Evaluating the Role of the CoPE in Relation to Established Laryngology PROMs

Laryngology patient-reported outcome measures (PROMs) quantify symptoms related to voice, swallowing, and/or breathing. Vocal Cord Paralysis Experience (CoPE) is a PROM developed to evaluate disabilities associated with unilateral vocal fold paralysis (UVFP). The relationship between disease-specific and general symptom-based PROMs has not been previously studied in Laryngology. Correlations between CoPE and established Laryngology PROMs [e.g., Voice Handicap Index-10 (VHI-10), Eating Assessment Tool-10 (EAT-10), Dyspnea Index (DI)] assessed the role and added benefit of CoPE.

Patients with UVFP at a tertiary Laryngology clinic completed CoPE, VHI-10, EAT-10, and DI during routine visits. Comparisons across PROMs were performed.

One hundred and eight unique data collection epochs were obtained from 80 patients (34 men, 46 women), mean age of 62.6 years. Mean scores were 43.4 ± 22 for CoPE, 21.2 ± 10.2 for VHI-10, 9.2 ± 8.5 for EAT-10, and 10.5 ± 9.9 for DI. Comparison of CoPE score to other Laryngology PROMS demonstrated statistically significant, positive correlations: CoPE versus VHI-10 (R = 0.596, p = 0.000), CoPE versus DI (R = 0.424, p = 0.000), and CoPE versus EAT-10 (R = 0.447, p = 0.000). CoPE subscale scores similarly demonstrated statistically significant, positive correlations: CoPE voice subscale versus VHI-10 (R = 0.641, p = 0.000) and CoPE swallowing subscale versus EAT-10 (R = 0.603, p = 0.000).

PROMs are critical for assessing UVFP-related functional impairments. CoPE does not appear to capture unique aspects of the UVFP experience not already covered by VHI-10, DI, and EAT-10. Furthermore, these commonly used Laryngology PROMs have broad utility across many pathologic conditions and can be implemented prior to diagnosis, offering psychometric advantages. Clinicians and researchers can confidently employ commonly used Laryngology PROMs or CoPE to report UVFP results.