Figures
- FIGURE 1
The grading system illustrated by photographic images of the larynx showing the different grades of laryngeal obstruction at the glottic and supraglottic levels. #: the scores at each level (glottic (A and C) and supraglottic (B and D)) were assessed at moderate (A, B) (when the subject started to run) and at maximal (C, D) (just before the subject stopped running on the treadmill) effort; all four levels (A–D) were noted together with a sum score (E) for each test/subject. Reproduced from [11] with permission from the publisher.
- FIGURE 2
Diagnostic implications: one or more changes in exercise-induced laryngeal obstruction diagnosis (i.e. having or not having clinically significant laryngeal obstruction at either the glottic or the supraglottic level) over the course of the four tests. In a secondary analysis, the first test was excluded from analysis to depict implications due to intra-rater and test–retest variation only (i.e. excluding any learning effect; see also figure 3).
- FIGURE 3
Learning effect on test duration. Data are presented as predicted means±se from a linear mixed model of group and time as predictors of test duration. EILO: exercise-induced laryngeal obstruction. *: p<0.05.
Tables
- TABLE 1
Subject characteristics
Sex n (%) Female 19 (83) Male 4 (17) Age years median (range) 23 (15–45) Body mass index kg·m−2 21.1 (4.6) FEV1 L 3.50 (1.2) FEV1 % pred 98.7 (25) FVC L 4.30 (1.2) FVC % pred 103.3 (26.1) Data are presented as median (interquartile range), unless otherwise stated. FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity.
- TABLE 2
Test–retest reliability of exercise-induced laryngeal obstruction grade scores and time to onset
Tests 1 and 2 Tests 2 and 3 Tests 3 and 4 Cohen's ϰ (95% CI) ICC (95% CI) Cohen's ϰ (95% CI) ICC (95% CI) Cohen's ϰ (95% CI) ICC (95% CI) Glottic scores 0.49 (0.32–0.67) 0.52 (0.35–0.70) 0.40 (0.23–0.57) Supraglottic scores 0.31 (0.07–0.55) 0.45 (0.25–0.65) 0.58 (0.41–0.76) Time to onset 0.61 (0.37–0.77) 0.86 (0.73–0.92) 0.79 (0.61–0.89) ICC: intraclass correlation coefficient (2,1), single measures.
- TABLE 3
Inter-rater agreement on exercise-induced laryngeal obstruction grade scores and time to onset
Raters 1 and 2 Raters 2 and 3 Raters 3 and 1 Cohen's ϰ (95% CI) ICC (95% CI) Cohen's ϰ (95% CI) ICC (95% CI) Cohen's ϰ (95% CI) ICC (95% CI) Glottic scores 0.16 (0.03–0.29) 0.45 (0.30–0.59) 0.16 (0.08–0.25) Supraglottic scores 0.42 (0.27–0.57) 0.40 (0.20–0.60) 0.30 (0.15–0.44) Time to onset 0.54 (0.29–0.72) 0.56 (0.00–0.80) 0.55 (0.36–0.70) ICC: intraclass correlation coefficient (2,1), single measures.
- TABLE 4
Intra-rater agreement on exercise-induced laryngeal obstruction grade scores and time to onset
Glottic scores Supraglottic scores Time to onset ϰ (95% CI) ϰ (95% CI) ICC (95% CI) Rater 1 0.30 (0.10–0.49) 0.41 (0.27–0.55) 0.45 (0.23–0.62) Rater 2 0.48 (0.31–0.64) 0.56 (0.40–0.71) 0.85 (0.74–0.92) Rater 3 0.67 (0.56–0.79) 0.43 (0.23–0.63) 0.43 (0.22–0.60) All raters 0.58 (0.49–0.66) 0.48 (0.39–0.57) 0.51 (0.39–0.61) ICC: intraclass correlation coefficient (2,1), single measures.
