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Munyemana MA, Kallogjeri D, Chernock R, Farrell NF, Schneider JS, Piccirillo JF, Roland LT. Prognostic Factors for Survival Using a Clinical Severity Staging System Among Patients With Acute Invasive Fungal Sinusitis. JAMA Otolaryngol Head Neck Surg 2024; 150:328-334. [PMID: 38421674 PMCID: PMC10905375 DOI: 10.1001/jamaoto.2024.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/12/2024] [Indexed: 03/02/2024]
Abstract
Importance Despite the aggressive progression of fulminant acute invasive fungal sinusitis (AIFS), data on prognostic factors have been disparate, hindering the development of a staging system. A composite staging system may improve prognostication for patient counseling and conduct of clinical research. Objective To identify prognostically important factors in AIFS and to incorporate the factors into a comprehensive Functional Severity Staging System and Clinical Severity Staging System. Design, Setting, and Participants This retrospective cohort study included adult patients diagnosed with pathology-proven AIFS from June 1, 1992, to December 31, 2022, at Washington University Medical Center and Barnes-Jewish Hospital, a tertiary care center in St Louis, Missouri. Data were analyzed from April to July 2023. Main Outcome and Measures Sequential sequestration and conjunctive consolidation was used to develop a composite staging system to predict 6-month overall survival. Results Of 71 patients with pathology-proven AIFS over the 30-year period, the median (range) age of the cohort was 56 (19-63) years, and there were 47 (66%) male patients. The median (range) follow-up time was 2 (0-251) months. There were 28 patients alive within 6 months, for a 39% survival rate. Symptoms, comorbidity burden, and presence and duration of severe neutropenia were associated with 6-month survival and were consolidated into a 3-category Clinical Severity Staging System with 6-month survival of 75% for stage A (n = 16), 41% for stage B (n = 27), and 18% for stage C (n = 28). The discriminative power of the composite staging system was moderate (C statistic, 0.63). Conclusion and Relevance This cohort study supports the clinical importance of symptomatology, comorbidity burden, and prolonged severe neutropenia at the time of AIFS presentation. The composite clinical staging system may be useful for clinicians when counseling patients with AIFS and conducting clinical research.
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Affiliation(s)
- Marie-Ange Munyemana
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Statistics Editor, JAMA Otolaryngology–Head & Neck Surgery
| | - Rebecca Chernock
- Division of Anatomic and Molecular Pathology, Department of Pathology and Immunology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Nyssa F. Farrell
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - John S. Schneider
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Editor, JAMA Otolaryngology–Head & Neck Surgery
| | - Lauren T. Roland
- Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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Dang S, Kallogjeri D, Dizdar K, Lee D, Bao JW, Varghese J, Walia A, Zhan K, Youssef S, Durakovic N, Wick CC, Herzog JA, Buchman CA, Piccirillo JF, Shew MA. Individual Patient Comorbidities and Effect on Cochlear Implant Performance. Otol Neurotol 2024; 45:e281-e288. [PMID: 38437816 PMCID: PMC10939851 DOI: 10.1097/mao.0000000000004144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
OBJECTIVE To examine the association between preoperative comorbidities and cochlear implant speech outcomes. STUDY DESIGN Retrospective cohort. SETTING Tertiary referral center. PATIENTS A total of 976 patients who underwent cochlear implantation (CI) between January 2015 and May 2022. Adult patients with follow-up, preoperative audiologic data, and a standardized anesthesia preoperative note were included. EXPOSURE Adult Comorbidity Evaluation 27 (ACE-27) based on standardized anesthesia preoperative notes. MAIN OUTCOME MEASURES Postoperative change in consonant-nucleus-consonant (CNC) score, AzBio Sentence score in quiet, and AzBio + 10 dB signal-to-noise ratio (SNR). Sentence score of the implanted ear at 3, 6, and 12 months. RESULTS A total of 560 patients met inclusion criteria; 112 patients (20%) had no comorbidity, 204 patients (36.4%) had mild comorbidities, 161 patients (28.8%) had moderate comorbidities, and 83 patients (14.8%) had severe comorbidities. Mixed model analysis revealed all comorbidity groups achieved a clinically meaningful improvement in all speech outcome measures over time. This improvement was significantly different between comorbidity groups over time for AzBio Quiet ( p = 0.045) and AzBio + 10 dB SNR ( p = 0.0096). Patients with severe comorbidities had worse outcomes. From preop to 12 months, the estimated marginal mean difference values (95% confidence interval) between the no comorbidity group and the severe comorbidity group were 52.3 (45.7-58.9) and 32.5 (24.6-40.5), respectively, for AzBio Quiet; 39.5 (33.8-45.2) and 21.2 (13.6-28.7), respectively, for AzBio + 10 dB SNR; and 43.9 (38.7-49.0) and 31.1 (24.8-37.4), respectively, for CNC. CONCLUSIONS Comorbidities as assessed by ACE-27 are associated with CI performance. Patients with more severe comorbidities have clinically meaningful improvement but have worse outcome compared to patients with no comorbidities.
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Affiliation(s)
- Sabina Dang
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | | | - Karmela Dizdar
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - David Lee
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - James W Bao
- Miller School of Medicine, University of Miami, Florida
| | - Jordan Varghese
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Amit Walia
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Kevin Zhan
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Stephanie Youssef
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Nedim Durakovic
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Cameron C Wick
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Jacques A Herzog
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Craig A Buchman
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
| | - Matthew A Shew
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, Missouri
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Piccirillo JF. JAMA Otolaryngology-Head & Neck Surgery-The Year in Review, 2023. JAMA Otolaryngol Head Neck Surg 2024:2816121. [PMID: 38512272 DOI: 10.1001/jamaoto.2024.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Affiliation(s)
- Jay F Piccirillo
- Washington University School of Medicine, St Louis, Missouri
- Editor, JAMA Otolaryngology-Head & Neck Surgery
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Bibbins-Domingo K, Flanagin A, Sietmann C, Bonow RO, Navar AM, Shinkai K, Roberson ML, Ayanian JZ, Ponce N, Inouye SK, Durant RW, Simon MA, Rivara FP, Vela M, Josephson SA, Rawls A, Disis MLN, Florez N, Bressler NM, Scott AW, Piccirillo JF, Osazuwa-Peters N, Christakis DA, Duncan AF, Öngür D, Bagot KS, Kibbe MR, Backhus LM, Malani PN. Advancing Equity at the JAMA Network-Self-Reported Demographics of Editors and Editorial Board Members. JAMA 2024; 331:837-839. [PMID: 38334991 DOI: 10.1001/jama.2024.1709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Affiliation(s)
| | | | | | | | - Ann Marie Navar
- Deputy Editor, Diversity, Equity, and Inclusion, JAMA Cardiology
| | | | - Mya L Roberson
- Associate Editor for Diversity, Equity, and Inclusion, JAMA Dermatology
| | | | - Ninez Ponce
- Associate Editor for Diversity, Equity, and Inclusion, JAMA Health Forum
| | | | - Raegan W Durant
- Associate Editor and Diversity, Equity, and Inclusion Associate Editor, JAMA Internal Medicine
| | - Melissa A Simon
- Associate Editor and Equity, Diversity, and Inclusion Editor, JAMA
| | | | - Monica Vela
- Diversity, Equity, and Inclusion Associate Editor, JAMA Network Open
| | | | - Ashley Rawls
- Associate Editor, Diversity, Equity, and Inclusion, JAMA Neurology
| | | | - Narjust Florez
- Associate Editor for Diversity, Equity, and Inclusion, JAMA Oncology
| | | | | | | | | | | | - Andrea F Duncan
- Associate Editor and Diversity, Equity, and Inclusion Editor, JAMA Pediatrics
| | | | - Kara S Bagot
- Diversity, Equity, and Inclusion Editor, JAMA Psychiatry
| | | | | | - Preeti N Malani
- Deputy Editor, JAMA , and Equity, Diversity, and Inclusion Editor, JAMA and the JAMA Network
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Munyemana MA, Ahmed OG, Takashima M, Dhanda AK, Tang D, Wu A, Wu MJ, Kallogjeri D, Piccirillo JF, Roland LT. Optimization of diagnostic and procedural codes to identify patients with acute invasive fungal sinusitis. Int Forum Allergy Rhinol 2024; 14:728-731. [PMID: 37565319 PMCID: PMC10858971 DOI: 10.1002/alr.23253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 07/29/2023] [Accepted: 08/07/2023] [Indexed: 08/12/2023]
Abstract
KEY POINTS Acute invasive fungal sinusitis (IFS) is a rare disease with high mortality There is no designated International Classification of Diseases code for IFS We propose a novel method to identify IFS using optimized codes complemented by medications.
