{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:34:54Z","timestamp":1761006894427,"version":"build-2065373602"},"reference-count":8,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,10,3]],"date-time":"2016-10-03T00:00:00Z","timestamp":1475452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5U24DC012206\u201002"],"award-info":[{"award-number":["5U24DC012206\u201002"]}],"id":[{"id":"10.13039\/100000002","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":[[2017,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To estimate the nonadherence rate of pressure equalization (tympanostomy) tube (PET) placement in the preceding 3\u2010year period before release of the 2013 American Academy of Otolaryngology\u2014Head and Neck Surgery Foundation clinical practice guideline (CPG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Analysis of the Truven Health MarketScan Research Databases (2010\u20102012).<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Medical claims data from 2010 to 2012 were analyzed. Children aged \u226412 years with otitis media (OM)\u2013related diagnoses were identified. Adherence and nonadherence rates for OM and PET placement were analyzed through administrative codes extrapolated from the key action statements (KASs) of the CPG. KASs were aggregated to estimate the overall nonadherence and determine areas for quality improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 9,726,411 visits with OM\u2010associated codes among 3,710,730 children were identified: 2.9% (80,451 of 3,239,700) were considered nonadherent to KAS 1 because a code for PET placement occurred with a first episode of OM with effusion &lt;3\u00a0months; 52.1% (14,534 of 27,913) underwent PET placement for OM with effusion of &gt;3\u00a0months and had a concurrent hearing loss code. For those without hearing loss who underwent PET placement, 48.3% (52,921 of 109,583) had a diagnosis code indicating risk for speech, language, or learning problems. For each KAS, we found heterogeneity of computed nonadherence rates by region, age, and season.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Before guideline dissemination, we found low to moderate rates of nonadherence to guideline recommendation. Deeper analysis of mega\u2010databases could provide better insights for measurement of guideline adherence. The expansion of administrative and clinical databases provides a unique opportunity to investigate the impact of CPGs.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599816669499","type":"journal-article","created":{"date-parts":[[2016,9,13]],"date-time":"2016-09-13T23:07:22Z","timestamp":1473808042000},"page":"87-95","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Nonadherence to Guideline Recommendations for Tympanostomy Tube Insertion in Children Based on Mega\u2010database Claims Analysis"],"prefix":"10.1002","volume":"156","author":[{"given":"Mirabelle","family":"Sajisevi","sequence":"first","affiliation":[{"name":"Division of Head and Neck Surgery and Communication Sciences Department of Surgery Duke University School of Medicine Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristine","family":"Schulz","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery and Communication Sciences Department of Surgery Duke University School of Medicine Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Derek D.","family":"Cyr","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Wojdyla","sequence":"additional","affiliation":[{"name":"Duke Clinical Research Institute Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard M.","family":"Rosenfeld","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology State University of New York Downstate Medical Center Brooklyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debara","family":"Tucci","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery and Communication Sciences Department of Surgery Duke University School of Medicine Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David L.","family":"Witsell","sequence":"additional","affiliation":[{"name":"Division of Head and Neck Surgery and Communication Sciences Department of Surgery Duke University School of Medicine Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,10,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.2.245"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599812468849"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.3924"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3488"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2004.02.002"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a1607"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510400036028"},{"key":"e_1_2_9_9_1","unstructured":"Truven Health Analytics. Research data and analytic tools.http:\/\/truvenhealth.com\/markets\/life\u2010sciences\/products\/data\u2010tools. Accessed August 1 2014."}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599816669499","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599816669499","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599816669499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:34:46Z","timestamp":1760956486000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599816669499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,10,3]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1177\/0194599816669499"],"URL":"https:\/\/doi.org\/10.1177\/0194599816669499","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"type":"print","value":"0194-5998"},{"type":"electronic","value":"1097-6817"}],"subject":[],"published":{"date-parts":[[2016,10,3]]},"assertion":[{"value":"2016-03-04","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-08-25","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-10-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}