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Kristine Ann Schulz

Adjunct Associate Professor in the Department of Head and Neck Surgery & Communication Sciences
Head and Neck Surgery & Communication Sciences
1526 Hosp South, Box 3805, Durham, NC 27710

Selected Publications


A Pragmatic Clinical Trial of Hearing Screening in Primary Care Clinics: Effect of Setting and Provider Encouragement.

Journal Article Ear Hear · January 2024 OBJECTIVES: The prevalence of hearing loss increases with age. Untreated hearing loss is associated with poorer communication abilities and negative health consequences, such as increased risk of dementia, increased odds of falling, and depression. Nonethe ... Full text Link to item Cite

A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening.

Journal Article Cost Eff Resour Alloc · June 25, 2022 BACKGROUND: Hearing loss is a high prevalence condition among older adults, is associated with higher-than-average risk for poor health outcomes and quality of life, and is a public health concern to individuals, families, communities, professionals, gover ... Full text Link to item Cite

A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study.

Journal Article BMC Oral Health · May 17, 2021 BACKGROUND: To assess variations in adherence to guideline-recommended processes of care for oral cavity cancer patients. METHODS: Retrospective study using a U.S. healthcare research database (MarketScan). Index diagnoses were considered from 2010 to 2012 ... Full text Link to item Cite

Utilization of Invasive Procedures for Adult Eustachian Tube Dysfunction.

Journal Article Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · November 2020 ObjectiveEustachian tube dysfunction (ETD) is a common diagnosis among adults presenting for outpatient care. We sought to determine national utilization and the associated cost of invasive procedures for adult ETD.Study designCross-secti ... Full text Cite

The use of balloon dilation in revision sinus surgery.

Journal Article Int Forum Allergy Rhinol · October 2020 BACKGROUND: Recent studies have demonstrated a dramatic increase in the use of balloon sinus dilation (BSD) in the United States. However, the use of BSD specifically in revision sinus surgery has not been investigated. This study addresses the question of ... Full text Link to item Cite

Comparative implementation-effectiveness of three strategies to perform hearing screening among older adults in primary care clinics: study design and protocol.

Journal Article BMC Geriatr · May 11, 2020 BACKGROUND: The burden of hearing loss among older adults could be mitigated with appropriate care. This study compares implementation of three hearing screening strategies in primary care, and examines the reliability and validity of patient self-assessme ... Full text Link to item Cite

The effect of lateral neck dissection on complication rate for total thyroidectomy.

Journal Article Am J Otolaryngol · 2020 PURPOSE: To determine the complication profile for total thyroidectomy with and without concomitant lateral neck dissection using a large administrative database. MATERIALS AND METHODS: The IBM MarketScan® Commercial Database (2010-2014) analytic cohort wa ... Full text Link to item Cite

Health Care Utilization and Prescribing Patterns for Adult Eustachian Tube Dysfunction.

Journal Article Otolaryngol Head Neck Surg · June 2019 OBJECTIVE: Eustachian tube dysfunction (ETD) prompts >2 million adult visits in the United States annually. While disease prevalence and health care utilization are established for children, practice patterns for adults remain unknown. Our objective was to ... Full text Link to item Cite

A pathway to value-based care of chronic rhinosinusitis using a claims database.

Journal Article Laryngoscope Investig Otolaryngol · February 2019 OBJECTIVE: To construct a comprehensive picture of the typical chronic rhinosinusitis (CRS) patient in the United States including the demographics, comorbidities, and geographic prevalence. The study will also identify the diagnostic and treatment regimen ... Full text Link to item Cite

Balloon Catheter Dilation of the Sinuses: A 2011-2014 MarketScan Analysis.

Journal Article Otolaryngol Head Neck Surg · December 2018 OBJECTIVE: This study uses a large national claims-based database to analyze recent practice patterns related to balloon catheter dilation (BCD) of the sinuses. STUDY DESIGN: Retrospective study. SETTING: Academic. SUBJECTS AND METHODS: Patients with chron ... Full text Link to item Cite

Steroid Use for Sudden Sensorineural Hearing Loss: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · November 2018 OBJECTIVE: The objective of this study was to describe patterns of corticosteroid treatment for sudden sensorineural hearing loss and to evaluate effectiveness based on delivery mode (oral vs intratympanic vs both). STUDY DESIGN: Cross-sectional repeated m ... Full text Link to item Cite

Idiopathic Sudden Sensorineural Hearing Loss Is Not a Sentinel Event for Acute Myocardial Infarction.

