Evidence map›Paper›PMID 31730729›Full record

ArticleThe Laryngoscope2020

Clinician adherence to the clinical practice guideline: Acute otitis externa.

Nicholas Mildenhall, Adam Honeybrook, Thomas Risoli, Sarah B Peskoe, Amie Kim, David Kaylie

Abstract read
In one paragraph

Article in The Laryngoscope, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Evaluation of pain management strategies in acute infectious otologic conditions: a national survey of ENT trainees.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025
    Article
  2. Review
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

6 authors.

Nicholas MildenhallDepartment of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina, U.S.A.ORCID 0000-0002-9331-6623
Adam HoneybrookDepartment of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina, U.S.A.ORCID 0000-0002-5697-7588
Thomas RisoliDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, U.S.A.
Sarah B PeskoeDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, U.S.A.
Amie KimDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, U.S.A.
David KaylieDepartment of Head and Neck Surgery & Communication Sciences, Duke University Health System, Durham, North Carolina, U.S.A.

Funding

Support for QA/QC for Prior Approval ProcessUL1TR002553 · NCATS · DUKE UNIVERSITY · PI LI, JENNIFER S, MCNAMARA, JAMES O. · 2018 to 2023
$58.5M
NCATS NIH HHS UL1 TR002553
6 · The paper itself

Abstract

objectives/hypothesisOver 10 years have passed since the Clinical Practice Guideline: Acute Otitis Externa (CPG-AOE) was first published, and it has been several years since its update. We sought to assess clinicians' adherence as well as referral patterns. STUDY

designSurvey.

methodsA 23-question survey was distributed to regional primary care clinicians evaluating demographic data, perception of the clinical practice guideline (CPG), adherence, and details of specialist referral. Statistical analysis was performed to compare adherence and referral patterns using the Fisher exact test or the χ

resultsOne hundred seventeen clinicians completed the survey. Fifteen respondents (12.8%) had reviewed the CPG. The recommendations with the least reported adherence were pain management (39.1%) and accounting for prior radiotherapy as a modifying factor (43.0%). The recommendations of prescribing ototopical therapy and avoiding systemic antimicrobials in uncomplicated acute otitis externa had adherence of 94.0% and 83.8%, respectively. When analyzed by provider type (e.g., resident, nurse practitioner/physician assistant), there were no significant differences in adherence. No significant differences in adherence were observed based on previous review of the CPG. When reporting frequency of specialist referral, the majority of respondents selected rarely (53.9%). The most favored reason for referral was symptoms >4 weeks (86.3%).

conclusionsOf the providers who responded, very few had reviewed the CPG-AOE. Despite the added emphasis on pain management in the CPG update, this recommendation had the lowest adherence. Rates of adherence were similar across provider types and did not differ significantly if the CPG was reviewed. Efforts at improved provider education should be considered to increase adherence to the CPG. LEVEL OF EVIDENCE: NA Laryngoscope, 130:1565-1571, 2020.

Indexed as

Acute DiseaseGuideline AdherenceHealth Care SurveysHumansOtitis ExternaPractice Patterns, Physicians'acute otitis externaadherenceClinical practice guidelinereferral

Identifiers

PMID31730729
PMCPMC7335535

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.