| Awareness of, Opinions About, and Adherence to Evidence-Based Guidelines in Otorhinolaryngology [Original Article] |
| Archives of Otolaryngology February 1, 2012, 12:00 pm |
| Background Guidelines may assist physicians and patients in decisions about effective and safe care. Little is known about the awareness of, opinions about, and adherence to evidence-based guidelines in otolaryngology.
Methods We performed a survey among 440 otorhinolaryngologists of the Dutch Society of Otolaryngology–Head and Neck Surgery. The questionnaire consisted of questions about the characteristics of the respondents, their knowledge and opinions of available evidence-based guidelines, and their adherence to them. Furthermore, 2 clinical scenarios were included to test their knowledge regarding the guideline for diagnosis and treatment of obstructive sleep apnea–hypopnea syndrome.
Results The daily practice of most otorhinolaryngologists (70%) was influenced by evidence based guidelines: 62% stated that evidence-based guidelines supported their clinical practice; 32% stated that guidelines directed their clinical practice. The mean confidence in the evidence of recommendations stated in the guidelines was 77%. The mean percentage of nonadherence to guideline recommendations was 45%. The guideline adherence was higher in younger otorhinolaryngologists. Sex, type of hospital, and PhD grade did not affect the preferences of the responders. In general, surveyed otorhinolaryngologists treated patients in accordance with the guidelines. However, when disease characteristics were less distinct, on the one hand, the guidelines included a wider range of treatment options, and on the other hand, variation in chosen treatment by otorhinolaryngologists increased.
Conclusions Dutch otorhinolaryngologists are well aware of the available evidence-based guidelines, and many use these to support their clinical practice. The treatment by Dutch otorhinolaryngologists is in accordance with the Dutch guidelines. When guidelines, however, do not provide strict recommendations and allow flexibility in treatment, larger variations in chosen treatment occur. This may reflect that otorhinolaryngologists still may encounter difficulties when applying the current guidelines to an individual patient. |
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| Incidence of Pediatric Acute Mastoiditis: 1997-2006 [Original Article] |
| Archives of Otolaryngology April 16, 2012, 12:00 pm |
| Objectives To evaluate the incidence of acute mastoiditis in children in the United States over the years 1997 through 2006 and to explore possible explanations for the conflicting conclusions of recent studies of this topic.
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| Incidence of Pediatric Acute Mastoiditis: 1997-2006 [Original Article] |
| Archives of Otolaryngology April 16, 2012, 12:00 pm |
| Objectives To evaluate the incidence of acute mastoiditis in children in the United States over the years 1997 through 2006 and to explore possible explanations for the conflicting conclusions of recent studies of this topic.
Design Comparison of periodic incidence over a decade.
Setting Academic and community, general, and pediatric specialty hospitals |
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