Does an Otolaryngology‐Specific Database Have Added Value? A Comparative Feasibility Analysis

Abstract

Objectives There are multiple nationally representative databases that support epidemiologic and outcomes research, and it is unknown whether an otolaryngology-specific resource would prove indispensable or superfluous. Therefore, our objective was to determine the feasibility of analyses in the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) databases as compared with the otolaryngology-specific Creating Healthcare Excellence through Education and Research (CHEER) database. Study Design Parallel analyses in 2 data sets. Setting Ambulatory visits in the United States. Subjects and Methods To test a fixed hypothesis that could be directly compared between data sets, we focused on a condition with expected prevalence high enough to substantiate availability in both. This query also encompassed a broad span of diagnoses to sample the breadth of available information. Specifically, we compared an assessment of suspected risk factors for sensorineural hearing loss in subjects 0 to 21 years of age, according to a predetermined protocol. We also assessed the feasibility of 6 additional diagnostic queries among all age groups. Results In the NAMCS/NHAMCS data set, the number of measured observations was not sufficient to support reliable numeric conclusions (percentage standard error among risk factors: 38.6–92.1). Analysis of the CHEER database demonstrated that age, sex, meningitis, and cytomegalovirus were statistically significant factors associated with pediatric sensorineural hearing loss (P <.01). Among the 6 additional diagnostic queries assessed, NAMCS/NHAMCS usage was also infeasible; the CHEER database contained 1585 to 212,521 more observations per annum. Conclusion An otolaryngology-specific database has added utility when compared with already available national ambulatory databases.

The Burden and Epidemiology of Eustachian Tube Dysfunction in Adults

“…They are, however, designed to support estimates of visit frequency, an ideal characteristic for this inquiry. Fourth, NAMCS/NHAMCS is not a dedicated otolaryngology–head and neck surgery database, 28 and there were, unfortunately, not sufficient observations to explore the specific population of those with head and neck malignancies and related radiation therapy in this data source. Prior studies demonstrate that ipsilateral OME and conductive hearing loss are present in 26% to 40% of patients with nasopharyngeal carcinoma, respectively 29,30 .…”

The Potential of Life with CHEER

“…CHEER is designed to obtain further insight into otolaryngology‐specific conditions. This feature is a particular boon, as currently available national databases may have limitations in their ability to assess conditions that are fundamental in our field, such as chronic suppurative otitis media, cholesteatoma, adenoid hypertrophy, and inferior turbinate hypertrophy 7 . Since CHEER focuses on disorders within otolaryngology–head and neck surgery, there is a wealth of specialty‐ and disease‐specific data that may be obtained through the organization’s efforts.…”

“…11 A sixth study focuses on the feasibility of analyses in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey databases as compared with the CHEER database. 7 A seventh publication describes the management of sudden sensorineural hearing loss in enrollees at 16 sites 12 in comparison with recommendations in the related clinical practice guideline. 13 These publications incorporate data from our practices, both community and academic-spanning the nationwide breadth of our specialty expertise and exemplifying a spirit of cooperation and commitment that we are proud to highlight.…”

“…A fifth evaluation spans 12 sites and centers on the use of vestibular testing for patients presenting with dizziness 11 . A sixth study focuses on the feasibility of analyses in the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey databases as compared with the CHEER database 7 . A seventh publication describes the management of sudden sensorineural hearing loss in enrollees at 16 sites 12 in comparison with recommendations in the related clinical practice guideline 13 .…”

Regent

“…The ability to produce reliable and reproducible results will be critical to those who want to maximally participate in this evolving paradigm. Databases such as CHEER (Creating Healthcare Excellence through Education and Research) and the one being developed by the American Academy of Otolaryngology—Head and Neck Surgery Foundation in its clinical data registry Regent,SM which Bellmunt et al discuss in this issue of the journal, 1 will be the key to compiling the evidence necessary for our members to meaningfully share in the progress toward better patient care while complying with the reporting requirements built into the post‐MACRA environment (ie, Medicare Access and Children’s Health Insurance Program Reauthorization Act).…”