title: CHEER National Study of Chronic Rhinosinusitis Practice Patterns: Disease Comorbidities and Factors Associated with Surgery.
abstract: Objectives (1) Describe national patterns of chronic rhinosinusitis (CRS) care across academic and community practices. (2) Determine the prevalence of comorbid disorders in CRS patients, including nasal polyposis, allergic rhinitis, asthma, and cystic fibrosis. (3) Identify demographic, clinical, and practice type factors associated with endoscopic sinus surgery (ESS). Study Design Multisite cross-sectional study. Setting Otolaryngology's national research network CHEER (Creating Healthcare Excellence through Education and Research). Subjects and Methods A total of 17,828 adult patients with CRS were identified, of which 10,434 were seen at community practices (59%, n = 8 sites) and 7394 at academic practices (41%, n = 10 sites). Multivariate logistic regression was used to evaluate the association between demographic, practice type, and clinical factors and the odds of a patient undergoing ESS. Results The average age was 50.4 years; 59.5% of patients were female; and 88.3% were Caucasian. The prevalence of comorbid diseases was as follows: allergic rhinitis (35.1%), nasal polyposis (13.3%), asthma (4.4%), and cystic fibrosis (0.2%). In addition, 24.8% of patients at academic centers underwent ESS, as compared with 12.3% at community sites. In multivariate analyses, nasal polyposis (odds ratio [OR], 4.28), cystic fibrosis (OR, 2.42), and academic site type (OR, 1.86) were associated with ESS ( P < .001), while adjusting for other factors. Conclusions We describe practice patterns of CRS care, as well as demographic and clinical factors associated with ESS. This is the first study of practice patterns in CRS utilizing the CHEER network and may be used to guide future research.
authors.affiliation: 1 Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Nikita
authors.initials: N
authors.lastname: Chapurin
authors.affiliation: 2 Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Pynnonen
authors.affiliation: 3 Duke Clinical Research Institute, Durham, North Carolina, USA.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Roberts
authors.affiliation: 1 Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Kristine
authors.initials: K
authors.lastname: Schulz
authors.affiliation: 4 Division of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Shin
authors.affiliation: 1 Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Witsell
authors.affiliation: 5 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: 6 Department of Otolaryngology, University of Washington, Seattle, Washington, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Langman
authors.affiliation: 1 Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: David
authors.initials: D
authors.lastname: Carpenter
authors.affiliation: 7 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: 8 Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Oregon, USA.
authors.forename: Anh
authors.initials: A
authors.lastname: Nguyen-Huynh
authors.affiliation: 3 Duke Clinical Research Institute, Durham, North Carolina, USA.
authors.forename: Anne
authors.initials: A
authors.lastname: Wolfley
authors.affiliation: 1 Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, North Carolina, USA.
authors.forename: Walter T
authors.initials: WT
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003550:Cystic Fibrosis / Q000150:complications; D004724:Endoscopy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000150:complications; D016017:Odds Ratio; D010036:Otolaryngology; D010256:Paranasal Sinuses / Q000601:surgery; D010818:Practice Patterns, Physicians'; D012220:Rhinitis / Q000150:complications / Q000601:surgery*; D065631:Rhinitis, Allergic / Q000150:complications; D012852:Sinusitis / Q000150:complications / Q000601:surgery*; D014481:United States
keywords: CHEER; CRS; ESS; FESS; academic; chronic rhinosinusitis; clinical practice guidelines; community; disease comorbidities; national research network; sinus surgery