{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:32:18Z","timestamp":1761006738411,"version":"build-2065373602"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,7,1]],"date-time":"2016-07-01T00:00:00Z","timestamp":1467331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>(1) Integrate practice\u2010based patient encounters using the Dartmouth Atlas Medicare database to understand practice treatments for M\u00e9ni\u00e8re\u2019s disease (MD). (2) Describe differences in the practice patterns between academic and community providers for MD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Practice\u2010based research database review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>CHEER (Creating Healthcare Excellence through Education and Research) network academic and community providers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>MD patient data were identified with <jats:italic>ICD\u20109<\/jats:italic> and <jats:italic>CPT<\/jats:italic> codes. Demographics, unique visits, and procedures per patient were tabulated. The Dartmouth Atlas of Health Care was used to reference regional health care utilization. Statistical analysis included 1\u2010way analyses of variance, bivariate linear regression, and Student\u2019s <jats:italic>t<\/jats:italic> tests, with significance set at <jats:italic>P<\/jats:italic> &lt;. 05.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2071 unique patients with MD were identified from 8 academic and 10 community otolaryngology\u2013head and neck surgery provider centers nationally. Average age was 56.5 years; 63.9% were female; and 91.4% self\u2010reported white ethnicity. There was an average of 3.2 visits per patient. Western providers had the highest average visits per patient. Midwest providers had the highest average procedures per patient. Community providers had more visits per site and per patient than did academic providers. Academic providers had significantly more operative procedures per site (<jats:italic>P<\/jats:italic> =. 0002) when compared with community providers. Health care service areas with higher total Medicare reimbursements per enrollee did not report significantly more operative procedures being performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This is the first practice\u2010based clinical research database study to describe MD practice patterns. We demonstrate that academic otolaryngology\u2013head and neck surgery providers perform significantly more operative procedures than do community providers for MD, and we validate these data with an independent Medicare spending database.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599815617752","type":"journal-article","created":{"date-parts":[[2016,7,1]],"date-time":"2016-07-01T14:22:21Z","timestamp":1467382941000},"page":"15-21","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["M\u00e9ni\u00e8re\u2019s Disease"],"prefix":"10.1002","volume":"155","author":[{"given":"Matthew G.","family":"Crowson","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine","family":"Schulz","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kourosh","family":"Parham","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery University of Connecticut Health Center Farmington Connecticut USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Vambutas","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Hofstra North Shore\u2013LIJ School of Medicine Long Island Jewish Medical Center New Hyde Park New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Witsell","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter T.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer J.","family":"Shin","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology Harvard Medical School Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa A.","family":"Pynnonen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anh","family":"Nguyen\u2010Huynh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health &amp; Science University Portland Oregon USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sheila E.","family":"Ryan","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery Department of Surgery Duke University Medical Center Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Langman","sequence":"additional","affiliation":[{"name":"Northwest Hearing &amp; Balance University of Washington Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AUD.0000000000000041"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00019052-200402000-00004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000286213"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-5998(95)70102-8"},{"volume-title":"The Dartmouth Atlas of Health Care","year":"1996","author":"Center for Evaluative Clinical Sciences","key":"e_1_2_8_6_1"},{"key":"e_1_2_8_7_1","unstructured":"GoodmanDC FisherES WennbergJE et al.The Dartmouth Atlas of Healthcare.http:\/\/www.dartmouthatlas.org\/. 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