Abstract:
BACKGROUND:This analysis explores the increasing heterogeneity of trends in allergy management under the premise that the practice of allergy has undergone significant changes in national economics, healthcare delivery, and treatment options from 2007 to 2016. METHODS:Centers for Medicare and Medicaid Services (CMS) data were obtained for: (1) temporal trends in allergy immunotherapy injection (Current Procedural Terminology [CPT] codes 95115, 95117) and testing (CPT 95004, 95024) from 2007 to 2016; (2) geographic trends; and (3) practitioners administering immunotherapy. Although there are no sublingual immunotherapy (SLIT) CPT codes, billing for unlisted allergy/immunologic services (CPT 95199) were obtained. RESULTS:Since 2007, there were 99.5 million allergy tests and 33.5 million immunotherapy injections billed to Medicare beneficiaries. Increases in testing have outpaced rising immunotherapy administration (49.7% vs 19.6% increase). Significant regional variation in testing rates was noted, with the greatest ratio of testing to immunotherapy in the South (0.35) and smallest ratio in the Northeast (0.18). The maximum unlisted allergy services billed was 594 (of which includes SLIT), compared to annual subcutaneous immunotherapy (SCIT) totals in the millions. The majority of immunotherapy in 2016 was administered by allergists/immunologists (51.6%) followed by otolaryngologists (31.2%), trends that have remained consistent since 2012. CONCLUSION:Physicians have been more aggressive in the workup of allergy-mediated disorders in recent years. Although differences in allergen load exist, there is tremendous geographic variation in the ratio of testing to immunotherapy. While the role otolaryngologists play in immunotherapy remains stable, allergists manage the majority of patients, reinforcing the importance of interdisciplinary cooperation and outreach. SLIT does not appear to play a significant role in this population.
journal_name
Int Forum Allergy Rhinoljournal_title
International forum of allergy & rhinologyauthors
Arianpour K,Svider PF,Yuhan B,Hooda Z,Eloy JA,Folbe AJdoi
10.1002/alr.22111subject
Has Abstractpub_date
2018-05-21 00:00:00eissn
2042-6976issn
2042-6984pub_type
杂志文章abstract:BACKGROUND:Treatment options for chronic rhinosinusitis with recurrent polyposis (CRSwNP) after endoscopic sinus surgery (ESS) are limited, and include frequent use of systemic steroids and revision surgery. A bioabsorbable, steroid-eluting implant was studied for its ability to dilate sinuses obstructed by polyps and ...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,多中心研究
doi:10.1002/alr.21309
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Debate still persists on the relation between olfactory bulb volume (OBV) and olfactory function. Many studies suggest that olfactory deprivation decreases the OBV. The aim of this study was to compare the olfactory threshold and OBV of patients with nasal polyps to healthy individuals and to evaluate the im...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21478
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Early postoperative care following endoscopic sinus surgery (ESS) has been suggested to minimize avoidable complications and optimize long-term outcomes. Several postoperative care strategies have been proposed but a formal comprehensive evaluation of the evidence has never been performed. The purpose of thi...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,评审
doi:10.1002/alr.20072
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:After endoscopic sinus surgery (ESS), endoscopy is used to gauge surgical success and clinical outcomes. Prior studies have not examined this topic prospectively using validated outcome metrics across multiple institutions. METHODS:A multi-institutional, prospective study of patients with chronic rhinosinus...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,多中心研究
doi:10.1002/alr.21651
更新日期:2016-02-01 00:00:00
abstract:BACKGROUND:Chronic sphenoid rhinosinusitis (CSR) refractory to both medical management and 1 or more sphenoidotomies is a difficult entity to treat. In contrast to the surgical hierarchy that exists for the frontal sinus, there is no systematic approach for addressing persistent disease in the sphenoid. Sphenoid marsup...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.20006
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Despite considerable research, the pathogenesis of chronic rhinosinusitis (CRS) remains poorly understood. Potential microbial roles in the etiology or progression of CRS have long been hypothesized, yet few specific associations have been identified. In this study we investigate associations between pattern...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21871
更新日期:2017-03-01 00:00:00
abstract:BACKGROUND:Nasal polyposis is characterized by persistent inflammation and remodeling in sinonasal mucosa. Toll-like receptor 9 (TLR9) is a DNA receptor of the innate immune system that plays a pivotal role in fibrosis and inflammatory responses. The aim of this study is to explore the expression, activity, and potenti...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22155
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:The objective of this case series was to report what is to the best of our knowledge the first reports of nasopharyngeal and soft palate pseudomeningoceles tracking submucosally from the sphenoid sinus. METHODS:Analysis of cases through medical records. RESULTS:Two cases of middle-aged male patients presen...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21242
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:Sufficient clinical data are not available on the effect of hypothyroidism on olfactory function in adults. In this study, we aimed to evaluate the olfactory function of adult patients diagnosed with primary hypothyroidism. METHODS:Forty-five patients aged between 18 and 60 years who were diagnosed with cli...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21565
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Current clinical classifications of chronic rhinosinusitis (CRS) have been largely defined based upon preconceived notions of factors thought to be important, such as polyp or eosinophil status. Unfortunately, these classification systems have little correlation with symptom severity or treatment outcomes. U...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,多中心研究
doi:10.1002/alr.21496
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Patients with eosinophilic chronic rhinosinusitis (ECRS) have been shown to have greater disease severity and poorer treatment outcomes after sinus surgery. Although the inflammatory pattern of ECRS is essential to diagnosing this subtype, there is currently no consensus for diagnosis. Our aim in this study ...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,meta分析
doi:10.1002/alr.22194
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:The objective of this work was to evaluate prevalence of eosinophilic esophagitis (EoE) in the United States, and analyze prevalence of atopic disease in patients with EoE. The study design was a retrospective administrative database analysis in U.S.-based outpatient settings. METHODS:A retrospective claims...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21968
