Clinical Decision Support Systems in Otolaryngology-Head and Neck Surgery: A State of the Art Review.

Objective: To offer practical, evidence-informed knowledge on clinical decision support systems (CDSSs) and their utility in improving care and reducing costs in otolaryngology-head and neck surgery. This primer on CDSSs introduces clinicians to both the capabilities and the limitations of this technology, reviews the literature on current state, and seeks to spur further progress in this area.

Data Sources: PubMed/MEDLINE, Embase, and Web of Science.

Does Quitting Smoking Make a Difference Among Newly Diagnosed Head and Neck Cancer Patients?

Introduction: To determine if smoking after a cancer diagnosis makes a difference in mortality among newly diagnosed head and neck cancer patients.

Methods: Longitudinal data were collected from newly diagnosed head and neck cancer patients with a median follow-up time of 1627 days (N = 590). Mortality was censored at 8 years or September 1, 2011, whichever came first.

Socioeconomic and Other Demographic Disparities Predicting Survival among Head and Neck Cancer Patients.

Background: The Institute of Medicine (IOM) report, "Unequal Treatment," which defines disparities as racially based, indicates that disparities in cancer diagnosis and treatment are less clear. While a number of studies have acknowledged cancer disparities, they have limitations of retrospective nature, small sample sizes, inability to control for covariates, and measurement errors.

Objective: The purpose of this study was to examine disparities as predictors of survival among newly diagnosed head and neck cancer patients recruited from 3 hospitals in Michigan, USA, while controlling for a number of covariates (health behaviors, medical comorbidities, and treatment modality).

Factors associated with smoking among operating engineers.

Although disparities in smoking prevalence between white collar workers and blue collar workers have been documented, reasons for these disparities have not been well studied. The objective of this study was to determine variables associated with smoking among Operating Engineers, using the Health Promotion Model as a guide. With cross-sectional data from a convenience sample of 498 Operating Engineers, logistic regression was used to determine personal and health behaviors associated with smoking.

Factors associated with sleep quality among operating engineers.

Blue collar workers generally report high job stress and are exposed to loud noises at work and engage in many of risky health behavioral factors, all of which have been associated with poor sleep quality. However, sleep quality of blue collar workers has not been studied extensively, and no studies have focused Operating Engineers (heavy equipment operators) among whom daytime fatigue would place them at high risk for accidents. Therefore, the purpose of this study was to determine variables associated with sleep quality among Operating Engineers.

Comprehensive analysis of DNA methylation in head and neck squamous cell carcinoma indicates differences by survival and clinicopathologic characteristics.

Head and neck squamous cell carcinoma (HNSCC) is the eighth most commonly diagnosed cancer in the United States. The risk of developing HNSCC increases with exposure to tobacco, alcohol and infection with human papilloma virus (HPV). HPV-associated HNSCCs have a distinct risk profile and improved prognosis compared to cancers associated with tobacco and alcohol exposure.

Health behaviors predict higher interleukin-6 levels among patients newly diagnosed with head and neck squamous cell carcinoma.

Background: Health behaviors have been shown to be associated with recurrence risk and survival rates in patients with cancer and are also associated with interleukin-6 (IL-6) levels, but few epidemiologic studies have investigated the relationship of health behaviors and IL-6 among cancer populations. The purpose of the study is to look at the relationship between five health behaviors, viz.: smoking, alcohol problems, body mass index (BMI; a marker of nutritional status), physical activity, and sleep and pretreatment IL-6 levels in persons with head and neck cancer.

Pretreatment dietary patterns, weight status, and head and neck squamous cell carcinoma prognosis.

Background: Few studies have evaluated the association of diet and weight status with head and neck cancer outcomes.

Objective: The purpose of this study was to determine whether pretreatment dietary patterns and weight status are associated with head and neck cancer prognosis.

Design: This was a longitudinal study of 542 patients with newly diagnosed head and neck cancer who completed food-frequency questionnaires and health surveys before treatment.

Predictors of pain among patients with head and neck cancer.

OBJECTIVE To determine predictors of pain 1 year after the diagnosis of head and neck cancer. DESIGN Prospective, multisite cohort study. SETTING Three academically affiliated medical centers.

Factors associated with health-related quality of life among operating engineers.

Background: Because health-related quality of life among blue-collar workers has not been well studied, the purpose of this study was to determine factors associated with health-related quality of life among Operating Engineers.

Methods: With cross-sectional data from a convenience sample of 498 Operating Engineers, personal and health behavioral factors associated with health-related quality of life were examined.

Results: Multivariate linear regression analysis revealed that personal factors (older age, being married, more medical comorbidities, and depression) and behavioral factors (smoking, low fruit and vegetable intake, low physical activity, high body mass index, and low sleep quality) were associated with poor health-related quality of life.

Higher micronutrient intake is associated with human papillomavirus-positive head and neck cancer: a case-only analysis.

No studies have investigated dietary differences between head and neck squamous cell carcinoma (HNSCC) patients with human papillomavirus (HPV)-positive tumors and patients with HPV-negative tumors. This study was designed to investigate the relationship between diet and HPV status in HNSCC patients. Cases of HNSCC were recruited from 2 clinical centers participating in the University of Michigan Head and Neck Specialized Program of Research Excellence (SPORE).