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Affiliation(s)
- Marie-Ange Munyemana
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Omar G. Ahmed
- Department Otolaryngology-Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
| | - Mas Takashima
- Department Otolaryngology-Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
| | - Aatin K Dhanda
- Department Otolaryngology-Head and Neck Surgery, Houston Methodist Hospital, Houston, Texas
| | - Dennis Tang
- Department Otolaryngology-Head and Neck Surgery, Cedars-Sinai
| | - Arthur Wu
- Department Otolaryngology-Head and Neck Surgery, Cedars-Sinai
| | - Matthew J. Wu
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Lauren T. Roland
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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Lander DP, Kallogjeri D, Piccirillo JF. Smoking, Drinking, and Dietary Risk Factors for Head and Neck Cancer in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Participants. JAMA Otolaryngol Head Neck Surg 2024; 150:249-256. [PMID: 38329760 PMCID: PMC10853863 DOI: 10.1001/jamaoto.2023.4551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/09/2023] [Indexed: 02/09/2024]
Abstract
Importance There is a paucity of large-scale prospective studies evaluating the risk of developing head and neck cancer (HNC) associated with smoking, drinking, and dietary habits. Objective To determine the association of smoking, drinking, and dietary habits with the risk of developing HNC. Design, Setting, and Participants A nested cohort survival analysis of Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial participants was performed. Participants were between 55 and 74 years of age and recruited at 10 centers across the US from November 1993 to July 2001. Participants who developed HNC were matched with controls based on demographics and family history of HNC for analysis of smoking habits; for the analysis of drinking and dietary habits, matching was performed on smoking status and duration in addition to demographics and family history of HNC. Data analysis was performed from January to November 2023. Exposures Smoking, drinking, and dietary habits. Main Outcome and Measure Diagnosis of HNC. Results In total, 139 926 participants (51% female; mean [SD] age, 62.6 [5.4] years) were included in the analysis of smoking habits with a median (IQR) follow-up time of 12.1 (10.3-13.6) years, 571 of whom developed HNC. HNC risk associated with smoking increased the closer the proximity of the head and neck subsite to the lungs, with the greatest risk associated with smoking observed in laryngeal cancer (current smoker hazard ratio [HR], 9.36; 95% CI, 5.78-15.15 compared to a nonsmoker). For analysis of drinking and dietary habits, 94 466 participants were included in the analysis of smoking habits with a median (IQR) follow-up time of 12.2 (10.5-13.6) years, 264 of whom developed HNC. HNC risk increased with heavy drinking (HR, 1.85; 95% CI, 1.44-2.38) and decreased with consumption of whole grains (HR, 0.78; 95% CI, 0.64-0.94/oz per day), whole fruits (HR, 0.90; 95% CI, 0.82-0.98/cup per day), and overall healthy eating, as scored by Healthy Eating Index 2015 (HR, 0.87; 95% CI, 0.78-0.98/10 points). Conclusions and Relevance In this nested cohort study, the risk of HNC associated with smoking was higher for subsites that were closer to the lungs; heavy drinking was associated with greater HNC risk, while healthy eating was associated with a modest reduction in HNC risk.
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Affiliation(s)
- Daniel P. Lander
- Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Statistics Editor, JAMA Otolaryngology–Head & Neck Surgery
| | - Jay F. Piccirillo
- Department of Otolaryngology–Head & Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Editor, JAMA Otolaryngology–Head & Neck Surgery
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Mahadev A, Kallogjeri D, Piccirillo JF. Validation of Minimal Clinically Important Difference (MCID) for University of Pennsylvania Smell Identification Test (UPSIT). Am J Rhinol Allergy 2024; 38:123-132. [PMID: 38055971 DOI: 10.1177/19458924231218037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023]
Abstract
BACKGROUND The University of Pennsylvania Smell Identification Test is widely used to measure change in olfactory function, but a minimal clinically important difference (MCID) has not been well-established. A study published in 1997 regarding patients with head trauma reported an MCID of 4 but did not detail the methods used in the calculation. OBJECTIVE To validate the MCID for UPSIT in patients with postviral, sinusitis, and procedure-associated olfactory loss. METHODS This was a secondary analysis of prospectively collected data from 5 clinical research studies related to olfactory function. Three studies included subjects with COVID-19-related olfactory dysfunction, one with chronic sinusitis subjects, and one with subjects undergoing transsphenoidal surgery. All subjects had completed a baseline and follow-up UPSIT, baseline and follow-up Clinical Global Impression-Severity (CGI-Severity), and a follow-up CGI-Improvement. Both distribution- and anchor-based methods were used to determine the MCID of UPSIT. Distribution-based method calculated MCID using half standard deviation of baseline UPSIT and delta UPSIT scores. Clinical-anchor method determined MCID by comparing delta UPSIT scores between consecutive CGI-I clinical categories ranging from very much better to very much worse. RESULTS The study population comprised 295 subjects. Subjects had a mean (SD) baseline UPSIT score of 27 (7.5), and follow-up score of 28 (7.9), and a mean UPSIT change of 0.6 (5.8). Half the baseline UPSIT SD was 3.75 and half the delta UPSIT SD was 2.9. With the anchor-based approach, an MCID of 4 was defined as clinically meaningful by exploring the relationship between delta UPSIT and CGI-Improvement. Using a more conservative approach based on the MCID values identified from both methods, we determined that a change of 4 or greater is the appropriate MCID for UPSIT. CONCLUSION Investigators in the future should use 4 as MCID for UPSIT and report the percentage of study subjects who achieve a clinically meaningful difference. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Ashna Mahadev
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Jay F Piccirillo
- Department of Otolaryngology - Head and Neck Surgery, Washington University School of Medicine, St. Louis, MO, USA
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Javeed S, Benedict B, Yakdan S, Saleem S, Zhang JK, Botterbush K, Frumkin MR, Hardi A, Neuman B, Kelly MP, Steinmetz MP, Piccirillo JF, Goodin BR, Rodebaugh TL, Ray WZ, Greenberg JK. Implications of Preoperative Depression for Lumbar Spine Surgery Outcomes: A Systematic Review and Meta-Analysis. JAMA Netw Open 2024; 7:e2348565. [PMID: 38277149 PMCID: PMC10818221 DOI: 10.1001/jamanetworkopen.2023.48565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/07/2023] [Indexed: 01/27/2024] Open
Abstract
Importance Comorbid depression is common among patients with degenerative lumbar spine disease. Although a well-researched topic, the evidence of the role of depression in spine surgery outcomes remains inconclusive. Objective To investigate the association between preoperative depression and patient-reported outcome measures (PROMs) after lumbar spine surgery. Data Sources A systematic search of PubMed, Cochrane Database of Systematic Reviews, Embase, Scopus, PsychInfo, Web of Science, and ClinicalTrials.gov was performed from database inception to September 14, 2023. Study Selection Included studies involved adults undergoing lumbar spine surgery and compared PROMs in patients with vs those without depression. Studies evaluating the correlation between preoperative depression and disease severity were also included. Data Extraction and Synthesis All data were independently extracted by 2 authors and independently verified by a third author. Study quality was assessed using Newcastle-Ottawa Scale. Random-effects meta-analysis was used to synthesize data, and I2 was used to assess heterogeneity. Metaregression was performed to identify factors explaining the heterogeneity. Main Outcomes and Measures The primary outcome was the standardized mean difference (SMD) of change from preoperative baseline to postoperative follow-up in PROMs of disability, pain, and physical function for patients with vs without depression. Secondary outcomes were preoperative and postoperative differences in absolute disease severity for these 2 patient populations. Results Of the 8459 articles identified, 44 were included in the analysis. These studies involved 21 452 patients with a mean (SD) age of 57 (8) years and included 11 747 females (55%). Among these studies, the median (range) follow-up duration was 12 (6-120) months. The pooled estimates of disability, pain, and physical function showed that patients with depression experienced a greater magnitude of improvement compared with patients without depression, but this difference was not significant (SMD, 0.04 [95% CI, -0.02 to 0.10]; I2 = 75%; P = .21). Nonetheless, patients with depression presented with worse preoperative disease severity in disability, pain, and physical function (SMD, -0.52 [95% CI, -0.62 to -0.41]; I2 = 89%; P < .001), which remained worse postoperatively (SMD, -0.52 [95% CI, -0.75 to -0.28]; I2 = 98%; P < .001). There was no significant correlation between depression severity and the primary outcome. A multivariable metaregression analysis suggested that age, sex (male to female ratio), percentage of comorbidities, and follow-up attrition were significant sources of variance. Conclusions and Relevance Results of this systematic review and meta-analysis suggested that, although patients with depression had worse disease severity both before and after surgery compared with patients without depression, they had significant potential for recovery in disability, pain, and physical function. Further investigations are needed to examine the association between spine-related disability and depression as well as the role of perioperative mental health treatments.
