Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Apr 2014
Multicenter Study Comparative StudyTrans-oral brush biopsies and quantitative PCR for EBV DNA detection and screening of nasopharyngeal carcinoma.
To evaluate a newly developed noninvasive ambulatory, quantitative polymerase chain reaction (Q-PCR) Epstein-Barr virus (EBV) DNA detection and screening system (NP Screen™) for nasopharyngeal carcinoma (NPC). ⋯ The trans-oral brushing system fulfills the characteristics of a noninvasive, sensitive, specific detection method suitable for routine, large-scale ambulatory NPC risk assessment for high-risk NPC populations.
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Otolaryngol Head Neck Surg · Apr 2014
Comparative StudyThe interrater and intrarater reliability of the Philpott-Javer staging system based on level of training.
The Philpott-Javer postoperative endoscopic mucosal staging system for allergic fungal rhinosinusitis has previously demonstrated acceptable interrater reliability among rhinologists. There are, however, numerous learners involved in patient care at tertiary centers. This study aims to analyze the interrater and intrarater reliability of this system among learners in otolaryngology at different stages in training. ⋯ Results suggest that the Philpott-Javer staging system has acceptable intrarater and interrater reliability among learners of differing levels of clinical experience and is suitable for evaluating progress following surgery.
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Otolaryngol Head Neck Surg · Apr 2014
Comparative StudyA frailty index identifies patients at high risk of mortality after tracheostomy.
To evaluate the utility of a modified frailty index as an indicator of postoperative mortality in patients undergoing tracheostomy. ⋯ A modified frailty index identifies patients without head and neck cancer at high risk of postoperative mortality after tracheostomy.
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Otolaryngol Head Neck Surg · Apr 2014
Comparative StudyPrevalence and risk factors for central sleep apnea in infants with laryngomalacia.
To identify the prevalence of and risk factors for central sleep apnea (CSA) in infants who are diagnosed with laryngomalacia. ⋯ CSA is relatively common in infants with laryngomalacia. There seems to be a higher prevalence of CSA in infants with certain risk factors, but none of the risk factors are statistically significant. The presence of CSA can lead to alteration in sleep architecture. In addition to clinical evaluation, polysomnography may be warranted for the evaluation of infants with laryngomalacia and associated complex medical conditions.
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Otolaryngol Head Neck Surg · Mar 2014
ReviewIndividualized clinical practice guidelines: the next step in the evidence-based health care evolution?
Clinical practice guidelines (CPGs) are playing an increasing role in the evolution of evidence-based health care. CPGs involve a process in which the best evidence in translated into best practice principles that are then applied on a wide range of patients. ⋯ The individualized guideline (IG) is an approach that builds on the concept of the CPG by specifying treatment recommendation based on important individual baseline characteristics. The IG approach could potentially lead to superior outcomes but necessitates a substantial increase in complexity to the CPG development process.