The Experts below are selected from a list of 2157 Experts worldwide ranked by ideXlab platform
David A Kieff - One of the best experts on this subject based on the ideXlab platform.
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preapproval of sinus computed tomography for otolaryngologic evaluation of chronic rhinosinusitis does not save health care costs
Laryngoscope, 2014Co-Authors: Ahmad R Sedaghat, Stacey T Gray, David A KieffAbstract:Objectives/Hypothesis To evaluate the cost-effectiveness of preapproval requirements for computed tomography (CT) of the sinuses in the evaluation and management of chronic rhinosinusitis (CRS). Study Design Retrospective analysis of prospectively collected data. Methods Over a 6-month period, all sinus CT scans ordered by an otolaryngology practice and requiring preapproval by a third-party payor were tabulated. Characteristics of the preapproval process that were recorded and analyzed included time spent by office administrative staff, need for peer-to-peer review, and time spent by the ordering physician. Results All 111 sinus CT scans ordered during the 6-month time period required preapproval based on insurer requirements—38 performed by computer, 71 by telephone, and two required both—costing an average of 8.1 minutes per scan by administrative staff (range, 2.0–20.0 minutes). Thirteen preapprovals required peer-to-peer telephone interaction by the ordering physician, utilizing an average of 7.7 minutes (range, 5–12 minutes). In no case was the insurance company peer an Otolaryngologist. Ultimately, no sinus CT scan request was rejected by a third-party payor. Conclusions Preapprovals for sinus CTs ordered by Otolaryngologists are unlikely to save costs for third-party payors, as sinus CT for the evaluation of CRS is well established and therefore unlikely to be rejected. Preapproval in this context comes at the expense of practice administrative and physicians' time. Based on our results, preapproval for sinus CT scans ordered by an Otolaryngologist for evaluation of CRS appears to be an unnecessary and costly requirement. Laryngoscope, 124:373–377, 2014 Level of Evidence N/A.
Stacey T Gray - One of the best experts on this subject based on the ideXlab platform.
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association of gender with financial relationships between industry and academic Otolaryngologists
Archives of Otolaryngology-head & Neck Surgery, 2017Co-Authors: Jean Anderson Eloy, Peter F Svider, Stacey T Gray, Michael Bobian, Ashley Culver, Bianca Siegel, Soly Baredes, Sujana S Chandrasekhar, Adam J. FolbeAbstract:Importance Gender disparities continue to exist in the medical profession, including potential disparities in industry-supported financial contributions. Although there are potential drawbacks to industry relationships, such industry ties have the potential to promote scholarly discourse and increase understanding and accessibility of novel technologies and drugs. Objectives To evaluate whether gender disparities exist in relationships between pharmaceutical and/or medical device industries and academic Otolaryngologists. Design, Setting, and Participants An analysis of bibliometric data and industry funding of academic Otolaryngologists. Main Outcomes and Measures Industry payments as reported within the CMS Open Payment Database. Methods Online faculty listings were used to determine academic rank, fellowship training, and gender of full-time faculty Otolaryngologists in the 100 civilian training programs in the United States. Industry contributions to these individuals were evaluated using the CMS Open Payment Database, which was created by the Physician Payments Sunshine Act in response to increasing public and regulatory interest in industry relationships and aimed to increase the transparency of such relationships. The Scopus database was used to determine bibliometric indices and publication experience (in years) for all academic Otolaryngologists. Results Of 1514 academic Otolaryngologists included in this analysis, 1202 (79.4%) were men and 312 (20.6%) were women. In 2014, industry contributed a total of $4.9 million to academic Otolaryngologists. $4.3 million (88.5%) of that went to men, in a population in which 79.4% are male. Male Otolaryngologists received greater median contributions than did female Otolaryngologists (median [interquartile range (IQR)], $211 [$86-$1245] vs $133 [$51-$316]). Median contributions were greater to men than women at assistant and associate professor academic ranks (median [IQR], $168 [$77-$492] vs $114 [$55-$290] and $240 [$87-$1314] vs $166 [$58-$328], respectively). Overall, a greater proportion of men received industry contributions than women (68.0% vs 56.1%,). By subspecialty, men had greater median contribution levels among otologists and rhinologists (median [IQR], $609 [$166-$6015] vs $153 [$56-$336] and $1134 [$286-$5276] vs $425 [$188-$721], respectively). Conclusions and Relevance A greater proportion of male vs female academic Otolaryngologists receive contributions from industry. These differences persist after controlling for academic rank and experience. The gender disparities we have identified may be owing to men publishing earlier in their careers, with women often surpassing men later in their academic lives, or as a result of previously described gender disparities in scholarly impact and academic advancement.