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Affiliation(s)
- Saad Javeed
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Braeden Benedict
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Salim Yakdan
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Samia Saleem
- Department of Musculoskeletal Research, Washington University, St Louis, Missouri
| | - Justin K. Zhang
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Kathleen Botterbush
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Madelyn R. Frumkin
- Department of Psychology and Brain Sciences, Washington University, St Louis, Missouri
| | - Angela Hardi
- Becker Medical Library, Washington University, St Louis, Missouri
| | - Brian Neuman
- Department of Orthopedic Surgery, Washington University, St Louis, Missouri
| | - Michael P. Kelly
- Department of Orthopedic Surgery, Rady Children’s Hospital, University of California, San Diego, San Diego
| | | | - Jay F. Piccirillo
- Department of Otolaryngology, Washington University, St Louis, Missouri
| | - Burel R. Goodin
- Department of Anesthesiology, Washington University, St Louis, Missouri
| | - Thomas L. Rodebaugh
- Department of Psychology and Brain Sciences, Washington University, St Louis, Missouri
| | - Wilson Z. Ray
- Department of Neurological Surgery, Washington University, St Louis, Missouri
| | - Jacob K. Greenberg
- Department of Neurological Surgery, Washington University, St Louis, Missouri
- Department of Neurological Surgery, Cleveland Clinic, Cleveland, Ohio
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Piccirillo JF. Fiscal Irresponsibility Is a Public Health Threat. JAMA Otolaryngol Head Neck Surg 2024; 150:5-6. [PMID: 37801335 DOI: 10.1001/jamaoto.2023.3695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Affiliation(s)
- Jay F Piccirillo
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Editor, JAMA Otolaryngology-Head & Neck Surgery
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Peterson AM, Miller BJ, Kallogjeri D, Piccirillo JF, Kukuljan S, Roland LT, Schneider JS, Crock LW, Farrell NF. Stellate Ganglion Block for the Treatment of COVID-19-Induced Olfactory Dysfunction: A Prospective Pilot Study. Otolaryngol Head Neck Surg 2024; 170:272-276. [PMID: 37750244 PMCID: PMC10842956 DOI: 10.1002/ohn.530] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 09/27/2023]
Abstract
OBJECTIVE The objective of this study was to explore the safety and feasibility of stellate ganglion blocks (SGBs) to treat persistent COVID-19-induced olfactory dysfunction (OD). Secondarily, the goal was to determine effect sizes to plan a future randomized clinical trial. STUDY DESIGN Prospective case series. SETTING Quaternary Care Academic Medical Center. METHODS In this single-arm pilot trial, adult participants with a COVID-19 diagnosis ≥ 12 months prior to enrollment with OD underwent bilateral SGBs. Subjects were followed for 1 month after completion of SGB. The primary outcome measure was the change in the Clinical Global Impression-Improvement Scale for smell loss. Secondary outcome measures included changes in the University of Pennsylvania Smell Identification Test (UPSIT) and Olfactory Dysfunction Outcomes Rating (ODOR). RESULTS Twenty participants were enrolled with a mean (SD) age of 46 (11) years and a mean (SD) duration of OD of 21 (5) months. At 1 month, 10 (50%) participants experienced at least slight subjective improvement in their OD, 11 (55%) attained a clinically meaningful improvement in smell identification using the UPSIT, and 7 (35%) achieved a clinically meaningful improvement in olfactory-specific quality of life (QoL) measured by the ODOR. The median difference between UPSIT scores at baseline and 1 month was 6 (95% confidence interval: 3-11), exceeding the minimal clinically important difference of 4. There were no serious adverse events. CONCLUSION Sequential SGBs for COVID-19-associated OD were safe and associated with modest improvements in subjective olfaction, odor identification, and olfactory-specific QoL. A placebo-controlled trial is warranted to determine the efficacy of SGBs for COVID-19-associated OD.
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Affiliation(s)
- Andrew M Peterson
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Brevin J Miller
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Sara Kukuljan
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Lauren T Roland
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - John S Schneider
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Lara W Crock
- Department of Anesthesiology, Division of Pain Management, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Nyssa F Farrell
- Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
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11
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Miller BJ, Kallogjeri D, Shew MA, Piccirillo JF. Identifying Predictors of Treatment Response in Meniere's Disease: A Clinical Severity Staging System. Otolaryngol Head Neck Surg 2024; 170:212-220. [PMID: 37622528 PMCID: PMC10843393 DOI: 10.1002/ohn.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 07/08/2023] [Accepted: 07/24/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE Identify clinically important factors associated with conservative treatment response in Meniere's disease and incorporate these factors into a composite clinical severity staging system. STUDY DESIGN Retrospective cohort. SETTING Tertiary academic medical center. METHODS Adult patients newly diagnosed with Meniere's disease between January 1, 2016 and December 31, 2019 were eligible. Patients with previous treatment for Meniere's disease, prior otologic surgery, or a lack of follow-up data were excluded. Treatment-responsive patients were managed with only conservative therapies (eg, dietary modifications, diuretics) and unresponsive patients underwent more intensive therapies (eg, intratympanic procedures, surgical interventions). RESULTS Of 78 patients included in the study, 49 (63%) were responsive to conservative therapies and 29 (37%) were not. Responsive patients had higher proportions of no or mild vertigo (24%, 95% confidence interval [CI]: 3.1%-45.8%) and none or mild comorbidity (27%, 95% CI: 9.2%-44.7%) and a lower proportion of hearing loss (19%, 95% CI: 5.6%-32.4%) compared to unresponsive patients. Conjunctive consolidation of these 3 factors was performed to develop a three-stage system with a treatment response gradient ranging from 100% to 64% to 18% for stage 1 (n = 11), stage 2 (n = 56), and stage 3 (n = 11), respectively. CONCLUSIONS This study identified decreased vertigo severity, reduced comorbidity burden, and absence of hearing loss as factors associated with conservative treatment response in Meniere's disease. A composite clinical severity staging system including these 3 factors can be used to optimize treatment selection and promote patient-centered management of Meniere's disease.
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Affiliation(s)
- Brevin J. Miller
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Matthew A. Shew
- Department of Otolaryngology-Head and Neck Surgery, Division of Otology/Neurotology, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
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12
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Stoller E, Hentati F, Kallogjeri D, Piccirillo JF, Lenze EJ, Farrell NF. Depression, anxiety, and suicidal ideation in adults with COVID-induced parosmia. Int Forum Allergy Rhinol 2023; 13:2240-2243. [PMID: 37318115 PMCID: PMC10721717 DOI: 10.1002/alr.23211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/16/2023]
Abstract
KEY POINTS COVID-induced parosmia is associated with anxiety, depression, and suicidal ideation. Parosmic patients have low rates of treatment benefit and little hope for improvement. Hyposmia may mitigate the quality-of-life burden in patients with parosmia.
