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Almost 1000 surveys in 3 days

Dr. Walter Lee collected quality of life data based on a PROMIS instrument from almost 1000 patients in hospitals in Vietnam. This was accomplished via paper and daily data entry on Kindle Fire tablets into a REDCap database. The low-cost, easy-to-use tablets enabled quick completion of the forms and no worries about papers going astray or anyone needing to log in to the secured database. A survey link on the native browser directed to Dr Lee’s survey for anonymous data entry, and automatically looped to the beginning of the survey as each one was submitted, allowing for efficient anonymous data gathering.

Patients were asked to rate their overall health, overall quality of life, overall mental health,
social satisfaction, ability to socialize, ability to perform daily physical activities, how often they were bothered by emotional problems, fatigue, and pain.

Questions were based on the PROMIS SF v1.1 – Global Health short form.

This pilot data will inform Dr. Lee’s future projects. We look forward to seeing what happens next!

ACCEPTED! Migraine

Patterns of Migraine Disease in Otolaryngology: A CHEER network study, has been accepted for publication by Otolaryngology-Head and Neck Surgery.

This CHEER project involved established and custom questionnaires for patients and their providers, and was deployed in multiple sites across the country, with a goal of describing the frequency and types of migraine in the general otolaryngology patient population.

ACCEPTED! Sensorineural Hearing Loss

Steroid Use for Sudden Sensorineural Hearing Loss: a CHEER Network Study.

Another manuscript from the SSHL CHEER project has been accepted for publication in Otolaryngology-Head and Neck Surgery

The objective of this study was to describe patterns of corticosteroid treatment for sudden sensorineural hearing loss (SSNHL), and evaluate effectiveness based on delivery mode (oral vs. intratympanic vs. both). Patients were recruited from practices within the Creating Healthcare Excellence through Education and Research (CHEER) Network. CHEER is an NIH funded nationwide network of 30 community and academic otolaryngology practice sites.

What’s Walter Lee Doing in Vietnam?

In just two days, Dr. Lee has collected anonymous quality of life data on more than 350 patients in Vietnam, using economical tablets and REDCap.

Dr. Lee chose a PROMIS instrument, which was then translated by his colleagues in Vietnam. The translation came back to Duke in a Word document, and the fields were copied into REDCap, which renders the Vietnamese alphabet. All fields included the original English, as well. Kindle Fires were set up with the survey link, and the survey settings adjusted so that upon completion of one, it would circle back and present the beginning of the survey ready for the next participant. Dr. Lee packed ten Fires in his luggage, and flew to Vietnam for several projects. On January 22 and 24, more than 350 completed surveys were logged into REDCap.

We look forward to getting the full story on this global health project from Dr. Lee upon his return!

Evaluation of Compliance for Treatment of Sudden Hearing Loss: A CHEER Network Study.

Witsell DL, Khoury T, Schulz KA, Stachler R, Tucci DL, Wojdyla D.

Otolaryngol Head Neck Surg. 2016 Jul;155(1):48-55. doi: 10.1177/0194599816650175.

Abstract
OBJECTIVE:
The objective of this study is to describe the presentation and management of sudden sensorineural hearing loss for patients seen in academic and community-based practices within the context of the American Academy of Otolaryngology-Head and Neck Surgery Foundation’s “Clinical Practice Guideline: Sudden Hearing Loss.” The intention is to use these findings to guide implementation strategies and quality improvement initiatives and as pilot data for the development of clinical research initiatives.

STUDY DESIGN:
A cross-sectional study of patients with sudden hearing loss.

SETTING:
Patients were recruited from practices within the Creating Healthcare Excellence through Education and Research (CHEER) network. The CHEER network is an National Institutes of Health-funded network of 30 otolaryngology sites across the country, half of which are community based and half of which are academic practices.

SUBJECTS AND METHODS:
A total of 173 patients were recruited. Data were gathered via custom questionnaires collected by study site coordinators and entered into a secure online platform. Descriptive analyses and correlation statistics were run with SAS 9.3.1.

RESULTS:
Of the 13 guideline statements in the American Academy of Otolaryngology-Head and Neck Surgery Foundation’s clinical practice guideline on sudden hearing loss, 11 statements were evaluable through this study. Compliance for otolaryngologists was >95% for key action statements (KASs) 1, 3, and 6; 90% to 95% for KASs 5 and 10; and <90% for KASs 7 and 13. Compliance was <45% for nonotolaryngologists for KASs 3 and 5-7. CONCLUSIONS: There is opportunity for nonotolaryngologists to improve for statements 3 and 5-7. Otolaryngologists are compliant with many of the KASs overall, but there is significant room for improvement. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

CHEER National Study of Chronic Rhinosinusitis Practice Patterns: Disease Comorbidities and Factors Associated with Surgery.

Chapurin N, Pynnonen MA, Roberts R, Schulz K, Shin JJ, Witsell DL, Parham K, Langman A, Carpenter D, Vambutas A, Nguyen-Huynh A, Wolfley A, Lee WT.

Otolaryngol Head Neck Surg. 2017 Apr;156(4):751-756. doi: 10.1177/0194599817691476. Epub 2017 Feb 14.

Objectives (1) Describe national patterns of chronic rhinosinusitis (CRS) care across academic and community practices. (2) Determine the prevalence of comorbid disorders in CRS patients, including nasal polyposis, allergic rhinitis, asthma, and cystic fibrosis. (3) Identify demographic, clinical, and practice type factors associated with endoscopic sinus surgery (ESS). Study Design Multisite cross-sectional study. Setting Otolaryngology’s national research network CHEER (Creating Healthcare Excellence through Education and Research). Subjects and Methods A total of 17,828 adult patients with CRS were identified, of which 10,434 were seen at community practices (59%, n = 8 sites) and 7394 at academic practices (41%, n = 10 sites). Multivariate logistic regression was used to evaluate the association between demographic, practice type, and clinical factors and the odds of a patient undergoing ESS. Results The average age was 50.4 years; 59.5% of patients were female; and 88.3% were Caucasian. The prevalence of comorbid diseases was as follows: allergic rhinitis (35.1%), nasal polyposis (13.3%), asthma (4.4%), and cystic fibrosis (0.2%). In addition, 24.8% of patients at academic centers underwent ESS, as compared with 12.3% at community sites. In multivariate analyses, nasal polyposis (odds ratio [OR], 4.28), cystic fibrosis (OR, 2.42), and academic site type (OR, 1.86) were associated with ESS ( P < .001), while adjusting for other factors. Conclusions We describe practice patterns of CRS care, as well as demographic and clinical factors associated with ESS. This is the first study of practice patterns in CRS utilizing the CHEER network and may be used to guide future research.

Manuscripts on the move!

In cooperation with leaders of the Association of Migraine Disorders, CHEER has completed a study outlining the prevalence of migraine in the otolaryngology patient population. The first manuscript is currently in revision to appear in Otolaryngology.

CHEER sites have also completed a study looking at the care and treatment pathways of sudden sensorineural hearing loss. This study also has a manuscript in revision to appear in Otolaryngology.