Use of Advanced Imaging Technology and Endoscopy for Chronic Rhinosinusitis Varies by Physician Specialty

Pynnonen, Melissa A.; Lin, Guojian; Dunn, Rodney L.; Hollenbeck, Brent K.

doi:10.2500/ajra.2012.26.3817

Cited by 7 publications

(9 citation statements)

References 18 publications

(28 reference statements)

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“…Though exact utilization rates cannot be determined from this data, approximately 10% of the visits involved CT imaging (∼5 scans in 50 patients). This would appear to be in congruence with the utilization rates of between 10.4% and 16.0% reported . This further corroborates the recent study by Bhattacharyya, noting that despite widespread availability of imaging and strong prevalence of sinonasal diagnoses, CT ordering patterns in otolaryngologists did not result in increased utilization over a 6‐year period.…”

Section: Discussionsupporting

confidence: 89%

“…A recent analysis of the National Ambulatory Medical Care Survey from 2005 through 2008 showed that otolaryngologists use advanced radiographic imaging at a statistically significant higher rate than primary care physicians per outpatient visit for diagnosis of CRS (16.0% vs 1.93%) . This widespread utility underscores the concerns related to sinus CT imaging, including potential for overutilization, substantial costs, and excessive radiation exposure.…”

mentioning

confidence: 99%

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Computed tomography imaging practice patterns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology–Head and Neck Surgery and American Rhinologic Society membership

Batra

Setzen²,

et al. 2015

Int Forum Allergy Rhinol

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Section: Discussionsupporting

confidence: 89%

mentioning

confidence: 99%

Computed tomography imaging practice patterns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology–Head and Neck Surgery and American Rhinologic Society membership

Batra

Setzen²,

et al. 2015

Int Forum Allergy Rhinol

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“…Although we must be careful not to over generalize the results of this study, the implication is that a substantial proportion of the millions of PC and EM visits attributed to chronic sinusitis every year may be misdiagnoses. 2,3,14,15 Many patients may have migraine, tension headache, other neurologic conditions, and rhinitis—conditions known to be common among patients misdiagnosed with chronic sinusitis. 4,5,16,17 Given the burden of disease attributed to chronic sinusitis this is an economically important issue.…”

Section: Discussionmentioning

confidence: 99%

A diagnostic dilemma: chronic sinusitis diagnosed by non‐otolaryngologists

Novis

Akkina

Lynn

et al. 2016

Int Forum Allergy Rhinol

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Background Ambulatory care visits for chronic sinusitis outnumber visits for acute sinusitis. The majority of these visits are with non-otolaryngologists. In order to better understand patients diagnosed with chronic sinusitis by non-otolaryngologists, we sought to determine if incident cases of chronic sinusitis diagnosed by primary care (PC) or emergency medicine (EM) providers meet diagnostic criteria. Methods Retrospective cohort. Patients were identified using administrative data, 2005–2006. The dataset was then clinically annotated based on chart review. We excluded prevalent cases. Results We identified 114 patients with newly diagnosed chronic sinusitis in EM (75) or PC settings (39). Rhinorrhea (EM 61%, PC 59%) and nasal obstruction (EM 67%, PC 64%) were common in both settings but facial fullness (EM 80%, PC 39%) and pain (EM 40%, PC 18%) were more common in the EM setting. Few patients reported symptoms of 90 days or longer (EM 6.0%, PC 24%) and no patient had evidence of inflammation on physical examination. A minority of patients received a sinus CT scan (22.8%) or nasal endoscopy (1.8%). In total only 1 patient diagnosed with chronic sinusitis met the diagnostic criteria. Conclusions Most patients diagnosed with chronic sinusitis by non-otolaryngologists do not have the condition. Caution should be used in studying chronic sinusitis using administrative data from non-otolaryngology providers as a large proportion of the patients may not actually have the disease.

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“…33–36 It has also provided data for pediatric-specific inquiries on a broader scale. 37,38 Nonetheless, for the basic inquiry into the risk factors for pediatric SNHL over a 1-year time frame, the database did not house adequate observations for a complete analysis.…”

Section: Discussionmentioning

confidence: 99%

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

Bellmunt

Roberts

Lee

et al. 2016

Otolaryngol.--head neck surg.

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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.

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Use of Advanced Imaging Technology and Endoscopy for Chronic Rhinosinusitis Varies by Physician Specialty

Abstract: ABSTRACT

Cited by 7 publications

References 18 publications

Computed tomography imaging practice patterns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology–Head and Neck Surgery and American Rhinologic Society membership

Computed tomography imaging practice patterns in adult chronic rhinosinusitis: survey of the American Academy of Otolaryngology–Head and Neck Surgery and American Rhinologic Society membership

A diagnostic dilemma: chronic sinusitis diagnosed by non‐otolaryngologists

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

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