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Affiliation(s)
- Emily Stoller
- Washington University in St. Louis, St. Louis, Missouri, USA
| | - Firas Hentati
- Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Eric J Lenze
- Department of Psychiatry, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Nyssa Fox Farrell
- Division of Rhinology, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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13
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Ioerger P, Kallogjeri D, Roland L, Schneider JS, Piccirillo JF, Farrell NF. Development and Validation of the Parosmia Olfactory Dysfunction Outcomes Rating (DisODOR). Otolaryngol Head Neck Surg 2023; 169:1654-1661. [PMID: 37622602 DOI: 10.1002/ohn.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/25/2023] [Accepted: 07/17/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE Develop and validate a quality-of-life (QoL) outcome measure for patients with dysosmia. STUDY DESIGN Cross-sectional survey study. SETTING Otolaryngology clinics, research registries, and Facebook support groups. METHODS A 59-item pilot survey with questions addressing parosmia concerns was developed using input from subjects with parosmia and clinical expertise from Otolaryngologists. After item reduction, the Parosmia Olfactory Dysfunction Outcomes Rating (DisODOR) was reduced to its final 29 items. DisODOR maximum score is 116 (each item score 0-4) with higher scores indicating a higher degree of dysfunction from smell distortion. DisODOR was validated using participants with parosmia persisting >3 months after severe acute respiratory syndrome coronavirus 2 (cases) and healthy controls. Reliability, face and content validity, internal consistency, convergent validity, discriminative validity, sensitivity to change, and the minimal clinically important difference (MCID) were assessed. RESULTS A total of 134 cases and 20 controls completed DisODOR. The mean (SD) age was 45.9 (12.2) for cases and 29.6 (8.9) for controls. The mean score difference between cases and controls was 45.0 (95% confidence interval, 40.5-49.5) displaying good discriminative validity. DisODOR showed strong test-retest reliability (r = .942) with high internal consistency (Cronbach's α = .971). DisODOR had a moderate correlation with SNOT-22 scores (r = .619) indicating good convergent validity. There is an excellent association with the global impression of severity categories (η2 = 0.447). Based on the distribution method, the MCID is 15. CONCLUSION DisODOR is a valid, reliable QoL instrument for parosmia that can be used to measure the functional impact and QoL impairment for parosmia patients. DisODOR is sensitive to change and thus can be used in studies investigating treatments for parosmia.
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Affiliation(s)
- Patrick Ioerger
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
- School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Lauren Roland
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - John S Schneider
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
| | - Nyssa Fox Farrell
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA
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Mahadev A, Hentati F, Miller B, Bao J, Perrin A, Kallogjeri D, Piccirillo JF. Efficacy of Gabapentin For Post-COVID-19 Olfactory Dysfunction: The GRACE Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2023; 149:1111-1119. [PMID: 37733356 PMCID: PMC10514889 DOI: 10.1001/jamaoto.2023.2958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 08/02/2023] [Indexed: 09/22/2023]
Abstract
Importance The COVID-19 pandemic affected millions of people and has become a dominant etiology of olfactory dysfunction (OD). No interventions with definitive clinical utility exist. Gabapentin represents a potential therapy for COVID-19-induced OD. Objective To evaluate the efficacy of oral gabapentin on olfactory function and olfaction-related quality of life in patients with COVID-19-induced OD. Design, Setting, and Participants This pilot double-blinded, placebo-controlled randomized clinical trial (RCT) was conducted at Washington University School of Medicine in St Louis from January 7, 2022, to February 3, 2023. Adults with at least 3 months of OD after COVID-19 infection were eligible for inclusion. Participants with a history of other causes of OD or contraindications to gabapentin were excluded. Intervention Patients were randomized 1:1 to oral gabapentin or placebo. All patients underwent titration to a maximum tolerable dose, which was maintained during an 8-week fixed-dose (FD) phase then tapered off. Participants were monitored for 4 weeks following cessation of study medication. Main Outcomes and Measures Outcomes were assessed following the 8-week FD phase and 4 weeks after taper completion. The primary outcome measure was the response rate determined by subjective improvement in OD on the Clinical Global Impression of Improvement (CGI-I) after the FD phase. Other subjective and objective measures of olfactory function were also assessed as secondary outcome measures. Results Sixty-eight participants were enrolled (34 randomized to each arm), a total of 44 participants completed the FD period and 20 (45.4%) reported response to treatment with at least slight improvement in olfaction from baseline. Of those randomized, 51 (75%) were women and 56 were White (82%) with a mean (SD) age of 43 (13.5) years. Baseline demographic features including age, sex, and race and ethnicity were not significantly different between the groups. Of the 18 participants in the gabapentin group, 8 (44%) were responders and of the 26 participants in the placebo group, 12 (46%) reported response to treatment (percent difference, 1.7%; 95% CI, -31.6% to 28.2%). Mixed-model analysis of all secondary outcome measures demonstrated no clinically meaningful or statistically significant difference between the gabapentin and placebo groups throughout the trial. There were no serious adverse events. Conclusions and Relevance In this randomized clinical trial, gabapentin was not associated with statistically significant or clinically meaningful benefit over placebo and likely is not an efficacious therapy for COVID-19-induced OD. Trial Registration ClinicalTrials.gov Identifier: NCT05184192.
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Affiliation(s)
- Ashna Mahadev
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
- Family Care Health Centers, St Louis, Missouri
| | - Firas Hentati
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Case Western Reserve University School of Medicine, Cleveland, Ohio
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Brevin Miller
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
- Family Care Health Centers, St Louis, Missouri
| | - James Bao
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- University of Miami Miller School of Medicine, Miami, Florida
| | - Amber Perrin
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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15
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Tharakan T, Piccirillo JF, Miller B, Reed DR, Kallogjeri D, Paniello R, Puram SV, Jackson RS. Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery. Laryngoscope 2023; 133:3520-3528. [PMID: 37551882 PMCID: PMC10843268 DOI: 10.1002/lary.30939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/23/2023] [Accepted: 07/17/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES To compare taste changes after transoral robotic surgery (TORS) to taste changes in healthy controls. METHODS Oropharyngeal cancer patients receiving TORS and healthy controls were recruited. Participants underwent posterolateral and whole-mouth psychophysical taste testing (identification, intensity, and hedonics) at baseline and at 2 weeks postoperatively (patients) or follow-up (controls). Surgeons reported suspension time and glossopharyngeal nerve injury (GNI) based on the identification and sacrifice of the nerve. A Clinical Global Impression (CGI) of taste symptoms was completed at each session ("My sense of taste bothers me" on a 5-point scale from Never [1] to Always [5]). A taste disorder (TD) was a CGI of 3 (Sometimes) or worse. Within-subject changes in CGI and psychophysical scores were computed. "Worsened taste" was a CGI increase by ≥1 point at follow-up. RESULTS Of 69 participants, most (33/37 tumor, 31/32 controls) had normal baseline taste (CGI < 3). 14/33 (42%) TORS patients and no controls developed new TDs at follow-up. More smokers (7/9) had worsened taste than nonsmokers (19/60, difference = 46% [95% CI 16%-76%]). More patients without GNI (6/22) than with GNI (0/15) had postoperative phantogeusia (difference = 27% [95% CI 9-45%]). Tumor-ipsilateral taste identification (TI) decreased more in patients (-11.3%) than controls (0.8%, difference = 12.2% [95% CI 5.0-19.3%]). Suspension time was not associated with worsened taste symptoms or psychophysical changes. CONCLUSIONS Patient-reported taste changes after TORS are frequent. Compared to healthy controls, TORS patients have decreased tumor-ipsilateral TI. Suspension time and GNI are unlikely to cause symptomatic TDs. Further investigations of the etiology and long-term symptom burden of TORS-associated TDs will aid in the management of oropharyngeal cancer patients. LEVEL OF EVIDENCE 3 (non-randomized controlled cohort study) Laryngoscope, 133:3520-3528, 2023.