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Spacers are inserted into the middle meatal space (MMS) following functional endoscopic sinus surgery (FESS) to prevent lateralization of the middle turbinate, scarring, and synechiae. Our objective was to determine if the incidence of postoperative synechiae, facial pain/discomfort, pain during spacer remov...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22119
更新日期:2018-03-30 00:00:00
abstract:BACKGROUND:Olfactory-specific quality of life (QOL) can be measured using the Questionnaire of Olfactory Disorders-Negative Statements (QOD-NS), which examines various aspects of olfactory dysfunction. It is unknown if certain factors of the QOD-NS differentially impact QOL. METHODS:Patients with chronic rhinosinusiti...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22112
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Previous studies have shown controversial results of topical amphotericin B (AMB) nasal irrigation for chronic rhinosinusitis (CRS). The purpose of this study was to evaluate the efficacy of 200 μg/mL AMB nasal irrigation as an adjuvant therapy after functional endoscopic sinus surgery (FESS). METHODS:Patie...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,随机对照试验
doi:10.1002/alr.22033
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:A genetic basis to chronic rhinosinusitis (CRS) is postulated, but remains elusive. We have recently identified low levels of circulating CD8 lymphocytes as a frequent finding in difficult-to-treat or refractory CRS. In major histocompatibility complex 1 class 1 (MHC1) deficiency, low circulating levels of C...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21174
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the ch...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22106
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:Chronic rhinosinusitis (CRS) in aspirin-exacerbated respiratory disease (AERD) represents a recalcitrant form of sinonasal inflammation for which a multidisciplinary consensus on patient management has not been reached. Several medical interventions have been investigated, but a formal comprehensive evaluati...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,评审
doi:10.1002/alr.21826
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:As part of this primer, this article is intended to introduce new and emerging therapies for treating asthma. METHODS:A PubMed search was performed for the years 2013 through 2015 for asthma review, asthma treatment, asthma therapy, and asthma new. Subset searches were additionally performed as suggested by...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,评审
doi:10.1002/alr.21611
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:We recently demonstrated the bitter taste receptor T2R38 upregulates sinonasal mucosal innate defense in response to gram-negative quorum-sensing molecules through increased nitric oxide production and mucociliary clearance. T2R38 was initially identified in the quest to understand the variability in bitter ...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21140
更新日期:2013-03-01 00:00:00
abstract:BACKGROUND:Patients with chronic rhinosinusitis (CRS) exhibit centrally mediated behavioral changes commonly referred to as "sickness behavior." Sleep alteration is a component of sickness behavior which is estimated to affect up to 70 million patients annually. Patients with CRS have poor sleep quality, and little is ...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,评审
doi:10.1002/alr.21217
更新日期:2013-11-01 00:00:00
abstract:BACKGROUND:The ciprofloxacin-coated sinus stent (CSS) has unique therapeutic potential to deliver antibiotics to the sinuses. The objective of this study is to evaluate the efficacy of the CSS stent in eliminating Pseudomonas aeruginosa infection in a rabbit model of sinusitis. METHODS:A ciprofloxacin-eluting sinus st...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22081
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Interleukin 13 (IL-13) is a pleiotropic cytokine that has been shown to be important in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP) and other type 2 inflammation-related diseases. Increased IL-13 expression can elicit several pro-inflammatory effects, including eosinophilia, and pat...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22630
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:The available allergic rhinitis (AR) literature continues to grow. Critical evaluation and understanding of this literature is important to appropriately utilize this knowledge in the care of AR patients. The International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR) has been pro...
journal_title:International forum of allergy & rhinology
pub_type: 共识发展会议,杂志文章
doi:10.1002/alr.22070
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:The treatment of the middle turbinate (MT) during endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) remains a contentious issue with arguments both for and against its resection. The purpose of this study was to examine the clinical impact of partial MT resection (PMTR) during ESS, paying parti...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22127
更新日期:2018-04-06 00:00:00
abstract:BACKGROUND:Allergy-related illness impacts millions of individuals worldwide. Our objectives were to characterize current trends of clinical trials research relating to allergen immunotherapy and to describe the landscape of allergen immunotherapy in National Institutes of Health (NIH)-supported research inquiry. METH...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22016
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Previous studies have consistently shown that females with chronic rhinosinusitis (CRS) have a greater CRS symptom burden than males with CRS. Our objective was to determine whether differential disease perception could explain this phenomenon. METHODS:A total of 500 participants (239 males, 261 females) wi...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.22390
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:Topical intranasal corticosteroid sprays (INCSs) are standard treatment for nasal polyps (NPs), but their efficacy is reduced by poor patient compliance and impaired access of drug to the sinus mucosa. A corticosteroid-eluting sinus implant was designed to address these limitations in patients with recurrent...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章,随机对照试验
doi:10.1002/alr.22084
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:The histological features of osteitis in chronic rhinosinusitis (CRS) in animal studies induced by bacterial inoculation into maxillary sinuses revealed inflammatory involvement of the underlying bone matrix and/or the Haversian system; however, human studies do not mention these findings. The objective of t...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21291
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:Olfaction is one of the important senses for humans. Systemic glucocorticoids are the most commonly used medications for olfactory loss because of their strong anti-inflammatory effects. However, their effect on olfactory function is still controversial and the precise mechanism is not clear. To gain a globa...
journal_title:International forum of allergy & rhinology
pub_type: 杂志文章
doi:10.1002/alr.21586
更新日期:2015-10-01 00:00:00