Role of Psychological Processes on Symptom Burden in Laryngopharyngeal Reflux

心理过程对咽喉反流症状负担的作用

• 批准号: 10640761
• 负责人: Rena Hiren Yadlapati
• 金额: $ 12.51万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-04-15 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10640761
• 关键词: Accounting; Adult; Affective; Anxiety; Behavior; Behavior Therapy; Caring; Categories; Chronic; Classification; Clinical; Clinical Trials Design; Cognition; Cognitive; Cognitive Therapy; Combined Modality Therapy; Consultations; Coughing; Data; Diagnosis; Diagnostic tests; Discriminant Analysis; Disease; Dysphonia; Esophagus; Fundoplication; Future; Gastroesophageal reflux disease; General Population; Goals; Health Care Costs; Heartburn; Interview; Larynx; Measures; Mental Depression; Mental Health; Mentored Patient-Oriented Research Career Development Award; Methods; Modeling; Operative Surgical Procedures; Patient Self-Report; Patients; Phenotype; Physiological; Principal Component Analysis; Process; Property; Prospective Studies; Proton Pump Inhibitors; Psychometrics; Quality of life; Questionnaires; Randomized, Controlled Trials; Reflux; Reporting; Research; Research Proposals; Resources; Role; Severities; Sore Throat; Speech; Symptoms; Syndrome; Treatment outcome; United States National Institutes of Health; Work; career; clinical practice; comparison intervention; efficacy evaluation; experience; health related quality of life; healthy volunteer; inhibitor therapy; innovation; instrument; laryngopharyngeal reflux; novel; poor health outcome; programs; psychologic; psychological distress; psychological stressor; psychosocial; success; symptomatic improvement; targeted treatment; therapeutic target; tool; treatment response

PROJECT SUMMARY/ABSTRACT Generalized approaches for laryngopharyngeal reflux (LPR), a prevalent and heterogeneous syndrome in which laryngeal symptoms are attributed to gastroesophageal reflux, have led to poor health outcomes, inappropriate resource utilization, and tremendous healthcare costs. The long-term career goal is to discover phenotype guided care paradigms for LPR, focused on distinct disease mechanism. Our preliminary findings have generated the central hypothesis that identification of distinct LPR phenotypes is feasible and that psychological processes such as hypervigilance and anxiety impact symptom burden in LPR. Thus, the overall objectives in this proposal are to establish a validated method to measure levels of hypervigilance and anxiety surrounding laryngeal symptoms and understand whether distinct LPR phenotypes report differing levels of hypervigilance and anxiety. The rationale for this project is that it will highlight the impact of cognitive-affective processes on LPR symptom burden and generate hypotheses surrounding the role of behavioral interventions in LPR. Thus, two specific aims will be pursued: 1) validate the laryngeal hypervigilance and anxiety scale [LHAS] self-report instrument, and 2) measure levels of hypervigilance and anxiety across distinct LPR phenotypes. Under the first aim, 200 symptomatic patients and 40 healthy volunteers will complete the LHAS and a set of validated instruments measuring psychological distress and health related quality of life. Psychometric properties of the LHAS will be assessed and a preliminary cutoff for the LHAS will be determined. Under the second aim, the 200 symptomatic patients will be categorized into LPR phenotypes utilizing our prior model from discriminant analysis of principal components. Levels of laryngeal hypervigilance and anxiety will be measured and compared across LPR phenotypes, as well as the healthy volunteers. The proposed research is significant as it is expected to fill a key evidence gap about the interplay of psychological stressors on LPR symptom burden. This research is innovative as it will provide a novel clinical tool to evaluate cognitive affective processes in patients with LPR as well as inform the framework of a first-of- its-kind phenotype stratified randomized controlled trial to assess efficacy of behavioral interventions compared to traditional anti-reflux therapy such as proton pump inhibitors in patients with LPR.

项目概要/摘要 喉咽反流 (LPR) 的通用方法，这是一种常见的异质综合征 哪些喉部症状归因于胃食管反流，导致健康结果不佳， 资源利用不当，以及巨大的医疗费用。长期的职业目标是发现 LPR 表型指导护理范例，重点关注不同的疾病机制。我们的初步调查结果 产生了中心假设，即识别不同的 LPR 表型是可行的，并且 过度警觉和焦虑等心理过程会影响 LPR 的症状负担。因此，总体 该提案的目标是建立一种经过验证的方法来测量过度警觉和焦虑的水平 周围喉部症状并了解不同的 LPR 表型是否报告不同水平的 过度警惕和焦虑。该项目的基本原理是它将强调认知情感的影响 LPR 症状负担的过程并产生围绕行为干预作用的假设 在LPR中。因此，将追求两个具体目标：1）验证喉部过度警觉和焦虑量表 [LHAS] 自我报告工具，2) 测量不同 LPR 的过度警觉和焦虑水平 表型。第一个目标是 200 名有症状的患者和 40 名健康志愿者将完成 LHAS 以及一套经过验证的测量心理困扰和健康相关生活质量的仪器。 将评估 LHAS 的心理测量特性，并确定 LHAS 的初步截止值 决定。根据第二个目标，200名有症状的患者将被分为LPR表型 利用我们先前的主成分判别分析模型。喉部过度警觉程度 将对 LPR 表型以及健康志愿者的焦虑进行测量和比较。这 拟议的研究意义重大，因为它有望填补关于相互作用的关键证据空白 LPR 症状负担的心理压力源。这项研究具有创新性，因为它将提供一种新的临床方法 评估 LPR 患者认知情感过程的工具，并为第一个框架提供信息 同类表型分层随机对照试验评估行为干预措施的疗效比较 LPR 患者的质子泵抑制剂等传统抗反流治疗。