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Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally

OBJECTIVE: To compare the prevalence of acute sinusitis (AS) and chronic sinusitis (CS) diagnosed by primary care and emergency medicine physicians in our academic institution to national data. STUDY DESIGN: Cross‐sectional pilot study of institutional census data and a population‐based national sam...

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Detalles Bibliográficos
Autores principales: Akkina, Sarah R., Novis, Sarah J., Keshavarzi, Nahid R., Pynnonen, Melissa A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113312/
https://www.ncbi.nlm.nih.gov/pubmed/27917402
http://dx.doi.org/10.1002/lio2.30
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author Akkina, Sarah R.
Novis, Sarah J.
Keshavarzi, Nahid R.
Pynnonen, Melissa A.
author_facet Akkina, Sarah R.
Novis, Sarah J.
Keshavarzi, Nahid R.
Pynnonen, Melissa A.
author_sort Akkina, Sarah R.
collection PubMed
description OBJECTIVE: To compare the prevalence of acute sinusitis (AS) and chronic sinusitis (CS) diagnosed by primary care and emergency medicine physicians in our academic institution to national data. STUDY DESIGN: Cross‐sectional pilot study of institutional census data and a population‐based national sample. The setting was primary care and emergency departments at an academic healthcare institution and community healthcare practices nationally. MATERIALS AND METHODS: We determined the proportion of adults visits at our institution for AS and CS from January 1, 2005, to December 31, 2010. We used the same parameters with the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. As a control comparison, we determined the proportion of visits for epistaxis. RESULTS: The sinusitis prevalence was considerably lower at our academic institution: all sinusitis (AS and CS combined) ranged from 0.8% to 1.0% at our institution compared to 3.1% to 3.7% nationally. There were very small differences between AS rates at the academic institution (0.7%–0.8%) and nationally (0.8%–1.4%, P < 0.001) but very large differences between CS rates at the academic institution (0.1%) and national data (1.7%–2.9%, P < 0.001). Epistaxis rates were nearly identical in both datasets (0.1%–0.2%, P = 0.98–0.99). CONCLUSION: The prevalence of CS is much lower at our academic institution, but the prevalence of AS and epistaxis are similar to national data. This suggests CS is over‐diagnosed by primary care and emergency medicine providers and that CS diagnosed outside of an academic institution or a specialty clinic may not hold up to diagnostic scrutiny. For this reason, diagnostic and treatment protocols for CS that have been developed in academic specialty clinics should not be extrapolated to patients diagnosed with CS in the community setting. The most appropriate intervention for the majority of patients diagnosed with CS in primary care and emergency medicine may be education of providers and patients about conditions that may be misdiagnosed as CS.
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spelling pubmed-51133122016-12-02 Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally Akkina, Sarah R. Novis, Sarah J. Keshavarzi, Nahid R. Pynnonen, Melissa A. Laryngoscope Investig Otolaryngol Allergy, Rhinology, and Immunology OBJECTIVE: To compare the prevalence of acute sinusitis (AS) and chronic sinusitis (CS) diagnosed by primary care and emergency medicine physicians in our academic institution to national data. STUDY DESIGN: Cross‐sectional pilot study of institutional census data and a population‐based national sample. The setting was primary care and emergency departments at an academic healthcare institution and community healthcare practices nationally. MATERIALS AND METHODS: We determined the proportion of adults visits at our institution for AS and CS from January 1, 2005, to December 31, 2010. We used the same parameters with the National Ambulatory Medical Care Survey and the National Hospital Ambulatory Medical Care Survey. As a control comparison, we determined the proportion of visits for epistaxis. RESULTS: The sinusitis prevalence was considerably lower at our academic institution: all sinusitis (AS and CS combined) ranged from 0.8% to 1.0% at our institution compared to 3.1% to 3.7% nationally. There were very small differences between AS rates at the academic institution (0.7%–0.8%) and nationally (0.8%–1.4%, P < 0.001) but very large differences between CS rates at the academic institution (0.1%) and national data (1.7%–2.9%, P < 0.001). Epistaxis rates were nearly identical in both datasets (0.1%–0.2%, P = 0.98–0.99). CONCLUSION: The prevalence of CS is much lower at our academic institution, but the prevalence of AS and epistaxis are similar to national data. This suggests CS is over‐diagnosed by primary care and emergency medicine providers and that CS diagnosed outside of an academic institution or a specialty clinic may not hold up to diagnostic scrutiny. For this reason, diagnostic and treatment protocols for CS that have been developed in academic specialty clinics should not be extrapolated to patients diagnosed with CS in the community setting. The most appropriate intervention for the majority of patients diagnosed with CS in primary care and emergency medicine may be education of providers and patients about conditions that may be misdiagnosed as CS. John Wiley and Sons Inc. 2016-08-04 /pmc/articles/PMC5113312/ /pubmed/27917402 http://dx.doi.org/10.1002/lio2.30 Text en © 2016 The Authors Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Allergy, Rhinology, and Immunology
Akkina, Sarah R.
Novis, Sarah J.
Keshavarzi, Nahid R.
Pynnonen, Melissa A.
Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally
title Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally
title_full Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally
title_fullStr Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally
title_full_unstemmed Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally
title_short Academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally
title_sort academic institution pilot study shows far fewer diagnoses of sinusitis than reported nationally
topic Allergy, Rhinology, and Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113312/
https://www.ncbi.nlm.nih.gov/pubmed/27917402
http://dx.doi.org/10.1002/lio2.30
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