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preapproval of sinus computed tomography for otolaryngologic evaluation of chronic rhinosinusitis does not save health care costs
Laryngoscope, 2014Co-Authors: Ahmad R Sedaghat, Stacey T Gray, David A KieffAbstract:Objectives/Hypothesis To evaluate the cost-effectiveness of preapproval requirements for computed tomography (CT) of the sinuses in the evaluation and management of chronic rhinosinusitis (CRS). Study Design Retrospective analysis of prospectively collected data. Methods Over a 6-month period, all sinus CT scans ordered by an otolaryngology practice and requiring preapproval by a third-party payor were tabulated. Characteristics of the preapproval process that were recorded and analyzed included time spent by office administrative staff, need for peer-to-peer review, and time spent by the ordering physician. Results All 111 sinus CT scans ordered during the 6-month time period required preapproval based on insurer requirements—38 performed by computer, 71 by telephone, and two required both—costing an average of 8.1 minutes per scan by administrative staff (range, 2.0–20.0 minutes). Thirteen preapprovals required peer-to-peer telephone interaction by the ordering physician, utilizing an average of 7.7 minutes (range, 5–12 minutes). In no case was the insurance company peer an Otolaryngologist. Ultimately, no sinus CT scan request was rejected by a third-party payor. Conclusions Preapprovals for sinus CTs ordered by Otolaryngologists are unlikely to save costs for third-party payors, as sinus CT for the evaluation of CRS is well established and therefore unlikely to be rejected. Preapproval in this context comes at the expense of practice administrative and physicians' time. Based on our results, preapproval for sinus CT scans ordered by an Otolaryngologist for evaluation of CRS appears to be an unnecessary and costly requirement. Laryngoscope, 124:373–377, 2014 Level of Evidence N/A.
Michael J Brenner - One of the best experts on this subject based on the ideXlab platform.
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covid 19 survivorship how Otolaryngologist head and neck surgeons can restore quality of life after critical illness
American Journal of Otolaryngology, 2021Co-Authors: Vinciya Pandian, Martin B Brodsky, Emily P Brigham, Ann M Parker, Alexander T Hillel, Joshua M Levy, Christopher H Rassekh, Anil K Lalwani, Dale M Needham, Michael J BrennerAbstract:Mortality from COVID-19 has obscured a subtler crisis - the swelling ranks of COVID-19 survivors. After critical illness, patients often suffer post-intensive care syndrome (PICS), which encompasses physical, cognitive, and/or mental health impairments that are often long-lasting barriers to resuming a meaningful life. Some deficits after COVID-19 critical illness will require otolaryngologic expertise for years after hospital discharge. There are roles for all subspecialties in preventing, diagnosing, or treating sequelae of COVID-19. Otolaryngologist leadership in multidisciplinary efforts ensures coordinated care. Timely tracheostomy, when indicated, may shorten the course of intensive care unit stay and thereby potentially reduce the impairments associated with PICS. Otolaryngologists can provide expertise in olfactory disorders; thrombotic sequelae of hearing loss and vertigo; and laryngotracheal injuries that impair speech, voice, swallowing, communication, and breathing. In the aftermath of severe COVID-19, Otolaryngologists are poised to lead efforts in early identification and intervention for impairments affecting patients' quality of life.
