Interdisciplinary Pediatric Aerodigestive Care and Reduction in Health Care Costs and Burden

Collaco, Joseph M.; Aherrera, Angela; Yeung, Karla J. Au; Lefton‐Greif, Maureen A.; Hoch, Jeannine; Skinner, Michael

doi:10.1001/jamaoto.2014.3057

Cited by 74 publications

(77 citation statements)

References 25 publications

(20 reference statements)

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“…After screening titles and abstracts, 72 full text articles were reviewed for eligibility. Ultimately, seven articles were included in the scoping review . The flow diagram for the search can be seen in Figure , and the qualitative description of included articles can be seen in Table .…”

Section: Resultsmentioning

confidence: 99%

Scoping review: Awareness of neurotoxicity from anesthesia in children in otolaryngology literature

2017

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Despite the high volume of pediatric otolaryngologic procedures performed annually, there remains limited awareness in our literature discussing neurotoxicity as an outcome. Prospective data from anesthesia literature is still pending; therefore, specific recommendations cannot be made at this time. Otolaryngologists should be aware of the concerns and work toward defining elective procedures, combining surgical procedures with other procedures or imaging, and reassessing the timing and frequency of various interventions under general anesthesia in young children. Laryngoscope, 127:1930-1937, 2017.

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Section: Resultsmentioning

confidence: 99%

Scoping review: Awareness of neurotoxicity from anesthesia in children in otolaryngology literature

2017

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“…Historically, multidisciplinary clinics were formed to improve the care of complex patients, as well as the quality of life of their parents, by decreasing hospital expenses, length of stay, and the burden of keeping several appointments with multiple subspecialists (1–3). With the advancement in medicine, the number of surviving extremely premature patients has increased.…”

Section: Introductionmentioning

confidence: 99%

Aerodigestive Approach to Chronic Cough in Children

Naime

Batra

Fiorillo

et al. 2018

Curr Treat Options Peds

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Purpose of review: Chronic cough is the most common presenting complaint in a pediatric aerodigestive clinic. The etiology of chronic cough is varied and often includes more than one organ system. This review aims to summarize the current literature for a multidisciplinary approach when evaluating a child with chronic cough. Recent findings: There is very little medical literature focused on a multidisciplinary approach to chronic cough. In the limited data available, multidisciplinary clinics have been shown to be more cost-efficient for the families of children with complex medical problems, and also increase the likelihood of successfully obtaining a diagnosis. Summary: There is no consensus in the literature on how to work-up a child with chronic cough presenting to an aerodigestive clinic. Current studies from these clinics have shown improved outcomes related to cost-effectiveness and identifying definitive diagnoses. Future studies evaluating clinical outcomes are necessary to help delineate the utility of testing routinely performed, and to demonstrate the impact of interventions from each specialty on quality of life and specific functional outcome measures.

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“…Some programs may also include other service lines such as occupational therapy, general pediatrics, genetics, surgery, anesthesiology, and/or radiology . Historically, these specialties have functioned separately “in siloes” versus integrated within a single clinic due to their expense necessitating extensive investment by the hospital …”

Section: Introductionmentioning

confidence: 99%

“…There has been limited research regarding the most effective algorithm of diagnostic testing in the aerodigestive clinic and its subsequent impact on clinical outcomes . The global care models commonly coordinate radiographic studies such as upper gastrointestinal fluoroscopic studies (UGI) and video fluoroscopic swallowing study (VFSS) with consultation from the subspecialists.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the yield of gastrointestinal testing in pediatric patients in aerodigestive clinic

DeBoer

Kinder

Duggar

et al. 2018

Pediatric Pulmonology

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Objective To improve understanding of the interrelatedness of airway and esophageal diagnoses by evaluating the yield of procedural and radiographic testing of the gastrointestinal tract in children with airway conditions by their referring diagnoses in a pediatric aerodigestive clinic. Methods A retrospective chart review of all 325 patients seen in the aerodigestive program from 2010 to 2013 was performed in a single academic medical center. Demographics and results from esophagogastroduodenoscopies with biopsies (EGD), upper gastrointestinal fluoroscopy studies (UGI), and pH multichannel intraluminal impedance probe (pH‐MII) performed within 30 days of the clinic visit were evaluated according to presenting diagnoses. Results Mean patient age was 3.15 years (range 0.15‐24 years) and 41.2% were born premature. 189/325 (58.1%) were on acid suppression. A total of 295 EGD, 193 pH‐MII, and 54 UGI were performed. The most common diagnosis with an abnormal pH‐MII was asthma. The most common diagnoses with an abnormal EGD were feeding difficulty and tracheal esophageal fistula/ esophageal atresia (TEF/EA). EGDs were normal in 188/295 (63.7%), while 39/295 (13.2%) demonstrated esophagitis, and 22/295 (7.5%) had >15 esophageal eosinophils per high power field. The majority of pH‐MII (144/193 [74.6%]) and UGI (47/54 [87%]) were normal. Conclusions Children with feeding difficulty, TEF/EA, and asthma were the mostly likely to have a histologic abnormality on EGD or an abnormal pH‐MII. The majority of children were previously prescribed acid suppression medication and had a referring diagnosis of gastroesophageal reflux disease but were subsequently found to have normal evaluation. Prospective studies are needed to optimize care of this population.

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Interdisciplinary Pediatric Aerodigestive Care and Reduction in Health Care Costs and Burden

Cited by 74 publications

References 25 publications

Scoping review: Awareness of neurotoxicity from anesthesia in children in otolaryngology literature

Scoping review: Awareness of neurotoxicity from anesthesia in children in otolaryngology literature

Aerodigestive Approach to Chronic Cough in Children

Evaluating the yield of gastrointestinal testing in pediatric patients in aerodigestive clinic

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