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Affiliation(s)
- Theresa Tharakan
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Jay F. Piccirillo
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Brevin Miller
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- School of Medicine, University of Missouri Kansas City, Kansas City, MO
| | | | - Dorina Kallogjeri
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Randall Paniello
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
| | - Sidharth V. Puram
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
- Department of Genetics, Washington University School of Medicine, St Louis, MO
| | - Ryan S. Jackson
- Department of Otolaryngology – Head and Neck Surgery, Washington University School of Medicine, St Louis, MO
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16
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA 2023; 330:923-924. [PMID: 37594877 DOI: 10.1001/jama.2023.14719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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17
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Oliveira G, Egloff AM, Afeyan AB, Wolff JO, Zeng Z, Chernock RD, Zhou L, Messier C, Lizotte P, Pfaff KL, Stromhaug K, Penter L, Haddad RI, Hanna GJ, Schoenfeld JD, Goguen LA, Annino DJ, Jo V, Oppelt P, Pipkorn P, Jackson R, Puram SV, Paniello RC, Rich JT, Webb J, Zevallos JP, Mansour M, Fu J, Dunn GP, Rodig SJ, Ley J, Morris LG, Dunn L, Paweletz CP, Kallogjeri D, Piccirillo JF, Adkins DR, Wu CJ, Uppaluri R. Preexisting tumor-resident T cells with cytotoxic potential associate with response to neoadjuvant anti-PD-1 in head and neck cancer. Sci Immunol 2023; 8:eadf4968. [PMID: 37683037 PMCID: PMC10794154 DOI: 10.1126/sciimmunol.adf4968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 07/31/2023] [Indexed: 09/10/2023]
Abstract
About 50% of patients with locally advanced head and neck squamous cell carcinoma (HNSCC) experience recurrences after definitive therapy. The presurgical administration of anti-programmed cell death protein 1 (PD-1) immunotherapy results in substantial pathologic tumor responses (pTR) within the tumor microenvironment (TME). However, the mechanisms underlying the dynamics of antitumor T cells upon neoadjuvant PD-1 blockade remain unresolved, and approaches to increase pathologic responses are lacking. In a phase 2 trial (NCT02296684), we observed that 45% of patients treated with two doses of neoadjuvant pembrolizumab experienced marked pTRs (≥50%). Single-cell analysis of 17,158 CD8+ T cells from 14 tumor biopsies, including 6 matched pre-post neoadjuvant treatment, revealed that responding tumors had clonally expanded putative tumor-specific exhausted CD8+ tumor-infiltrating lymphocytes (TILs) with a tissue-resident memory program, characterized by high cytotoxic potential (CTX+) and ZNF683 expression, within the baseline TME. Pathologic responses after 5 weeks of PD-1 blockade were consistent with activation of preexisting CTX+ZNF683+CD8+ TILs, paralleling loss of viable tumor and associated tumor antigens. Response was associated with high numbers of CD103+PD-1+CD8+ T cells infiltrating pretreatment lesions, whereas revival of nonexhausted persisting clones and clonal replacement were modest. By contrast, nonresponder baseline TME exhibited a relative absence of ZNF683+CTX+ TILs and subsequent accumulation of highly exhausted clones. In HNSCC, revival of preexisting ZNF683+CTX+ TILs is a major mechanism of response in the immediate postneoadjuvant setting.
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Affiliation(s)
- Giacomo Oliveira
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School; Boston, MA, USA
| | - Ann Marie Egloff
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School; Boston, MA, USA
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Alexander B. Afeyan
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School; Boston, MA, USA
| | - Jacquelyn O. Wolff
- Center for Immuno-Oncology, Dana-Farber Cancer Institute; Boston, MA, USA
| | - Zexiang Zeng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rebecca D. Chernock
- Department of Pathology and Immunology, Washington University School of Medicine; St. Louis, MO, USA
| | - Liye Zhou
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Cameron Messier
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute; Boston, MA, USA
| | - Patrick Lizotte
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute; Boston, MA, USA
| | - Kathleen L Pfaff
- Center for Immuno-Oncology, Dana-Farber Cancer Institute; Boston, MA, USA
| | - Kari Stromhaug
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Livius Penter
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School; Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Hematology, Oncology and Tumor immunology, Campus Virchow Klinikum, Berlin, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robert I. Haddad
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Glenn J. Hanna
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | | | - Laura A. Goguen
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Donald J. Annino
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
| | - Vickie Jo
- Department of Pathology, Brigham and Women’s Hospital; Boston, MA, USA
| | - Peter Oppelt
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine/Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Patrik Pipkorn
- Department of Otolaryngology, Washington University School of Medicine; St. Louis, MO, USA
| | - Ryan Jackson
- Department of Otolaryngology, Washington University School of Medicine; St. Louis, MO, USA
| | - Sidharth V. Puram
- Department of Otolaryngology, Washington University School of Medicine; St. Louis, MO, USA
| | - Randal C. Paniello
- Department of Otolaryngology, Washington University School of Medicine; St. Louis, MO, USA
| | - Jason T. Rich
- Department of Otolaryngology, Washington University School of Medicine; St. Louis, MO, USA
| | - Jason Webb
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Jose P. Zevallos
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Mena Mansour
- Department of Pathology and Immunology, Washington University School of Medicine; St. Louis, MO, USA
| | - Jingxin Fu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Gavin P. Dunn
- Department of Neurological Surgery, Massachusetts General Hospital; Boston, MA, USA
| | - Scott J. Rodig
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Pathology, Brigham and Women’s Hospital; Boston, MA, USA
| | - Jessica Ley
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine/Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Luc G.T. Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lara Dunn
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Cloud P. Paweletz
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Belfer Center for Applied Cancer Science, Dana-Farber Cancer Institute; Boston, MA, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology, Washington University School of Medicine; St. Louis, MO, USA
| | - Jay F. Piccirillo
- Department of Otolaryngology, Washington University School of Medicine; St. Louis, MO, USA
| | - Douglas R. Adkins
- Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
- Department of Medicine/Medical Oncology, Washington University School of Medicine, St. Louis, MO, USA
| | - Catherine J. Wu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School; Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Ravindra Uppaluri
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School; Boston, MA, USA
- Department of Surgery, Brigham and Women’s Hospital, Boston, MA, USA
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Rodriguez CR, Piccirillo JF, Rodebaugh TL. Acceptability of Cognitive Behavioral Therapy for Tinnitus: A Study With Veterans and Nonveterans. Am J Audiol 2023; 32:593-603. [PMID: 37566882 PMCID: PMC10558150 DOI: 10.1044/2023_aja-23-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 04/18/2023] [Accepted: 05/25/2023] [Indexed: 08/13/2023] Open
Abstract
PURPOSE Cognitive behavioral therapy (CBT) is a gold standard yet underutilized treatment for tinnitus, and tinnitus is especially highly prevalent among veterans. The aims of this study were twofold: to determine (a) if CBT for tinnitus is underutilized because participants find it less acceptable than other behavioral treatments for tinnitus and (b) if veterans and nonveterans rate behavioral treatments for tinnitus differently. METHOD This cross-sectional study was conducted online with a sample of 277 adults in the United States who self-reported at least some level of bothersome tinnitus in the past week. The sample for this study consisted of 129 veterans and 148 nonveterans. Participants read descriptions of CBT, tinnitus retraining therapy (TRT), and mindfulness-based stress reduction (MBSR). For each treatment, presented to them in random order, they provided credibility, expectancy, and acceptability ratings. RESULTS Among 277 participants, 147 (53.07%) reporting gender were women, 216 (77.98%) reporting race/ethnicity were White, and 129 (46.57%) were veterans of any branch of the U.S. Armed Forces. Veteran ratings of credibility, expectancy, and acceptability were significantly lower than nonveteran ratings across treatments. There were differences in credibility, expectancy, and acceptability ratings across treatments, and post hoc testing revealed that TRT was consistently rated higher than CBT or MBSR. CONCLUSIONS Despite strong research support, CBT was rated as less acceptable than a different, less widely empirically supported treatment. Veterans' ratings of acceptability were lower than those of nonveterans across all treatments.
