Faculty Collaboration Database

Nasal airway obstruction: allergy and otolaryngology perspectives. Ann Allergy Asthma Immunol 2008 Dec;101(6):593-8

Date

01/06/2009

Pubmed ID

19119702

DOI

10.1016/S1081-1206(10)60221-9

Scopus ID

2-s2.0-57449094207 (requires institutional sign-in at Scopus site)   11 Citations

Abstract

BACKGROUND: Diagnostic test preferences and management strategies for nasal airway obstruction (NAO) may vary depending on medical specialty.

OBJECTIVE: To discern current attitudes and practices of different medical specialties regarding diagnostic and management strategies for patients with NAO.

METHODS: Cross-sectional survey of all practicing otolaryngologists and medical allergists in Wisconsin and parts of northern Illinois (N = 268). Survey participants were asked to rank the tests they most commonly perform to differentiate causes of NAO and to rank the diagnostic tests they believed were most sensitive and specific (criterion standard) for NAO. The second portion of the survey provided 3 distinct patient scenarios, and participants were surveyed on their treatment plans.

RESULTS: The survey response rate was approximately 50% for both specialties. Nasal endoscopy was the most common diagnostic test for otolaryngologists vs allergists (58% vs 2%, P < .001), and allergy testing was most commonly used first by allergists (92% vs 0%, P < .001). Nasal endoscopy was considered the criterion standard for evaluating NAO by 70% of otolaryngologists vs 29% of allergists (P < .001), although nasal endoscopy was ranked in the top 3 for both specialties without a statistically significant difference. Patient scenario responses, however, demonstrated no statistically significant differences between the specialties.

CONCLUSION: Differences were demonstrated in the diagnostic workup preferences and perceptions of the criterion standard for NAO between the 2 medical specialties. Specialty bias, practitioner comfort level, and patient selection likely accounted for differences in responses. However, patient management decisions, medical or surgical, seemed to be similar between the specialties.

Author List

Shemirani NL, Rhee JS, Chiu AM

Authors

Asriani M. Chiu MD Professor in the Pediatrics department at Medical College of Wisconsin
John S. Rhee MD Chair, Professor in the Otolaryngology and Communication Sciences department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Allergy and Immunology
Cross-Sectional Studies
Diagnosis, Differential
Endoscopy
Humans
Illinois
Immunologic Tests
Nasal Cavity
Nasal Decongestants
Nasal Obstruction
Otolaryngology
Physicians
Practice Guidelines as Topic
Practice Patterns, Physicians'
Skin Tests
Surveys and Questionnaires
Wisconsin