A new clinical ’toolkit’ designed to improve the management of inducible laryngeal obstruction/vocal cord dysfunction (ILO/VCD), a complex airway disorder, has been developed and launched by University of Newcastle and Hunter Medical Research Institute researchers. 

The Inducible Laryngeal Obstruction/Vocal Cord Dysfunction (ILO/VCD) Toolkit is a free, evidence-based, online resource that helps clinicians assess and manage the condition, so they can provide the best possible care for their patients. 

Developed by the Centre of Excellence in Treatable Traits, the toolkit consolidates current clinical guidance, diagnostic aids, educational materials, and management strategies into one accessible platform for health professionals across Australia and beyond.

The misdiagnosis challenge of ILO/VCD 

ILO/VCD is a condition where the vocal cords temporarily close or narrow during breathing, causing airflow restriction and symptoms such as shortness of breath, wheezing, coughing, or throat tightness. These symptoms closely resemble those of asthma, and as a result, patients are often misdiagnosed and may be prescribed unnecessary or potentially harmful treatments such as oral corticosteroids.

The condition is more common than previously thought, affecting around 20 per cent of people with asthma, 10 per cent of high-level athletes, and up to 70 per cent of individuals with chronic cough. 

University of Newcastle’s Dr Vanessa Clark, from HMRI’s Asthma and Breathing Research Program, said the new resource will support clinicians in identifying and managing ILO/VCD more confidently, helping to improve outcomes for patients with symptoms that can resemble other respiratory conditions. 

“Recognition of ILO/VCD is growing, and we now understand it plays a key role across many specialties, from ENT and respiratory medicine to paediatrics, sports medicine, allergy, emergency medicine, neurology, intensive care, and speech pathology. When mistaken for asthma, ILO/VCD can make a condition seem more severe or difficult to treat than it really is, potentially leading to harm from unnecessary high-dose steroid treatments.” Dr Clark said. 

A resource built on collaboration

The ILO/VCD Toolkit was developed with input from more than 40 international experts across a wide range of medical specialties including respiratory medicine, ENT surgery, sports medicine, speech pathology, allergy, paediatrics, emergency medicine, neurology, and intensive care. 

It builds on the success of earlier toolkits such as the Severe Asthma Toolkit and Asthma in Pregnancy Toolkit, which have supported clinicians around the world in improving care for people with complex respiratory conditions. 

The toolkit was developed following a June 2022 international roundtable hosted by the Centre of Excellence in Treatable Traits, which brought together clinicians, researchers, and health sector stakeholders to address the clinical challenges of ILO/VCD. Consensus from this meeting confirmed the urgent need for a dedicated clinical and educational resource. 

Growing international recognition and support 

Recognition of ILO/VCD has grown significantly over recent years. In 2022, the International Olympic Committee formally acknowledged Exercise-Induced Laryngeal Obstruction (EILO), a form of ILO that frequently affects athletes. In 2023, the Brighton Collaboration Anaphylaxis Case Definition also noted that ILO/VCD can mimic anaphylaxis, underscoring the importance of accurate diagnosis in emergency settings. 

A recent Delphi study led by the Centre of Excellence in Treatable Traits published in the Journal of Allergy and Clinical Immunology established expert consensus on diagnostic criteria, further advancing international understanding of the condition. 

Bridging knowledge and practice 

The ILO/VCD Toolkit is designed to be user-friendly and accessible, and includes: 

• Diagnostic algorithms tailored for primary and specialist care 

• Current evidence-based clinical guidelines 

• Case studies and educational videos 

• Patient resources to support communication and care

It is intended for use by a broad range of healthcare professionals, including general practitioners, respiratory and ENT specialists, speech pathologists, and emergency clinicians. 

Professor Vanessa McDonald, from the University of Newcastle and HMRI’s Asthma and Breathing Research Program, said the ILO/VCD Toolkit fills a critical gap in care for people living with the condition and is a valuable resource for clinicians.

“The ILO/VCD Toolkit enhances community care by raising awareness among health professionals, supporting accurate diagnosis and effective management, and empowering patients through education. It bridges important knowledge gaps and ultimately helps improve outcomes for those living with inducible laryngeal obstruction / vocal cord dysfunction,” said Professor McDonald.

Access the toolkit