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Affiliation(s)
- Chavez R. Rodriguez
- Department of Psychiatry, University of Michigan, Ann Arbor
- Addiction Center, University of Michigan, Ann Arbor
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St. Louis, MO
| | - Thomas L. Rodebaugh
- Department of Psychological & Brain Sciences, Washington University in St. Louis, MO
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19
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Farrell NF, Pan J, Huang T, Piccirillo JF, Goldstein BJ, Brody SL. Simvastatin as a topical anti-inflammatory: Effect on airway epithelial cell homeostasis. Int Forum Allergy Rhinol 2023; 13:1817-1820. [PMID: 36757028 DOI: 10.1002/alr.23137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Affiliation(s)
- Nyssa Fox Farrell
- Division of Rhinology, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Jiehong Pan
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Tao Huang
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Bradley J Goldstein
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Steven L Brody
- Division of Pulmonary & Critical Care Medicine, Department of Medicine, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
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Ioerger P, Munyemana MA, Piccirillo JF. How to Fully Leverage the Power of Electronic Health Records for Research-Self-Service Analytics. JAMA Otolaryngol Head Neck Surg 2023; 149:771-772. [PMID: 37440222 DOI: 10.1001/jamaoto.2023.1581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Affiliation(s)
- Patrick Ioerger
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- University of Kansas Medical Center, Kansas City
| | - Marie-Ange Munyemana
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Editor, JAMA Otolaryngology-Head & Neck Surgery
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21
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Psychiatry 2023:2808637. [PMID: 37594887 DOI: 10.1001/jamapsychiatry.2023.3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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22
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Ophthalmol 2023:2808662. [PMID: 37594881 DOI: 10.1001/jamaophthalmol.2023.4021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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23
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Intern Med 2023:2808638. [PMID: 37594891 DOI: 10.1001/jamainternmed.2023.4474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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24
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Neurol 2023:2808773. [PMID: 37594882 DOI: 10.1001/jamaneurol.2023.3068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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25
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Otolaryngol Head Neck Surg 2023:2808700. [PMID: 37594890 DOI: 10.1001/jamaoto.2023.2746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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26
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Dermatol 2023:2808699. [PMID: 37594883 DOI: 10.1001/jamadermatol.2023.3212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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27
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Oncol 2023:2808718. [PMID: 37594876 DOI: 10.1001/jamaoncol.2023.3619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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28
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Cardiol 2023:2808661. [PMID: 37594888 DOI: 10.1001/jamacardio.2023.2857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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29
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Pediatr 2023:2808717. [PMID: 37594885 DOI: 10.1001/jamapediatrics.2023.3437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
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30
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Galbraith A, Flanagin A, Carroll AE, Ayanian JZ, Bonow RO, Bressler N, Christakis D, Disis MLN, Inouye SK, Josephson A, Öngür D, Piccirillo JF, Shinkai K, Bibbins-Domingo K. JAMA Network Call for Papers on Health and the 2024 US Election. JAMA Health Forum 2023; 4:e233014. [PMID: 37594884 DOI: 10.1001/jamahealthforum.2023.3014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023] Open
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31
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Khan AM, Kallogjeri D, Piccirillo JF. Visual-Olfactory Training and Patient Preference in Treatment of COVID-19 Olfactory Loss-How Salient Stimuli Might Support Recovery of Smell-Reply. JAMA Otolaryngol Head Neck Surg 2023; 149:651. [PMID: 37261823 DOI: 10.1001/jamaoto.2023.1135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Affiliation(s)
- Amish M Khan
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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Chang JL, Goldberg AN, Alt JA, Alzoubaidi M, Ashbrook L, Auckley D, Ayappa I, Bakhtiar H, Barrera JE, Bartley BL, Billings ME, Boon MS, Bosschieter P, Braverman I, Brodie K, Cabrera-Muffly C, Caesar R, Cahali MB, Cai Y, Cao M, Capasso R, Caples SM, Chahine LM, Chang CP, Chang KW, Chaudhary N, Cheong CSJ, Chowdhuri S, Cistulli PA, Claman D, Collen J, Coughlin KC, Creamer J, Davis EM, Dupuy-McCauley KL, Durr ML, Dutt M, Ali ME, Elkassabany NM, Epstein LJ, Fiala JA, Freedman N, Gill K, Boyd Gillespie M, Golisch L, Gooneratne N, Gottlieb DJ, Green KK, Gulati A, Gurubhagavatula I, Hayward N, Hoff PT, Hoffmann OM, Holfinger SJ, Hsia J, Huntley C, Huoh KC, Huyett P, Inala S, Ishman SL, Jella TK, Jobanputra AM, Johnson AP, Junna MR, Kado JT, Kaffenberger TM, Kapur VK, Kezirian EJ, Khan M, Kirsch DB, Kominsky A, Kryger M, Krystal AD, Kushida CA, Kuzniar TJ, Lam DJ, Lettieri CJ, Lim DC, Lin HC, Liu SY, MacKay SG, Magalang UJ, Malhotra A, Mansukhani MP, Maurer JT, May AM, Mitchell RB, Mokhlesi B, Mullins AE, Nada EM, Naik S, Nokes B, Olson MD, Pack AI, Pang EB, Pang KP, Patil SP, Van de Perck E, Piccirillo JF, Pien GW, Piper AJ, Plawecki A, Quigg M, Ravesloot MJ, Redline S, Rotenberg BW, Ryden A, Sarmiento KF, Sbeih F, Schell AE, Schmickl CN, Schotland HM, Schwab RJ, Seo J, Shah N, Shelgikar AV, Shochat I, Soose RJ, Steele TO, Stephens E, Stepnowsky C, Strohl KP, Sutherland K, Suurna MV, Thaler E, Thapa S, Vanderveken OM, de Vries N, Weaver EM, Weir ID, Wolfe LF, Tucker Woodson B, Won CH, Xu J, Yalamanchi P, Yaremchuk K, Yeghiazarians Y, Yu JL, Zeidler M, Rosen IM. International Consensus Statement on Obstructive Sleep Apnea. Int Forum Allergy Rhinol 2023; 13:1061-1482. [PMID: 36068685 PMCID: PMC10359192 DOI: 10.1002/alr.23079] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
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Affiliation(s)
- Jolie L. Chang
- University of California, San Francisco, California, USA
| | | | | | | | - Liza Ashbrook
- University of California, San Francisco, California, USA
| | | | - Indu Ayappa
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | - Maurits S. Boon
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Pien Bosschieter
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Itzhak Braverman
- Hillel Yaffe Medical Center, Hadera Technion, Faculty of Medicine, Hadera, Israel
| | - Kara Brodie
- University of California, San Francisco, California, USA
| | | | - Ray Caesar
- Stone Oak Orthodontics, San Antonio, Texas, USA
| | | | - Yi Cai
- University of California, San Francisco, California, USA
| | | | | | | | | | | | | | | | | | - Susmita Chowdhuri
- Wayne State University and John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - Peter A. Cistulli
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Claman
- University of California, San Francisco, California, USA
| | - Jacob Collen
- Uniformed Services University, Bethesda, Maryland, USA
| | | | | | - Eric M. Davis
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Mohan Dutt
- University of Michigan, Ann Arbor, Michigan, USA
| | - Mazen El Ali
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | - Kirat Gill
- Stanford University, Palo Alto, California, USA
| | | | - Lea Golisch
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | | | | | - Arushi Gulati
- University of California, San Francisco, California, USA
| | | | | | - Paul T. Hoff
- University of Michigan, Ann Arbor, Michigan, USA
| | - Oliver M.G. Hoffmann
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | - Jennifer Hsia
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Colin Huntley
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | - Sanjana Inala
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | | | | | | | | | | | - Meena Khan
- Ohio State University, Columbus, Ohio, USA
| | | | - Alan Kominsky
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Meir Kryger
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Derek J. Lam
- Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | | | | | - Atul Malhotra
- University of California, San Diego, California, USA
| | | | - Joachim T. Maurer
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Anna M. May
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Ron B. Mitchell
- University of Texas, Southwestern and Children’s Medical Center Dallas, Texas, USA
| | | | | | | | | | - Brandon Nokes
- University of California, San Diego, California, USA
| | | | - Allan I. Pack
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | | | - Mark Quigg
- University of Virginia, Charlottesville, Virginia, USA
| | | | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Armand Ryden
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | | | - Firas Sbeih
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | | | | | | | | | - Jiyeon Seo
- University of California, Los Angeles, California, USA
| | - Neomi Shah
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Ryan J. Soose
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Erika Stephens
- University of California, San Francisco, California, USA
| | | | | | | | | | - Erica Thaler
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sritika Thapa
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Nico de Vries
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | | - Ian D. Weir
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Josie Xu
- University of Toronto, Ontario, Canada
| | | | | | | | | | | | - Ilene M. Rosen
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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33
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Rodebaugh TL, Piccirillo ML, Frumkin MR, Kallogjeri D, Gerull KM, Piccirillo JF. Investigating Individual Variation Using Dynamic Structural Equation Modeling: A Tutorial with Tinnitus. Clin Psychol Sci 2023; 11:574-591. [PMID: 37408827 PMCID: PMC10321503 DOI: 10.1177/21677026221129279] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
A growing body of research suggests that standard group-based models might provide little insight regarding individuals. In the current study, we sought to compare group-based and individual predictors of bothersome tinnitus, illustrating how researchers can use dynamic structural equation modeling (DSEM) for intensive longitudinal data to examine whether findings from analyses of the group apply to individuals. A total of 43 subjects with bothersome tinnitus responded to up to 200 surveys each. In multi-level DSEM models, survey items loaded on three factors (tinnitus bother, cognitive symptoms, and anxiety) and results indicated a reciprocal relationship between tinnitus bother and anxiety. In fully idiographic models, the three-factor model fit poorly for two individuals, and the multilevel model did not generalize to most individuals, possibly due to limited power. Research examining heterogeneous conditions such as tinnitus bother may benefit from methods such as DSEM that allow researchers to model dynamic relationships.
