Practice Patterns in Multidisciplinary Voice Assessment and Diagnosis: results from a Global E-survey.

Objective: This study aims to present a current snapshot of the multidisciplinary practice in diagnostic voice assessment for adults with voice disorders, and to explore clinicians’ views on assessment utility. Published best practice guidelines for voice assessment recommend multidisciplinary evaluation utilizing a comprehensive range of standardised clinical measures. Previous survey studies have reported variations in assessment practices when compared with these guidelines.

Methods/Design: A 48-item voluntary anonymous web survey was administered between September 2022 and March 2023. Eligible participants were registered Otolaryngologists (ENTs) and Speech-Language Pathologists (SLPs) working in voice disorder services worldwide with any level of experience.

Results: Responses from 21 ENTs and 88 SLPs from 18 countries with a range of 1->25 years’ experience were analyzed. ENT-initiated and interdisciplinary assessment models were most frequently described, whereas SLP-initiated pathways were also reported by more than 50%. Respondents gave equal weighting to ENT and SLP assessments to aid diagnosis of muscle tension voice disorder and functional voice disorder. Case history was the highest ranked assessment tool for most voice disorder classifications, followed by laryngeal visualisation, then auditory-perceptual evaluation. Most clinicians favored non-validated measures for auditory-perceptual assessment, whilst standard clinical practice utilizing stroboscopy, voice recordings, acoustic measures and aerodynamic measures was divergent with the published recommended protocols.

Conclusions: This study provides important insights to the current multidisciplinary practice patterns of ENTs and SLPs in the assessment of adults with voice disorders, and their preferred utilization of clinical assessment tools in differential diagnosis. Clinicians overwhelmingly value a detailed case history to guide assessment before choosing a battery of assessments to assist diagnosis. Additionally, this study highlights areas where clinical practice does not align with currently available best practice guidance. Further research is needed to understand the decision-making processes of ENT and SLP clinicians during a diagnostic voice assessment.