Evidence-Based Statements (recommendation  levels  )

Grades / Levels of Evidence

1.     The use of GRBAS Scales for voice quality evaluation?

In the GRBAS Scales, four grades of scale are recommended because of their high reproduction rate and sufficient resolution

Strong Recommendation

A

2.     Using the VHI and V-RQOL as patient-reported outcome measures?

They  are,  strongly

recommended  as  subjective  evaluation  tools  for  voice  disorders as they are highly  reliable  and  validated

Strong Recommendation

A

3.     Laryngoscopy use for the assessment of dysphonia?.

Laryngoscopy is an essential tool for visualization of the larynx to diagnose the cause of dysphonia

Strong Recommendation

A

4.     The use of laryngostroboscopy in dysphonia?

Laryngostroboscopy is useful for diagnosis of voice disorders. It is also useful for the diagnosis and monitoring. Laryngostroboscopy was useful for the diagnosis of patients with voice disorders in 27.2% of cases

Recommendation

C

5.     Using acoustic analysis of voice clinically

Acoustic analysis is useful in objective evaluation of voice disorders, especially for evaluating effectiveness of treatment.

Recommendation

C

6.     The use of aerodynamic assessment of voice disorders

measurement  of  voice  strength, measurement  of  pitch,  measurement  of  expiratory  flow  in

phonation, measurement  of  MPT,  measured  individually or combined

Recommendation

C

7.     Antireflux medication

Clinicians should notprescribe antireflux medications to treat

isolated dysphonia based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or

laryngopharyngeal reflux (LPR), without visualization of the larynx

Recommendation against

C

8.     Corticosteroid therapy

Clinicians should notroutinely prescribe corticosteroids for patients

with dysphonia prior to visualization of the larynx

Recommendation against

C

9.     Antimicrobial therapy

Clinicians should not routinely prescribe antibiotics to treat

dysphonia.

Strong recommendation

against

A

10.  Advocating for voice therapy

clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy

Strong recommendation

A

11.  Imaging

clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) among patients with a primary voice complaint prior to visualization of the larynx

Recommendation against

c

12.  Education/prevention.

Clinicians should inform patients with dysphonia about control/preventive measures

Recommendation

C

13.  Outcomes

Clinicians should document resolution, improvement, or worsened symptoms of dysphonia or change in QOL among patients with dysphonia after treatment or observation.

Recommendation

C