Preoperative Computed Tomography Utilization in Patients Undergoing Balloon Sinus Dilation

Area of Science:

• Otolaryngology
• Medical Imaging
• Health Policy

Background:

• Computed tomography (CT) imaging is a standard prerequisite for sinus surgery, including balloon sinus dilation (BSD).
• Adherence to practice guidelines ensures optimal patient care and surgical outcomes.
• Variations in adherence can impact the quality of care and necessitate further investigation.

Purpose of the Study:

• To evaluate the adherence of otolaryngologists to practice guidelines regarding the use of CT imaging prior to balloon sinus dilation (BSD) procedures.
• To identify the prevalence of non-adherence and explore potential factors associated with it.

Main Methods:

• A cross-sectional study utilizing Medicare claims data from January 1, 2022, to December 31, 2023.
• Identified otolaryngologists performing at least 11 BSD procedures annually.
• Analyzed the availability of preprocedure CT imaging within one year of BSD and identified outlier physicians.

Main Results:

• The study analyzed 19,692 BSD procedures performed by 490 otolaryngologists.
• Preprocedure CT imaging was unavailable within one year for 15% of patients (2905/19692).
• 31.8% of otolaryngologists (156/490) were identified as outliers, with a subset accounting for a disproportionate number of cases lacking CT imaging.

Conclusions:

• Most otolaryngologists adhere to guidelines by obtaining pre-BSD CT imaging.
• A substantial minority of physicians do not consistently obtain necessary CT imaging, failing to meet standard practice guidelines.
• Improved monitoring systems are needed to ensure consistent adherence to CT imaging standards before BSD.