-and post-exercise flow-volume loops assessed by four separate physicians and with data from the loops (forced inspiratory flow (FIF) at 25% vs. FIF at 75% of forced inspiratory vital capacity (FIVC), forced expiratory flow at 50% of forced expiratory volume vs. FIF at 50% of FIVC, and FIVC vs. FIF at 50% of FIVC). Results: There was no significant association between the laryngoscopic findings and the flow-volume data. There was no agreement between the four physicians in their assessment of the flow-volume loops (kappa <0.00), and none of the individual physician's assessments were significantly associated with the laryngoscopic findings. Conclusions: Exercise-induced laryngeal obstructions cannot be diagnosed or excluded by physician evaluated pre-and post-exercise flow-volume loops or flow data alone.
U2 - 10.4104/pcrj.2013.00067
DO - 10.4104/pcrj.2013.00067
M3 - Journal article
C2 - 23955336
SN - 1471-4418
VL - 22
SP - 306
EP - 311
JO - Primary Care Respiratory Journal
JF - Primary Care Respiratory Journal
IS - 3
ER -