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Laryngology/Broncho-Esophagology

Novel QOL Survey Tracks Progression of Idiopathic Subglottic Stenosis

Monday, October 2, 2023
5:18 PM - 5:24 PM East Coast USA Time
Location: 106BC

    Presenting Author(s)

  • Richard J. Lu, MD, MBA, MSc

    Resident Physician
    New York Presbyterian - Columbia/Cornell, Harvard Medical School
    Ballwin, MO, United States

    • Co-Author(s)

  • Ramon A. Franco, Jr., MD

    Associate Professor
    Mass Eye and Ear/Harvard Medical School
    Boston, MA, United States

Disclosure(s):
Richard J. Lu, MD, MBA, MSc: No relevant relationships to disclose.
Ramon A. Franco, MD, Jr.: No relevant relationships to disclose.
Introduction: Idiopathic subglottic stenosis (ISGS) is a chronic disease defined by fibro-inflammatory narrowing of the subglottic airway. A key challenge in treatment of this recurrent disease is monitoring disease progression, which may be debilitating and unpredictable in timing. The overall aim of this study is twofold: (1) to validate the SGS-6 as a novel QoL instrument for patients with ISGS, and (2) to show its correlation with disease severity as a proactive and remote means of assessing patients’ breathing to offer more personalized and timely therapeutic intervention.

Methods: Panel data from 87 patients with idiopathic sub-glottic stenosis were collected from January 2012 through June 2022, representing 1,999 patient encounters including routine office visits and treatment encounters (i.e., with serial steroid injections or balloon dilations). Both subjective QoL scores (including the novel SGS-6, and established RAND-36 and EQ-5D VAS) and objective PFTs were collected at each visit. Subjective SGS-6 QoL scores were repeated within one week of initial reporting, and used as the basis for instrument validation. Panel regression analyses were performed to assess the relationship between QoL scores, PFT scores, and a patient’s need for intervention.

Results: Each increase in SGS-6 score, reported out of a total of 27, was associated with a 3.28% decrease in PEF%, 1.92 point decrease in RAND-36 Physical Health composite and 1.24 point decrease in RAND-36 Mental Health Composite, and 0.88 point decrease in EQ-5D VAS score. When compared to patient baselines, a patient’s need for intervention was associated with a 4-point increase in SGS-6. The intra-correlation coefficient for the SGS-6 Composite score is 0.838 (95% CI: 0.770-0.888), demonstrating good intra-test reliability.

Conclusions: Idiopathic subglottic stenosis (ISGS) disease severity can be modeled using the SGS-6 questionnaire, offering physicians and patients a potentially new method of tracking disease progression remotely and to assess when an intervention is needed in a more timely manner.