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Affiliation(s)
- Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St Louis
| | - Marilyn L Piccirillo
- Department of Psychological and Brain Sciences, Washington University in St Louis
| | - Madelyn R Frumkin
- Department of Psychological and Brain Sciences, Washington University in St Louis
| | - Dorina Kallogjeri
- Department of Otolaryngology, Washington University School of Medicine in St Louis
| | - Katherine M Gerull
- Department of Otolaryngology, Washington University School of Medicine in St Louis
| | - Jay F Piccirillo
- Department of Otolaryngology, Washington University School of Medicine in St Louis
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Sinha P, Tharakan T, Payne S, Piccirillo JF. Balloon Sinus Dilation Versus Functional Endoscopic Sinus Surgery for Chronic Rhinosinusitis: Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2023; 132:578-588. [PMID: 35703383 PMCID: PMC10559877 DOI: 10.1177/00034894221104939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the efficacy of balloon sinus dilation (BSD) compared to functional endoscopic sinus surgery (FESS) or medical management for chronic rhinosinusitis (CRS). METHODS A qualified medical librarian conducted a literature search for relevant publications that evaluate efficacy of BSD. Studies were assessed independently by 2 reviewers for inclusion in the systematic review and meta-analysis. RESULTS From 315 abstracts reviewed, 18 studies were included in qualitative review, and 7 were included in meta-analysis. Quantitative analysis included 4 randomized clinical trials (RCTs) and 3 cohort studies comparing baseline and post-operative Sinonasal Outcome Test (SNOT)-20 scores in BSD and FESS. A meta-analysis restricted to the studies reporting SD for changes from baseline (2 RCTs, 1 cohort) showed the pooled difference in means to be 0.435, less than a clinically meaningful difference of 0.8. A separate sensitivity analysis of the studies including 4 additional studies with imputed values of SD for changes from baseline showed the pooled difference of means to be 0.237 assuming the highest level of correlation (Corr .8) between the pre- and post-intervention scores. CONCLUSIONS There is limited high-quality evidence that assesses the efficacy of BSD versus FESS in the management of CRS patients. To better inform CRS management, future studies should compare BSD with endoscopic sinus surgery, hybrid procedures, and/or medical management alone using validated objective and patient-reported outcome measures.
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Affiliation(s)
- Parul Sinha
- Washington University School of Medicine, St Louis, Missouri
| | | | - Spencer Payne
- University of Virginia Health System, Charlottesville, Virginia
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35
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Douglas ZH, Piccirillo JF, Schneider J, Roland LT, Farrell NF. Is Tranexamic Acid Effective for Hemostasis During Endoscopic Sinus Surgery? Laryngoscope 2023; 133:716-718. [PMID: 36479704 DOI: 10.1002/lary.30513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/31/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Zachary H Douglas
- Division of Rhinology, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - John Schneider
- Division of Rhinology, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Lauren T Roland
- Division of Rhinology, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Nyssa Fox Farrell
- Division of Rhinology, Department of Otolaryngology-Head & Neck Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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36
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Piccirillo JF. JAMA Otolaryngology-Head & Neck Surgery-The Year in Review, 2022. JAMA Otolaryngol Head Neck Surg 2023; 149:387-389. [PMID: 36951850 DOI: 10.1001/jamaoto.2023.0130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Affiliation(s)
- Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
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Kallogjeri D, Piccirillo JF. A Simple Guide to Effect Size Measures. JAMA Otolaryngol Head Neck Surg 2023; 149:447-451. [PMID: 36951858 DOI: 10.1001/jamaoto.2023.0159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
Importance Effect size quantifies the magnitude of the difference or the strength of the association between variables. In clinical research it is important to calculate and report the effect size and the confidence interval (CI) because it is needed for sample size calculation, meaningful interpretation of results, and meta-analyses. Observations There are many different effect size measures that can be organized into 2 families or groups-d family and r family. The d family includes measures that quantify the differences between groups. The r family includes measures that quantify the strength of the association. Effect sizes that are presented in the same units as the characteristic being measured and compared are known as nonstandardized or simple effect sizes. The nonstandardized effect sizes have the advantage of being more informative, easier to interpret, and easier to evaluate in the light of clinical significance or practical relevance. Standardized effect sizes are unit-less and are helpful for combining and comparing effects of different outcome measures or across different studies (ie, meta-analysis). Conclusions and Relevance The choice of the correct effect size measure depends on the research question, study design, targeted audience, and the statistical assumptions being made. For a complete and meaningful interpretation of results from a clinical research study, the investigator should make clear the type of effect size being reported, its magnitude and direction, degree of uncertainty of the effect size estimate as presented by the CIs, and whether the results are compatible with a clinically meaningful effect.
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Affiliation(s)
- Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Jay F Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri
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38
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Greenberg JK, Frumkin MR, Javeed S, Zhang JK, Dai R, Molina CA, Pennicooke BH, Agarwal N, Santiago P, Goodwin ML, Jain D, Pallotta N, Gupta MC, Buchowski JM, Leuthardt EC, Ghogawala Z, Kelly MP, Hall BL, Piccirillo JF, Lu C, Rodebaugh TL, Ray WZ. Feasibility and Acceptability of a Preoperative Multimodal Mobile Health Assessment in Spine Surgery Candidates. Neurosurgery 2023; 92:538-546. [PMID: 36700710 PMCID: PMC10158869 DOI: 10.1227/neu.0000000000002245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 09/19/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Rapid growth in smartphone use has expanded opportunities to use mobile health (mHealth) technology to collect real-time patient-reported and objective biometric data. These data may have important implication for personalized treatments of degenerative spine disease. However, no large-scale study has examined the feasibility and acceptability of these methods in spine surgery patients. OBJECTIVE To evaluate the feasibility and acceptability of a multimodal preoperative mHealth assessment in patients with degenerative spine disease. METHODS Adults undergoing elective spine surgery were provided with Fitbit trackers and sent preoperative ecological momentary assessments (EMAs) assessing pain, disability, mood, and catastrophizing 5 times daily for 3 weeks. Objective adherence rates and a subjective acceptability survey were used to evaluate feasibility of these methods. RESULTS The 77 included participants completed an average of 82 EMAs each, with an average completion rate of 86%. Younger age and chronic pulmonary disease were significantly associated with lower EMA adherence. Seventy-two (93%) participants completed Fitbit monitoring and wore the Fitbits for an average of 247 hours each. On average, participants wore the Fitbits for at least 12 hours per day for 15 days. Only worse mood scores were independently associated with lower Fitbit adherence. Most participants endorsed positive experiences with the study protocol, including 91% who said they would be willing to complete EMAs to improve their preoperative surgical guidance. CONCLUSION Spine fusion candidates successfully completed a preoperative multimodal mHealth assessment with high acceptability. The intensive longitudinal data collected may provide new insights that improve patient selection and treatment guidance.
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Affiliation(s)
- Jacob K. Greenberg
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Madelyn R. Frumkin
- Department of Psychology and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Saad Javeed
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Justin K. Zhang
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Ruixuan Dai
- Department of Computer Science and Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Camilo A. Molina
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Brenton H. Pennicooke
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Paul Santiago
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Matthew L. Goodwin
- Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Deeptee Jain
- Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Nicholas Pallotta
- Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Munish C. Gupta
- Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Jacob M. Buchowski
- Department of Orthopaedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Eric C. Leuthardt
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Zoher Ghogawala
- Department of Neurosurgery, Lahey Hospital and Medical Center, Burlington, Massachusetts, USA
| | - Michael P. Kelly
- Department of Orthopaedic Surgery, Rady Children's Hospital, San Diego, California, USA
| | - Bruce L. Hall
- Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Jay F. Piccirillo
- Department of Otolaryngology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Chenyang Lu
- Department of Computer Science and Engineering, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Thomas L. Rodebaugh
- Department of Psychology and Brain Sciences, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Wilson Z. Ray
- Department of Neurological Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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39
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Peterson AM, Miller B, Ioerger P, Hentati F, Doering MM, Kallogjeri D, Piccirillo JF. Most-Cited Patient-Reported Outcome Measures Within Otolaryngology-Revisiting the Minimal Clinically Important Difference: A Review. JAMA Otolaryngol Head Neck Surg 2023; 149:261-276. [PMID: 36729451 PMCID: PMC10729312 DOI: 10.1001/jamaoto.2022.4703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Importance Patient-reported outcome measures (PROMs) allow clinicians and researchers to assess health-related information from a patient's perspective. These measures have been used more frequently over the last several decades, but an associated minimal clinically important difference (MCID) is needed to optimize their utility. This narrative review identified the top 100 most-cited otolaryngology-related PROM development and validation publications and assessed the presence and characteristics of the PROMs' associated MCID. Observations In this narrative review, a literature search in Scopus and Web of Science was conducted on June 29, 2022, using keywords related to PROM development and validation studies in otolaryngology and reference lists. Studies that met the definition of a PROM and assessed an otolaryngologic disorder or study population were included for full-text review. After full-text review of 188 articles, the top 100 most-cited PROM development and validation publications, resulting in 106 total PROMs, were chosen for review. A total of 39 (37%) of the identified PROMs had an associated MCID. Of those reporting an MCID, 14 (35.9%) used an anchor-based method, 12 (30.8%) used a distribution-based method, 10 (25.6%) used both, and 3 (7.7%) did not specify or used neither method. Rhinology had the greatest number of PROMs with an associated MCID (16 of 24, 66%), and pediatrics had the fewest (1 of 13, 7.7%). The median number of citations of PROMs with an MCID was higher than those without an MCID. Conclusions and Relevance The majority of the most-cited PROMs in otolaryngology lack an associated MCID. These data indicated that there are a multitude of PROMs that have been cited hundreds of times and used for decades without the ability to identify whether a particular change in score on the instrument is clinically meaningful. There is a need to determine and validate MCIDs for commonly used PROMs to aid clinical research and trial interpretation.
