A59-14 Evaluating the Tools: A Systematic Review of Questionnaires for Inducible Laryngeal Obstruction

Abstract Rationale The reliability, validity, and diagnostic utility of currently available inducible laryngeal obstruction (ILO) screening questionnaires is unclear. Methods A systematic search of six databases was conducted using MeSH terms “patients,” “vocal cord dysfunction,” and “surveys and questionnaires.”. Inclusion criteria were pediatric (0-18 years) and adult studies in English describing questionnaires for ILO or synonymous terms and ILO diagnostic confirmation via imaging or bronchoscopy. Data extraction was performed by two reviewers, with conflicts resolved by a third reviewer. Methodological quality and risk of bias were assessed using the COSMIN II tool and the study is reported using the PRISMA-STARDT guidelines. Results Of 2,626 records identified, 354 were duplicates, and 99 were assessed as full-texts. Twenty-two studies met inclusion criteria, with two additional studies identified through reference scanning. Two tools were developed for pediatric populations, two for adolescents/adults, and seven for adults. Number of items per tool ranged from 4-23, predominantly using Likert-type scales. Two questionnaires were completed by the screening physician, with others patient reported. Exercise-Induced Laryngeal Obstruction Diagnostic Index (EILODI) was designed to assess treatment responsiveness in adolescents aged 12-21 years with confirmed ILO, rather than diagnostic screening. All other tools were developed to screen prior to diagnostic imaging. Pittsburgh Vocal Cord Dysfunction Index was developed specifically to distinguish vocal cord dysfunction (VCD) from asthma, while six other tools (EILODI, Vocal Cord Dysfunction Questionnaire, Laryngeal Hypersensitivity Questionnaire, Nijmegen Questionnaire, Breathlessness Triggers Survey, and Paroxysmal Vocal Fold Motion Dysfunction Standard Questionnaire) reported discriminative validity data comparing asthma and VCD. Vocal Cord Dysfunction Questionnaire (VCDQ) demonstrated strong content validity, reliability, and discriminative validity, with secondary studies confirming good internal consistency and cross-cultural adaptation. Newcastle Laryngeal Hypersensitivity Questionnaire (NLHQ) showed robust development with strong content, structural, and convergent validity, though later studies found no significant pre-post treatment score changes. Dyspnea Index (DI) underwent the most comprehensive development process, incorporating both patient and clinician input to ensure excellent content and structural validity, as well as significant discriminative and convergent validity. Exercise Induced Laryngeal Obstruction Dysfunction Index (EILODI) demonstrated strong developmental rigor, including extensive focus group input to ensure pediatric relevance and comprehensibility, though it failed to achieve statistical significance in distinguishing asthma from ILO. Conclusions Across all tools, there was notable lack of cross-cultural validation and limited longitudinal follow-up assessing clinical effectiveness across different respiratory settings. Dyspnea Index emerged as the most rigorously developed and clinically applicable ILO screening questionnaire. This abstract is funded by: None