Evidence map›Paper›PMID 27625028›Full record

ArticleOtolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery2017

Nonadherence to Guideline Recommendations for Tympanostomy Tube Insertion in Children Based on Mega-database Claims Analysis.

Mirabelle Sajisevi, Kristine Schulz, Derek D Cyr, Daniel Wojdyla, Richard M Rosenfeld, Debara Tucci, David L Witsell

Abstract read
In one paragraph

Article in Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Healthcare utilisation, follow-up of guidelines and practice variation on rhinosinusitis in adults: A healthcare reimbursement claims study in The Netherlands.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2020
    Article
  3. Review
  4. Adherence to Clinical Practice Guidelines.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2017
    Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mirabelle Sajisevi1 Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Kristine Schulz1 Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
Derek D Cyr2 Duke Clinical Research Institute, Durham, North Carolina, USA.
Daniel Wojdyla2 Duke Clinical Research Institute, Durham, North Carolina, USA.
Richard M Rosenfeld3 Department of Otolaryngology, State University of New York Downstate Medical Center, Brooklyn, New York, USA.
Debara Tucci1 Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.
David L Witsell1 Division of Head and Neck Surgery and Communication Sciences, Department of Surgery, Duke University School of Medicine, Durham, North Carolina, USA.

Funding

The CHEER NetworkU24DC012206 · NIDCD · DUKE UNIVERSITY · PI WITSELL, DAVID L · 2012 to 2016
$4.1M
NIDCD NIH HHS U24 DC012206
6 · The paper itself

Abstract

Objective To estimate the nonadherence rate of pressure equalization (tympanostomy) tube (PET) placement in the preceding 3-year period before release of the 2013 American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guideline (CPG). Study Design Analysis of the Truven Health MarketScan Research Databases (2010-2012). Subjects and Methods Medical claims data from 2010 to 2012 were analyzed. Children aged ≤12 years with otitis media (OM)-related diagnoses were identified. Adherence and nonadherence rates for OM and PET placement were analyzed through administrative codes extrapolated from the key action statements (KASs) of the CPG. KASs were aggregated to estimate the overall nonadherence and determine areas for quality improvement. Results A total of 9,726,411 visits with OM-associated codes among 3,710,730 children were identified: 2.9% (80,451 of 3,239,700) were considered nonadherent to KAS 1 because a code for PET placement occurred with a first episode of OM with effusion <3 months; 52.1% (14,534 of 27,913) underwent PET placement for OM with effusion of >3 months and had a concurrent hearing loss code. For those without hearing loss who underwent PET placement, 48.3% (52,921 of 109,583) had a diagnosis code indicating risk for speech, language, or learning problems. For each KAS, we found heterogeneity of computed nonadherence rates by region, age, and season. Conclusion Before guideline dissemination, we found low to moderate rates of nonadherence to guideline recommendation. Deeper analysis of mega-databases could provide better insights for measurement of guideline adherence. The expansion of administrative and clinical databases provides a unique opportunity to investigate the impact of CPGs.

Indexed as

Guideline AdherenceMiddle Ear VentilationChildChild, PreschoolDatabases, FactualFemaleHumansInfantInsurance Claim ReviewMaleOtitis MediaPatient SelectionPractice Guidelines as TopicRetrospective StudiesAAO-HNSF clinical practice guidelineguideline complianceMarketScanotitis mediatympanostomy tubes

Identifiers

PMID27625028
PMCPMC5580253

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.