November 2015 - Vol. 34, No. 10

AAO-HNSF CLINICAL CONSENSUS STATEMENTSeptoplasty with or without inferior turbinate reduction

Nasal obstruction is a highly prevalent problem in the United States that can negatively impact quality of life. One of the common causes of nasal obstruction is a deviated septum, with or without hypertrophic inferior turbinates. In the presence of such nasal obstruction, nasal septoplasty and inferior turbinate reduction procedures can improve the nasal airway.

AAO-HNSF publishes methodology for developing clinical consensus statements

Since 2010, the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF) has published five clinical consensus statements (CCSs) in Otolaryngology–Head and Neck Surgery, including: Diagnosis and Management of Nasal Valve Compromise (2010); CT Imaging Indications for Paranasal Sinus Disease (2012); Tracheostomy Care (2012); Pediatric Chronic Rhinosinusitis (2014); and this month Septoplasty with or without Inferior Turbinoplasty (2015). The CCS development manual supplement also appears in this month’s issue. The manual describes the methodology used by the AAO-HNSF to promote rapid and consistent development of CCSs when the evidence is lacking for development of a clinical practice guideline (CPG). A CCS integrates structured expert opinions with the existing literature to try and provide some clarification on points that are quality improvement opportunities related to a particular topic. In contrast to CPGs, which are based primarily on high-level evidence, clinical consensus statements are more applicable to situations where evidence is limited or lacking, yet there are still opportunities to reduce uncertainty and improve quality of care. Much like the AAO-HNSF Clinical Practice Guideline Development Manual, Third Edition: A Quality-Driven Approach for Translating Evidence into Action, which has now been cited 119 times, the goal of the Clinical Consensus Statement Development Manual is to provide readers with the detailed methodology used by the AAO-HNSF to develop its clinical consensus statements. Publication of the manual facilitates transparency of the AAO-HNSF process and also provides a tool for other organizations to replicate our process. In summary, the AAO-HNSF utilizes a modified Delphi Survey Method to develop its CCSs. The Delphi Method involves using multiple anonymous surveys to assess for objective consensus within an expert panel. This rigorous and standardized approach minimized bias and facilitated content expert consensus. While the CCS development manual contains specific practices relevant to the AAO-HNSF, we believe that the principles explained therein will be a valuable tool for our Members, the subspecialty societies, and to external organizations as well. Comparison of key characteristics of consensus statements vs. guidelines* Characteristic Clinical consensus statement Clinical practice guideline Primary output Statements of fact based on best evidence and expert consensus Recommendations for action based on best evidence and explicit consideration of benefits, harms, values, and preferences Level of evidence Observational studies and expert consensus; higher levels of evidence when available Systematic reviews and randomized controlled trials; lower level evidence as needed for research gaps Size of development group 8 to 10; possibly more 15 to 20 Composition of development group Otolaryngologists; content experts a majority; may include other disciplines as needed Multidisciplinary, including consumers; content experts a minority; includes all stakeholders in the target audience Perspective of development group member Member serves as a content expert based on individual knowledge and experience Member advocates for the discipline or constituency they were appointed to represent Time frame 6 to 8 months 12 to 18 months Meeting venues Conference calls and electronic mail In-person meetings, conference calls, and electronic mail External review Limited review by relevant stakeholders Extensive review by all stakeholders, including open public comment *From the AAO-HNSF Clinical Consensus Statement Development Manual (2015). (In press)

2016 committee application opens November 1

Want to get more involved with your Academy? Apply to become a committee Member! The 2016 application cycle will open on November 1 and close on January 1, 2016.

Call for 2016 AAO-HNS election candidates

The Nominating Committee of the Academy is calling for recommendations of individuals to be considered for an AAO-HNS elective office. Academy Member(s) must be in good standing, have proven leadership qualities, be active in the Academy, be familiar with the strategic direction of the Academy, and be able to dedicate the necessary time to serve.

Teamwork

The following are the committee rosters of the Academy and Foundation, grouped by their clusters. These are all Members, unless otherwise noted who were appointed to terms October 1, 2015, as well as those continuing their service. The number following each name indicates the end of their term.

Leadership opportunity: State Trackers for 2016

The AAO-HNS thanks its Member-volunteer State Trackers for their dedicated efforts during the 2015 state legislative sessions to effectively monitor issues and trends important to the specialty, your practices, and your patients.

Deadline for new tech applications

Looking to apply for a new or revised CPT code? As specified by the “AAO-HNS New Technology Pathway Requests Policies and Procedures” document (www.entnet.org/New-Tech-Policies-and-Procedures), the AAO-HNS New or Revised CPT Code Application is required to be submitted to the Academy 180 days prior to the AMA CPT Proposal submission deadline. The next Academy deadline is December 29, 2015.

Access information anywhere with Otolaryngology–Head and Neck Surgery app

Print, online, and mobile—research can and should be available in multiple formats to meet the varying needs of our readership. This is why Otolaryngology–Head and Neck Surgery is available to you through a free mobile app.

Humanitarian mission trip to Cameroon

I recently had the opportunity of a lifetime to participate in a two-week otolaryngology mission trip to Mbingo Baptist Hospital, Cameroon, with my mentor, Wayne M. Koch, MD, in April 2015. Dr. Koch has a long-standing relationship wth Mbingo Baptist Hospital (MBH) and travels there a number of times a year.

Why are RUC surveys important?

Your help is needed. The Academy needs experts three times a year to fill out RUC surveys for the American Medical Association (AMA) Specialty Society/Relative Value Update Committee.

Development of a professional code of conduct in an academic otolaryngology departmentExpanded from the print edition

Otolaryngology departments are increasingly becoming aware of the critical importance of professionalism in the academic medical setting.1 Growing evidence is showing that lack of civility in the workplace harms patient safety, employee satisfaction, and the broader institutional mission. Literature from other medical departments and from fields outside medicine suggests that a formalized written code of conduct is an effective method of clearly codifying the culture for all members of the organization, and of improving professional behavior.2

There is an ‘I’ in team

At the heart of the word committee, both literally and figuratively, is the word commit. As former basketball coach Pat Riley said, “There are only two options regarding commitment. You’re either in or you’re out. There is no such thing as life in-between.” Ditto for a successful committee.

Legislative Advocacy highlights from Annual Meeting

Another successful Annual Meeting & OTO EXPO(SM) has come and gone. In case you were unable to join us in Dallas, below is a brief overview of what you missed.