Journal Article Otol Neurotol · August 2018 OBJECTIVE: Given ongoing debate about the suggested association, the primary objective was to determine if idiopathic sudden sensorineural hearing loss (ISSNHL) was a sentinel event for acute myocardial infarction (AMI) in adults. STUDY DESIGN: Case-contro ... Full text Link to item Cite

Patterns of Migraine Disease in Otolaryngology: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · July 2018 Objective To evaluate the prevalence of migraine disease in an otolaryngologic cohort and migraine-related otologic and sinonasal symptoms in this population. Study Design Cross-sectional study utilizing the CHEER (Creating Healthcare Excellence through Ed ... Full text Link to item Cite

Validations of the OM-6 Parent-Proxy Survey for Infants/Toddlers with Otitis Media.

Journal Article Otolaryngol Head Neck Surg · May 2018 Objective To validate the Otitis Media-6 (OM-6), a parent-proxy quality-of-life (QOL) questionnaire for infants/young children with OM, against other previously validated generic QOL questionnaires. Study Design Multi-institutional cross-sectional study. S ... Full text Link to item Cite

Payer database and geospatial analysis to evaluate practice patterns in treating allergy in North Carolina.

Journal Article Am J Otolaryngol · 2018 OBJECTIVE: The objective of this study was to characterize the delivery of allergy care in North Carolina using a large payer charge database and visualization techniques. STUDY DESIGN: Geospatial database analysis. SETTING: North Carolina State claims dat ... Full text Link to item Cite

CHEER National Study of Chronic Rhinosinusitis Practice Patterns: Disease Comorbidities and Factors Associated with Surgery.

Journal Article Otolaryngol Head Neck Surg · April 2017 Objectives (1) Describe national patterns of chronic rhinosinusitis (CRS) care across academic and community practices. (2) Determine the prevalence of comorbid disorders in CRS patients, including nasal polyposis, allergic rhinitis, asthma, and cystic fib ... Full text Link to item Cite

Nonadherence to Guideline Recommendations for Tympanostomy Tube Insertion in Children Based on Mega-database Claims Analysis.

Journal Article Otolaryngol Head Neck Surg · January 2017 Objective To estimate the nonadherence rate of pressure equalization (tympanostomy) tube (PET) placement in the preceding 3-year period before release of the 2013 American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guideli ... Full text Link to item Cite

Burden of Hearing Loss on Communication Partners and Its Influence on Pursuit of Hearing Evaluation.

Journal Article Ear Hear · 2017 OBJECTIVE: Describe how the burden on the communication partner (CP) from the patient's hearing loss, as perceived by both the patient and their CP, influences a patient's pursuit of hearing evaluation. DESIGN: Cross-sectional design. Demographics, percept ... Full text Link to item Cite

Access to Health Care and Hearing Evaluation in US Adults.

Journal Article Ann Otol Rhinol Laryngol · September 2016 OBJECTIVES: To explore self-reported hearing testing access for adults in a nationally representative survey. METHODS: Demographic and audiologic adult survey respondent variables in the National Health and Nutrition Examination Survey (NHANES) database 20 ... Full text Link to item Cite

A Pragmatic Clinical Trial of Hearing Screening in Primary Care Clinics: Effect of Setting and Provider Encouragement.

Journal Article Ear Hear · January 2024 OBJECTIVES: The prevalence of hearing loss increases with age. Untreated hearing loss is associated with poorer communication abilities and negative health consequences, such as increased risk of dementia, increased odds of falling, and depression. Nonethe ... Full text Link to item Cite

A pragmatic clinical trial of hearing screening in primary care clinics: cost-effectiveness of hearing screening.

Journal Article Cost Eff Resour Alloc · June 25, 2022 BACKGROUND: Hearing loss is a high prevalence condition among older adults, is associated with higher-than-average risk for poor health outcomes and quality of life, and is a public health concern to individuals, families, communities, professionals, gover ... Full text Link to item Cite

A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study.

Journal Article BMC Oral Health · May 17, 2021 BACKGROUND: To assess variations in adherence to guideline-recommended processes of care for oral cavity cancer patients. METHODS: Retrospective study using a U.S. healthcare research database (MarketScan). Index diagnoses were considered from 2010 to 2012 ... Full text Link to item Cite

Utilization of Invasive Procedures for Adult Eustachian Tube Dysfunction.

Journal Article Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · November 2020 ObjectiveEustachian tube dysfunction (ETD) is a common diagnosis among adults presenting for outpatient care. We sought to determine national utilization and the associated cost of invasive procedures for adult ETD.Study designCross-secti ... Full text Cite

The use of balloon dilation in revision sinus surgery.

Journal Article Int Forum Allergy Rhinol · October 2020 BACKGROUND: Recent studies have demonstrated a dramatic increase in the use of balloon sinus dilation (BSD) in the United States. However, the use of BSD specifically in revision sinus surgery has not been investigated. This study addresses the question of ... Full text Link to item Cite

Comparative implementation-effectiveness of three strategies to perform hearing screening among older adults in primary care clinics: study design and protocol.