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Affiliation(s)
- Andrew M. Peterson
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Brevin Miller
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- University of Missouri Kansas City School of Medicine, Kansas City, Missouri
| | - Patrick Ioerger
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- University of Kansas Medical Center, Kansas City, Kansas
| | - Firas Hentati
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Case Western Reserve University, Cleveland, Ohio
| | - Michelle M. Doering
- Becker Medical Library, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri
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40
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Dermatol 2023; 159:135-136. [PMID: 36516038 DOI: 10.1001/jamadermatol.2022.6161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
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41
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Intern Med 2023; 183:95-96. [PMID: 36516051 DOI: 10.1001/jamainternmed.2022.6493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
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42
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Surg 2023; 158:118-119. [PMID: 36516043 DOI: 10.1001/jamasurg.2022.7677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
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43
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Cardiol 2023; 8:109-110. [PMID: 36516027 DOI: 10.1001/jamacardio.2022.5261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics
- Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology
- Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery
- Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry
- McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery
- Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine
- Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open
- Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology
- Department of Dermatology, University of California, San Francisco
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44
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Khan AM, Piccirillo J, Kallogjeri D, Piccirillo JF. Efficacy of Combined Visual-Olfactory Training With Patient-Preferred Scents as Treatment for Patients With COVID-19 Resultant Olfactory Loss: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2023; 149:141-149. [PMID: 36580304 PMCID: PMC9857399 DOI: 10.1001/jamaoto.2022.4112] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022]
Abstract
Importance The number of olfactory dysfunction cases has increased dramatically because of the COVID-19 pandemic. Identifying therapies that aid and accelerate recovery is essential. Objective To determine the efficacy of bimodal visual-olfactory training and patient-preferred scents vs unimodal olfactory training and physician-assigned scents in COVID-19 olfactory loss. Design, Setting, and Participants This was a randomized, single-blinded trial with a 2-by-2 factorial design (bimodal, patient preferred; unimodal, physician assigned; bimodal, physician assigned; unimodal, patient preferred) and an independent control group. Enrollment occurred from February 1 to May 27, 2021. Participants were adults 18 to 71 years old with current olfactory loss defined as University of Pennsylvania Smell Identification Test (UPSIT) score less than 34 for men and less than 35 for women and duration of 3 months or longer. Olfactory loss was initially diagnosed within 2 weeks of COVID-19 infection. Interventions Participants sniffed 4 essential oils for 15 seconds with a 30-second rest in between odors for 3 months. Participants in the physician-assigned odor arms trained with rose, lemon, eucalyptus, and clove. Participants randomized to the patient-preferred arms chose 4 of 24 available scents. If assigned to the bimodal arm, participants were shown digital images of the essential oil they were smelling. Main Outcomes and Measures The primary end point was postintervention change in UPSIT score from baseline; measures used were the UPSIT (validated, objective psychometric test of olfaction), Clinical Global Impressions Impression-Improvement (CGI-I; self-report improvement scale), and Olfactory Dysfunction Outcomes Rating (ODOR; olfaction-related quality-of-life questionnaire). Results Among the 275 enrolled participants, the mean (SD) age was 41 (12) years, and 236 (86%) were female. The change in UPSIT scores preintervention to postintervention was similar between the study arms. The marginal mean difference for change in UPSIT scores preintervention to postintervention between participants randomized to patient-preferred vs physician-assigned olfactory training was 0.73 (95% CI, -1.10 to 2.56), and between participants randomized to bimodal vs unimodal olfactory training was 1.10 (95% CI, -2.92 to 0.74). Five (24%) participants in the control arm had clinically important improvement on UPSIT compared with 18 (53%) in the bimodal, patient-preferred arm for a difference of 29% (95% CI, 4%-54%). Four (19%) participants in the control group self-reported improvement on CGI-I compared with 12 (35%) in the bimodal, patient-preferred arm for a difference of 16% (95% CI, -7% to 39%). The mean change in ODOR score preintervention to postintervention was 11.6 points (95% CI, 9.2-13.9), which was not deemed clinically important nor significantly different between arms. Conclusions and Relevance Based on the change in UPSIT scores, this randomized clinical trial did not show any difference between intervention arms, but when exploring within-patient change in UPSIT as well as self-reported impression of improvement, active interventions were associated with larger improvement than controls with a potential advantage of bimodal intervention. While not definitive, these results suggest that patients with COVID-19 olfactory loss may benefit from bimodal visual-olfactory training with patient-preferred scents. Trial Registration ClinicalTrials.gov Identifier: NCT04710394.
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Affiliation(s)
- Amish M. Khan
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Jeffrey Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Dorina Kallogjeri
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Statistics Editor, JAMA Otolaryngology–Head & Neck Surgery
| | - Jay F. Piccirillo
- Clinical Outcomes Research Office, Department of Otolaryngology–Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri
- Editor in Chief, JAMA Otolaryngology–Head & Neck Surgery
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45
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Pediatr 2023; 177:120-121. [PMID: 36516044 DOI: 10.1001/jamapediatrics.2022.5697] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
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46
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Oncol 2023; 9:172-173. [PMID: 36516046 DOI: 10.1001/jamaoncol.2022.7502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
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47
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Neurol 2023; 80:132-133. [PMID: 36516048 DOI: 10.1001/jamaneurol.2022.5104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
| | | |
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48
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Otolaryngol Head Neck Surg 2023; 149:101-102. [PMID: 36516037 DOI: 10.1001/jamaoto.2022.4817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
| | | |
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49
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Psychiatry 2023; 80:107-108. [PMID: 36516039 DOI: 10.1001/jamapsychiatry.2022.4756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
| | | |
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50
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Bibbins-Domingo K, Shields B, Ayanian JZ, Bonow RO, Bressler NM, Christakis D, Disis ML, Josephson SA, Kibbe MR, Öngür D, Piccirillo JF, Redberg RF, Rivara FP, Shinkai K, Easley TJ. Public Access to Scientific Research Findings and Principles of Biomedical Research-A New Policy for the JAMA Network. JAMA Ophthalmol 2023; 141:115-116. [PMID: 36516036 DOI: 10.1001/jamaophthalmol.2022.6056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
| | | | - John Z Ayanian
- Editor, JAMA Health Forum.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor
| | - Robert O Bonow
- Editor, JAMA Cardiology.,Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Neil M Bressler
- Editor, JAMA Ophthalmology.,Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dimitri Christakis
- Editor, JAMA Pediatrics.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington
| | - Mary L Disis
- Editor, JAMA Oncology.,Fred Hutchinson Cancer Research Center, University of Washington, Seattle
| | - S Andrew Josephson
- Editor, JAMA Neurology.,Weill Institute for Neurosciences, Department of Neurology, University of California, San Francisco
| | - Melina R Kibbe
- Editor, JAMA Surgery.,Department of Surgery, University of Virginia, Charlottesville
| | - Dost Öngür
- Editor, JAMA Psychiatry.,McLean Hospital, Harvard Medical School, Belmont, Massachusetts
| | - Jay F Piccirillo
- Editor, JAMA Otolaryngology-Head & Neck Surgery.,Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Rita F Redberg
- Editor, JAMA Internal Medicine.,Department of Medicine, University of California, San Francisco
| | - Frederick P Rivara
- Editor, JAMA Network Open.,Department of Pediatrics, University of Washington, Seattle
| | - Kanade Shinkai
- Editor, JAMA Dermatology.,Department of Dermatology, University of California, San Francisco
| | | |
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