Ménière’s Disease

Abstract

Objective 1) Integrate practice-based patient encounters using the Dartmouth Atlas Medicare database to understand practice treatments for Meniere's Disease (MD). 2) Describe differences in the practice patterns between academic and community providers for MD. Study Design Practice-based research database review. Setting “CHEER Network” academic and community providers. Subjects and Methods MD patient data were identified using ICD-9 and CPT codes. Demographics, unique visits, and procedures per patient were tabulated. The Dartmouth Atlas of Healthcare was used to reference regional healthcare utilization. Statistical analysis included one-way analyses of variance (ANOVA), bivariate linear regression, and Student's t-tests with significance set at p-values less than 0.05. Results 2,071 unique patients with MD were identified from 8 academic and 10 community OHNS provider centers nationally. Average age was 56.5, 63.9% were female and 91.4% self-reported white ethnicity. There was an average of 3.2 visits per patient. Western providers had the highest average visits per patient. Midwest providers had the highest average procedures per patient. Community providers had more visits per site and per patient than academic providers. Academic providers had significantly more operative procedures per patient (p = 0.0002), compared to community providers. Healthcare Service Areas with higher total Medicare reimbursements per enrollee did not report significantly more operative procedures being performed. Conclusion This is the first practice-based clinical research database study to describe MD practice patterns. We demonstrate that academic OHNS providers perform significantly more operative procedures than community providers for MD, and validate this data with an independent Medicare spending database.

Trends in Management of Ménière Disease: A TriNetX Network Database Analysis

“…This plateau in intratympanic injection usage is a novel finding and may represent general acceptance of the strategy in tertiary centers comprising the cohort. Academic practices were previously observed to utilize such procedural treatment more frequently for MD than community centers 4,9 . Analysis of treatment trends in community practices after guideline publication might reveal trends not observed here.…”

“…Academic practices were previously observed to utilize such procedural treatment more frequently for MD than community centers. 4,9 Analysis of treatment trends in community practices after guideline publication might reveal trends not observed here.…”

Quality Indicators for the Diagnosis and Management of Menière's Disease

“…Furthermore, once a patient receives a definite diagnosis of MD, there is no universally accepted standard of care. Crowson et al (33) demonstrated that academic otolaryngologists perform significantly more operative procedures for MD patients than community otolaryngologists, although these variations have multiple explanations including operating room variability, training and ability, along with operative case referral.…”

Demografische und epidemiologische Risikofaktoren bei Patienten mit akuter unilateraler Vestibulopathie M. Menière (hydropische Innenohrerkrankung)

“…Die Neuropathia vestibularis (NV) ist nach dem benignen paroxysmalen Lagerungsschwindel (BPLS) die zweithäufigste Ursache für peripher-vestibulären Schwindel [1]. Im Vergleich zu periphervestibulären Schwindelerkrankungen wie dem Morbus Menière oder dem BPLS gibt es für die NV nur unzureichend Daten aus großen demografischen Studien [2,3].…”