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    Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction

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    Authors
    Haines, J.
    Smith, J. A.
    Wingfield-Digby, J.
    King, J.
    Yorke, Janelle
    Fowler, S. J.
    Affiliation
    Faculty of Biology, Medicine and Health, School of Biological Sciences, Division of Infection, Immunity & Respiratory Medicine, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK
    Issue Date
    2022
    
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    Abstract
    Introduction: Inducible laryngeal obstruction (ILO) describes transient laryngeal closure during respiration and can cause significant morbidity. Non-pharmacological behavioural therapy is the commonly cited treatment but efficacy is largely unknown. Aim: To synthesise the current evidence base on the effectiveness of non-pharmacological interventions used to treat adults with ILO. Methods: Electronic databases (Medline/Embase/CINAHL/PsycINFO/AMED/CENTRAL) were systematically searched, informed by a population, intervention, comparison, outcome framework. Two reviewers independently screened a representative sample, with lead-author completion due to excellent inter-rater reliability. Data was extracted using a predefined piloted form. Methodological quality was appraised (blindly by two reviewers) using the Joanna Briggs Institute Critical Appraisal Tools. A narrative synthesis was performed due to heterogeneity of studies (PROSPERO registration number: CRD42020213187). Results: Initial searching identified 3359 records. Full-text screening occurred in 92 records and 14 studies, comprising 527 participants, were deemed eligible. All studies were low-level evidence (observational by design, with four case reports), with a high risk of bias; none contained control arms for comparison. Intervention description was inconsistently and poorly described but direction of effect was positive in 76% of outcomes measured. The majority of studies showed a reduction in symptom scores and improved direct laryngeal imaging post intervention; there was an overall reduction, 59.5%, in healthcare utilisation. Discussion: The literature is in an embryonic state and lacks robust data to truly inform on the effectiveness of non-pharmacological interventions used to treat adults with ILO. However, positive signals in the synthesis performed support non-pharmacological treatment approaches and further development is warranted.
    Citation
    Haines J, Smith JA, Wingfield-Digby J, King J, Yorke J, Fowler SJ. Systematic review of the effectiveness of non-pharmacological interventions used to treat adults with inducible laryngeal obstruction. Vol. 9, BMJ Open Respiratory Research. BMJ; 2022. p. e001199.
    Journal
    Bmj Open Respiratory Research
    URI
    http://hdl.handle.net/10541/625375
    DOI
    10.1136/bmjresp-2022-001199
    PubMed ID
    35705262
    Additional Links
    https://dx.doi.org/10.1136/bmjresp-2022-001199
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1136/bmjresp-2022-001199
    Scopus Count
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    All Christie Publications

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