{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T01:37:05Z","timestamp":1767922625381,"version":"3.49.0"},"reference-count":11,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:sec id=\"ab-ooi250071-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Timely computed tomography (CT) imaging is a requirement before performance of sinus surgery, including balloon sinus dilation (BSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250071-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine adherence to practice guidelines for use of CT imaging before BSD procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250071-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This cross-sectional study used Medicare claims data to identify and include otolaryngologists who each performed at least 11 BSDs from January 1, 2022, to December 31, 2023. Data were analyzed from April 1 to September 9, 2025. using IBM-SPSS statistics version 29 and R 4.3.2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250071-7\">\n                    <jats:title>Main Outcome(s) and Measure(s)<\/jats:title>\n                    <jats:p>Percentage of physicians performing BSD without CT imaging available within 1 year of the procedure in greater than 10% of procedures (outliers). Physician variables were explored for potential association with outlier status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250071-8\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The analysis evaluated 490 otolaryngologists (29 female [5.9%] and 460 male [94.1%] individuals) who performed at least 10 BSD procedures annually in a total of 19\u202f692 patients. Preprocedure CT imaging was not available within 1 year prior of BSD for 2905 patients (15%). In all, 156 otolaryngologist-participants (31.8%) were identified as outliers; notably, 30 of these (6.1%) accounted for more than 50% of cases without preprocedure CT imaging, affecting 1880 patients (9.5%) undergoing BSD. Moreover, 42 participants (8.6%) accounted for 47.5% of all missed CTs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-ooi250071-9\">\n                    <jats:title>Conclusion and Relevance<\/jats:title>\n                    <jats:p>This cross-sectional study found that most otolaryngologists adhered to clinical consensus by obtaining CT imaging before performing BSD. However, a substantial portion did not obtain CT imaging before BSD and therefore, did not adhere to standard practice guidelines. These findings demonstrate the need for improved monitoring of adherence to the standard of practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamaoto.2025.4030","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T16:00:33Z","timestamp":1763049633000},"page":"53","source":"Crossref","is-referenced-by-count":1,"title":["Preoperative Computed Tomography Utilization in Patients Undergoing Balloon Sinus Dilation"],"prefix":"10.1001","volume":"152","author":[{"given":"Alexander A.","family":"Romashko","sequence":"first","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences; Medical College of Wisconsin, Milwaukee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nyssa Fox","family":"Farrell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dorina","family":"Kallogjeri","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Research Office, Department of Otolaryngology\u2212Head and Neck Surgery Washington University School of Medicine in St Louis, St Louis, Missouri"},{"name":"Statistics Editor, JAMA Otolaryngology\u2013Head & Neck Surgery\ufeff"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew P.","family":"S\u00e1enz","sequence":"additional","affiliation":[{"name":"Washington University in St Louis School of Medicine, St Louis, Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery; University of Utah School of Medicine, Salt Lake City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay F.","family":"Piccirillo","sequence":"additional","affiliation":[{"name":"Clinical Outcomes Research Office, Department of Otolaryngology\u2212Head and Neck Surgery Washington University School of Medicine in St Louis, St Louis, Missouri"},{"name":"Editor, JAMA Otolaryngology\u2013Head & Neck Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","reference":[{"issue":"3","key":"ooi250071r1","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1001\/jamaoto.2019.4357","article-title":"Medicare reimbursement for balloon catheter dilations among surgeons performing high volumes of the procedures to treat chronic rhinosinusitis.","volume":"146","author":"Kasle","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"10","key":"ooi250071r2","doi-asserted-by":"publisher","first-page":"2224","DOI":"10.1002\/lary.27919","article-title":"Utilization and reimbursements for sinus procedures: a five-year analysis.","volume":"129","author":"Koester","year":"2019","journal-title":"Laryngoscope"},{"issue":"7","key":"ooi250071r3","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1002\/lary.29824","article-title":"Otolaryngologist characteristics and outlier use of balloon sinuplasty in the Medicare population.","volume":"132","author":"Exilus","year":"2022","journal-title":"Laryngoscope"},{"issue":"2","key":"ooi250071r5","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1177\/0194599817750086","article-title":"Clinical consensus statement: balloon dilation of the sinuses.","volume":"158","author":"Piccirillo","year":"2018","journal-title":"Otolaryngol Head Neck Surg"},{"issue":"3","key":"ooi250071r7","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1001\/jamaoto.2019.4481","article-title":"The ever-expanding balloon-is profit shaping practice?","volume":"146","author":"Smith","year":"2020","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"8","key":"ooi250071r8","doi-asserted-by":"publisher","first-page":"199","DOI":"10.4329\/wjr.v3.i8.99","article-title":"Computed tomography scans of paranasal sinuses before functional endoscopic sinus surgery.","volume":"3","author":"Cashman","year":"2011","journal-title":"World J Radiol"},{"issue":"2","key":"ooi250071r9","first-page":"89","article-title":"Nasal and paranasal sinus imaging.","volume":"80","author":"Benson","year":"1997","journal-title":"J Belge Radiol"},{"issue":"2","key":"ooi250071r10","first-page":"49","article-title":"The role of CT in functional endoscopic sinus surgery.","volume":"31","author":"Kaluskar","year":"1993","journal-title":"Rhinology"},{"issue":"5","key":"ooi250071r11","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1177\/1945892418782248","article-title":"Outcomes and complications of balloon and conventional functional endoscopic sinus surgery.","volume":"32","author":"Chaaban","year":"2018","journal-title":"Am J Rhinol Allergy"},{"key":"ooi250071r4","unstructured":"Worstell? C. 2024 Medicare Statistics and Fast Facts. Accessed October 14, 2024. https:\/\/www.medicareadvantage.com\/resources\/medicare-statistics"},{"key":"ooi250071r6","unstructured":"American Rhinologic Society. ARS Position Statement: Criteria for Sinus-ostial Dilation. Updated January 28, 2023. Accessed January 5, 2025. https:\/\/www.american-rhinologic.org\/index.php?option=com_content&view=article&id=494:ostial-balloon-dilation-position-statement&catid=26:position-statements&Itemid=197"}],"container-title":["JAMA Otolaryngology\u2013Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/articlepdf\/2841502\/jamaotolaryngology_romashko_2025_oi_250071_1767893661.56389.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:00:12Z","timestamp":1767895212000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/2841502"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,1]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoto.2025.4030","relation":{},"ISSN":["2168-6181"],"issn-type":[{"value":"2168-6181","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1,1]]}}}