{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T14:02:58Z","timestamp":1787061778272,"version":"build-2736575974"},"reference-count":14,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T00:00:00Z","timestamp":1614297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective\/Hypothesis<\/jats:title>\n                    <jats:p>Advanced practice provider (APP) employment is becoming common in pediatric otolaryngology practices, though few studies have evaluated the consequences that APP\u2010led clinics have on access to care. The objectives of this study were: 1) to investigate whether access to bilateral myringotomy with tympanostomy tube placement (BMT) for recurrent acute otitis media (RAOM) differed between patients seen in otolaryngologist and APP\u2010led clinics 2) to compare clinical characteristics of patients seen by provider type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Retrospective cohort study at an academic, tertiary care pediatric otolaryngology practice. All children were &lt;18\u2009years old and underwent evaluation for RAOM followed by BMT. We compared time in days from scheduling pre\u2010operative appointment to appointment date and time from appointment to BMT between patients seen by APPs and otolaryngologists using Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests and multivariate linear regression models. We compared clinical characteristics by provider type using Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      tests and Fisher exact tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 957 children were included. Children seen by APPs had significantly shorter wait times for appointments (median 19 vs. 39\u2009days,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and shorter times from preoperative appointment to BMT (median 25 vs. 37\u2009days,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Patients seen by otolaryngologists had increased prevalence of craniofacial abnormalities, Down Syndrome, hearing loss, history of otologic surgery, and higher ASA physical status classification.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children seen by APPs received care more quickly than those seen by otolaryngologists. Patients seen by otolaryngologists tended to be more medically complex. Implementation of independent APP clinics may expedite and improve access to BMT for children with RAOM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 131:2133\u20132140, 2021\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.29477","type":"journal-article","created":{"date-parts":[[2021,2,26]],"date-time":"2021-02-26T09:55:09Z","timestamp":1614333309000},"page":"2133-2140","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Advanced Practice Provider Clinics: Expediting Care For Children Undergoing Tympanostomy Tube Placement"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8626-2866","authenticated-orcid":false,"given":"Michael A.","family":"Belsky","sequence":"first","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anisha","family":"Konanur","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Sim","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Yan","sequence":"additional","affiliation":[{"name":"University of Pittsburgh School of Medicine  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5783-9198","authenticated-orcid":false,"given":"Amber D.","family":"Shaffer","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Williams","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant R.","family":"Martsolf","sequence":"additional","affiliation":[{"name":"Department of Acute and Tertiary Care University of Pittsburgh School of Nursing  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chi","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noel","family":"Jabbour","sequence":"additional","affiliation":[{"name":"Division of Pediatric Otolaryngology UPMC Children's Hospital of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2018.1515"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/1062860619873216"},{"key":"e_1_2_6_4_1","unstructured":"Assistants NCoCoP.Statistical Report of Certified PAs by Specialty: 2017 Specialty Report.2017."},{"key":"e_1_2_6_5_1","unstructured":"Statistics USBoL.Occupational Outlook Handbook: Physician Assistants. U.S. Bureau of Labor Statistics. Occupational Outlook Handbook Web site. Available at:https:\/\/www.bls.gov\/ooh\/healthcare\/physician-assistants.htm. Published2020. Accessed August 16 2020."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.23274"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.22192"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2019.109770"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.09.025"},{"key":"e_1_2_6_10_1","volume-title":"Stata Statistical Software: Release 15","author":"StataCorp","year":"2017"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2017.09.053"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.21037\/cco.2016.05.01"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-015-0535-5"},{"key":"e_1_2_6_14_1","first-page":"213","article-title":"Building a team\u2010based gastroenterology practice with advanced practice providers","volume":"15","author":"Allen JI","year":"2019","journal-title":"Gastroenterol Hepatol (N Y)"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2019.05.004"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29477","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lary.29477","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.29477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,28]],"date-time":"2023-08-28T23:24:09Z","timestamp":1693265049000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.29477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,26]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,9]]}},"alternative-id":["10.1002\/lary.29477"],"URL":"https:\/\/doi.org\/10.1002\/lary.29477","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,26]]},"assertion":[{"value":"2020-11-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-11","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}