Predictors of poor sleep quality among head and neck cancer patients.

Objectives/hypothesis: The objective of this study was to determine the predictors of sleep quality among head and neck cancer patients 1 year after diagnosis.

Study Design: This was a prospective, multisite cohort study of head and neck cancer patients (N = 457).

Methods: Patients were surveyed at baseline and 1 year after diagnosis.

Perceived difficulty quitting predicts enrollment in a smoking-cessation program for patients with head and neck cancer.

Purpose/objectives: To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer.

Design: This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers' participation in a cessation intervention.

Setting: Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor.

Validation of the Sino-Nasal Outcome Test 20 (SNOT-20) domains in nonsurgical patients.

Background: The objectives of this study were, first, to confirm the presence of multiple domains within the Sino-Nasal Outcome Test 20 (SNOT-20) using a medically treated population, and, second, to reanalyze data from this population to reveal incremental information. A prospective, randomized controlled trial was performed.

Methods: One hundred twenty-seven adults with chronic rhinitis or rhinosinusitis symptoms were treated with nasal saline irrigation or spray.

Pretreatment health behaviors predict survival among patients with head and neck squamous cell carcinoma.

Purpose: Our prior work has shown that the health behaviors of head and neck cancer patients are interrelated and are associated with quality of life; however, other than smoking, the relationship between health behaviors and survival is unclear.

Patients And Methods: A prospective cohort study was conducted to determine the relationship between five pretreatment health behaviors (smoking, alcohol, diet, physical activity, and sleep) and all-cause survival among 504 head and neck cancer patients.

Results: Smoking status was the strongest predictor of survival, with both current smokers (hazard ratio [HR] = 2.

Probiotics as adjunctive treatment for chronic rhinosinusitis: a randomized controlled trial.

Objective: To determine if oral probiotics as adjunctive treatment are more effective than placebo in improving quality of life in patients with chronic inflammatory rhinosinusitis.

Design: Prospective, randomized, double-blind, placebo-controlled trial.

Methods: A total of 77 patients with chronic inflammatory rhinosinusitis were randomly assigned to receive oral probiotic Lactobacillus rhamnosus R0011 strain (500 million active cells/tablet twice daily) (n = 39) or oral placebo treatment (n = 38) for 4 weeks.

The effect of neck dissection on quality of life after chemoradiation.

Objective: To determine differences in quality of life (QOL) between patients with head and neck cancer who receive chemoradiation versus chemoradiation and neck dissection.

Methods: A prospective cohort study was conducted at two tertiary otolaryngology clinics and a Veterans Administration hospital.

Sample: 103 oropharyngeal patients with Stage IV squamous cell carcinoma treated via chemoradiation +/- neck dissection.

Interleukin-6 predicts recurrence and survival among head and neck cancer patients.

Background: Increased pretreatment serum interleukin (IL)-6 levels among patients with head and neck squamous cell carcinoma (HNSCC) have been shown to correlate with poor prognosis, but sample sizes in prior studies have been small and thus unable to control for other known prognostic variables.

Methods: A longitudinal, prospective cohort study determined the correlation between pretreatment serum IL-6 levels, and tumor recurrence and all-cause survival in a large population (N = 444) of previously untreated HNSCC patients. Control variables included age, sex, smoking, cancer site and stage, and comorbidities.

Quality of life scores predict survival among patients with head and neck cancer.

Purpose: The purpose of this study was to examine whether quality of life (QOL) scores predict survival among patients with head and neck cancer, controlling for demographic, health behavior, and clinical variables.

Patients And Methods: A self-administered questionnaire was given to 495 patients being treated for head and neck cancer while they were waiting to be seen for a clinic appointment. Data collected from the survey included demographics, health behaviors, and QOL as measured by Short Form-36 (SF-36) physical and mental component scores and the Head and Neck QOL scores.

Changes in quality of life over 1 year in patients with head and neck cancer.

Objectives: To characterize and compare quality of life (QOL) in patients with head and neck cancer shortly before initial treatment and 1 year later and to study the predictors of changes in QOL over 1 year.

Design: Prospective cohort study.

Setting: Three otolaryngology clinics.

Nasal saline for chronic sinonasal symptoms: a randomized controlled trial.

Objective: To determine if isotonic sodium chloride (hereinafter "saline") nasal irrigations performed with large volume and delivered with low positive pressure are more effective than saline sprays at improving quality of life and decreasing medication use.

Design: A prospective, randomized controlled trial.

Setting: Community.

Health behaviors of head and neck cancer patients the first year after diagnosis.

Background: This prospective, cohort study is the first to describe 5 health behaviors of head and neck cancer patients the first year after diagnosis.

Methods: Patients (N = 283) were recruited in otolaryngology clinic waiting rooms and asked to complete written surveys. A medical record audit was also conducted.

Clinical predictors of chronic rhinosinusitis.

Background: Chronic rhinosinusitis (CRS) is diagnosed by the presence of signs and symptoms of CRS in conjunction with physical evidence of mucosal inflammation. We sought to identify symptoms that predict CRS.

Methods: We performed a retrospective review of patients referred to a tertiary care rhinology clinic for evaluation of CRS.