Shortfalls of the American Academy of Otolaryngology-Head and Neck Surgery's Clinical practice guideline: Hoarseness (Dysphonia)

Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
Michael M JohnsClark A Rosen

Abstract

The Clinical Practice Guideline (CPG) on hoarseness (dysphonia) has several shortcomings that undermine its initial intent to improve the care of patients with dysphonia. The purpose of this document is to identify and comment on those shortcomings. The guideline authors made curious and unsupported policy recommendations in some areas, such as the recommendation for performance of laryngoscopy for hoarseness. For example, the guideline provides a three-month allowance for patients with voice change prior to examination of the larynx, which is a marked change from prior American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) documents suggesting laryngoscopy after two to four weeks of dysphonia and poses a health risk to patients with dysphonia without an established diagnosis. We believe the use of laryngoscopy for the evaluation is dysphonia is primal, plays a vital role in the care of our patients, and should be strongly advocated by the CPG. A significant challenge of the CPG is rooted in its basis on a symptom as opposed to a diagnosis. The decision to confuse the difference between a symptom (hoarseness) and a diagnosis leads to several misleading statements and recommendations. Finally, problems with insuffici...Continue Reading

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Citations

Feb 19, 2013·The Laryngoscope·Neil Bhattacharyya, Lynn J Kepnes
Oct 24, 2013·The Laryngoscope·David EiblingGregory Postma
Jun 28, 2013·The Laryngoscope·Babak SadoughiAndrew Blitzer
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Mar 2, 2018·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Robert J StachlerLorraine C Nnacheta
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