title: Thyroid Disease and Surgery in CHEER: The Nation's Otolaryngology-Head and Neck Surgery Practice-Based Network.
abstract: (1) Describe thyroid-related diagnoses and procedures in Creating Healthcare Excellence through Education and Research (CHEER) across academic and community sites. (2) Compare management of malignant thyroid disease across these sites. (3) Provide practice-based data related to flexible laryngoscopy vocal fold assessment before and after thyroid surgery based on the American Academy of Otolaryngology-Head and Neck Surgery Foundation's clinical practice guidelines.
  
  
  
  Review of retrospective data collection (RDC) database of the CHEER network using ICD-9 and CPT codes related to thyroid conditions.
  
  
  
  Multisite practice-based network.
  
  
  
  There were 3807 thyroid patients (1392 malignant, 2415 benign) with 10,160 unique visits identified from 1 year of patient data in the RDC. Analysis was performed for identified cohort of patients using demographics, site characteristics, and diagnostic and procedural distribution.
  
  
  
  Mean number of patients with thyroid disease per site was 238 (range, 23-715). In community practices, 19% of patients with thyroid disease had cancer versus 45% in the academic setting (P < .001). While academic sites manage more cancer patients, community sites are also surgically treating thyroid cancer and performed more procedures per cancer patient (4.2 vs 3.5, P < .001). Vocal fold function was assessed by flexible laryngoscopy in 34.0% of preoperative patients and in 3.7% postoperatively.
  
  
  
  This is the first overview of malignant and benign thyroid disease through CHEER. It shows how the RDC can be used alone and with national guidelines to inform of clinical practice patterns in academic and community sites. This demonstrates the potential for future thyroid-related studies utilizing the otolaryngology-head and neck surgery practice-based research network.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, USA.
authors.forename: Kourosh
authors.initials: K
authors.lastname: Parham
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Nikita
authors.initials: N
authors.lastname: Chapurin
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Kris
authors.initials: K
authors.lastname: Schulz
authors.affiliation: Division of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Shin
authors.affiliation: Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Pynnonen
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Witsell
authors.affiliation: Puget Sound Hearing & Balance Group, Seattle, Washington, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Langman
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Anh
authors.initials: A
authors.lastname: Nguyen-Huynh
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Sheila E
authors.initials: SE
authors.lastname: Ryan
authors.affiliation: Department of Otolaryngology, Hofstra North Shore-LIJ School of Medicine, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
authors.forename: Andrea
authors.initials: A
authors.lastname: Vambutas
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Wolfley
authors.affiliation: Duke Clinical Research Institute, Durham, North Carolina, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Roberts
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA walter.lee@duke.edu.
authors.forename: Walter T
authors.initials: WT
authors.lastname: Lee
mesh_terms: D000328:Adult; D016208:Databases, Factual; D005260:Female; D006302:Health Services Research; D006801:Humans; D038801:International Classification of Diseases; D007828:Laryngoscopy; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000453:epidemiology / Q000601:surgery*; D013965:Thyroidectomy; D014481:United States / Q000453:epidemiology
keywords: CHEER; academic; cancer; clinical practice guidelines; community; flexible laryngoscopy; practice-based research network; thyroid disease; thyroid surgery; thyroidectomy; vocal cord function