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covid 19 pandemic what every Otolaryngologist head and neck surgeon needs to know for safe airway management
Otolaryngology-Head and Neck Surgery, 2020Co-Authors: Karthik Balakrishnan, Norman D Hogikyan, Samuel A Schechtman, Anthony Yuen Bun Teoh, Brendan Mcgrath, Michael J BrennerAbstract:The novel coronavirus disease 2019 (COVID-19) pandemic has unfolded with remarkable speed, posing unprecedented challenges for health care systems and society. Otolaryngologists have a special role in responding to this crisis by virtue of expertise in airway management. Against the backdrop of nations struggling to contain the virus's spread and to manage hospital strain, Otolaryngologists must partner with anesthesiologists and front-line health care teams to provide expert services in high-risk situations while reducing transmission. Airway management and airway endoscopy, whether awake or sedated, expose operators to infectious aerosols, posing risks to staff. This commentary provides background on the outbreak, highlights critical considerations around mitigating infectious aerosol contact, and outlines best practices for airway-related clinical decision making during the COVID-19 pandemic. What Otolaryngologists need to know and what actions are required are considered alongside the implications of increasing demand for tracheostomy. Approaches to managing the airway are presented, emphasizing safety of patients and the health care team.
Susan Sedory Holzer - One of the best experts on this subject based on the ideXlab platform.
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the cooperative outcomes group for ent a multicenter prospective cohort study on the outcomes of tympanostomy tubes for children with otitis media
Otolaryngology-Head and Neck Surgery, 2005Co-Authors: David L Witsell, Michael G Stewart, Edwin M Monsell, James A Hadley, Jeffrey E Terrell, Bevan Yueh, Richard M Rosenfeld, Maureen T Hannley, Susan Sedory HolzerAbstract:Objective Outcomes for patients with otitis media were assessed in this prospective, multicenter study. Study design and setting Thirty-one Otolaryngologists enrolled 272 pediatric patients with otitis media; caregivers completed surveys at 3-month intervals, and clinical and treatment data was also collected. The Otitis Media 6 (OM-6) was the primary outcome measure. Results One hundred seventy-seven patients (mean age 2.0 years) completed 3-month follow-up. One hundred thirty-seven patients underwent tympanostomy tube placement. Large improvements in disease-specific quality of life (QOL) were seen up to 9 months of follow-up. Baseline OM-6 score was the best predictor of clinical success in regression modeling. Conclusions Patients referred to an Otolaryngologist for treatment of otitis media see large improvements in disease-specific QOL regardless of treatment rendered. Significance The study demonstrates the feasibility of multicenter outcomes studies and confirms appropriate triage of patients with otitis media into surgical versus medical interventions. EBM rating: C.
Ahmad R Sedaghat - One of the best experts on this subject based on the ideXlab platform.
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preapproval of sinus computed tomography for otolaryngologic evaluation of chronic rhinosinusitis does not save health care costs
Laryngoscope, 2014Co-Authors: Ahmad R Sedaghat, Stacey T Gray, David A KieffAbstract:Objectives/Hypothesis To evaluate the cost-effectiveness of preapproval requirements for computed tomography (CT) of the sinuses in the evaluation and management of chronic rhinosinusitis (CRS). Study Design Retrospective analysis of prospectively collected data. Methods Over a 6-month period, all sinus CT scans ordered by an otolaryngology practice and requiring preapproval by a third-party payor were tabulated. Characteristics of the preapproval process that were recorded and analyzed included time spent by office administrative staff, need for peer-to-peer review, and time spent by the ordering physician. Results All 111 sinus CT scans ordered during the 6-month time period required preapproval based on insurer requirements—38 performed by computer, 71 by telephone, and two required both—costing an average of 8.1 minutes per scan by administrative staff (range, 2.0–20.0 minutes). Thirteen preapprovals required peer-to-peer telephone interaction by the ordering physician, utilizing an average of 7.7 minutes (range, 5–12 minutes). In no case was the insurance company peer an Otolaryngologist. Ultimately, no sinus CT scan request was rejected by a third-party payor. Conclusions Preapprovals for sinus CTs ordered by Otolaryngologists are unlikely to save costs for third-party payors, as sinus CT for the evaluation of CRS is well established and therefore unlikely to be rejected. Preapproval in this context comes at the expense of practice administrative and physicians' time. Based on our results, preapproval for sinus CT scans ordered by an Otolaryngologist for evaluation of CRS appears to be an unnecessary and costly requirement. Laryngoscope, 124:373–377, 2014 Level of Evidence N/A.