Journal Article BMC Geriatr · May 11, 2020 BACKGROUND: The burden of hearing loss among older adults could be mitigated with appropriate care. This study compares implementation of three hearing screening strategies in primary care, and examines the reliability and validity of patient self-assessme ... Full text Link to item Cite

The effect of lateral neck dissection on complication rate for total thyroidectomy.

Journal Article Am J Otolaryngol · 2020 PURPOSE: To determine the complication profile for total thyroidectomy with and without concomitant lateral neck dissection using a large administrative database. MATERIALS AND METHODS: The IBM MarketScan® Commercial Database (2010-2014) analytic cohort wa ... Full text Link to item Cite

Health Care Utilization and Prescribing Patterns for Adult Eustachian Tube Dysfunction.

Journal Article Otolaryngol Head Neck Surg · June 2019 OBJECTIVE: Eustachian tube dysfunction (ETD) prompts >2 million adult visits in the United States annually. While disease prevalence and health care utilization are established for children, practice patterns for adults remain unknown. Our objective was to ... Full text Link to item Cite

A pathway to value-based care of chronic rhinosinusitis using a claims database.

Journal Article Laryngoscope Investig Otolaryngol · February 2019 OBJECTIVE: To construct a comprehensive picture of the typical chronic rhinosinusitis (CRS) patient in the United States including the demographics, comorbidities, and geographic prevalence. The study will also identify the diagnostic and treatment regimen ... Full text Link to item Cite

Balloon Catheter Dilation of the Sinuses: A 2011-2014 MarketScan Analysis.

Journal Article Otolaryngol Head Neck Surg · December 2018 OBJECTIVE: This study uses a large national claims-based database to analyze recent practice patterns related to balloon catheter dilation (BCD) of the sinuses. STUDY DESIGN: Retrospective study. SETTING: Academic. SUBJECTS AND METHODS: Patients with chron ... Full text Link to item Cite

Steroid Use for Sudden Sensorineural Hearing Loss: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · November 2018 OBJECTIVE: The objective of this study was to describe patterns of corticosteroid treatment for sudden sensorineural hearing loss and to evaluate effectiveness based on delivery mode (oral vs intratympanic vs both). STUDY DESIGN: Cross-sectional repeated m ... Full text Link to item Cite

Idiopathic Sudden Sensorineural Hearing Loss Is Not a Sentinel Event for Acute Myocardial Infarction.

Journal Article Otol Neurotol · August 2018 OBJECTIVE: Given ongoing debate about the suggested association, the primary objective was to determine if idiopathic sudden sensorineural hearing loss (ISSNHL) was a sentinel event for acute myocardial infarction (AMI) in adults. STUDY DESIGN: Case-contro ... Full text Link to item Cite

Patterns of Migraine Disease in Otolaryngology: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · July 2018 Objective To evaluate the prevalence of migraine disease in an otolaryngologic cohort and migraine-related otologic and sinonasal symptoms in this population. Study Design Cross-sectional study utilizing the CHEER (Creating Healthcare Excellence through Ed ... Full text Link to item Cite

Validations of the OM-6 Parent-Proxy Survey for Infants/Toddlers with Otitis Media.

Journal Article Otolaryngol Head Neck Surg · May 2018 Objective To validate the Otitis Media-6 (OM-6), a parent-proxy quality-of-life (QOL) questionnaire for infants/young children with OM, against other previously validated generic QOL questionnaires. Study Design Multi-institutional cross-sectional study. S ... Full text Link to item Cite

Payer database and geospatial analysis to evaluate practice patterns in treating allergy in North Carolina.

Journal Article Am J Otolaryngol · 2018 OBJECTIVE: The objective of this study was to characterize the delivery of allergy care in North Carolina using a large payer charge database and visualization techniques. STUDY DESIGN: Geospatial database analysis. SETTING: North Carolina State claims dat ... Full text Link to item Cite

CHEER National Study of Chronic Rhinosinusitis Practice Patterns: Disease Comorbidities and Factors Associated with Surgery.

Journal Article Otolaryngol Head Neck Surg · April 2017 Objectives (1) Describe national patterns of chronic rhinosinusitis (CRS) care across academic and community practices. (2) Determine the prevalence of comorbid disorders in CRS patients, including nasal polyposis, allergic rhinitis, asthma, and cystic fib ... Full text Link to item Cite

Nonadherence to Guideline Recommendations for Tympanostomy Tube Insertion in Children Based on Mega-database Claims Analysis.

Journal Article Otolaryngol Head Neck Surg · January 2017 Objective To estimate the nonadherence rate of pressure equalization (tympanostomy) tube (PET) placement in the preceding 3-year period before release of the 2013 American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guideli ... Full text Link to item Cite

Burden of Hearing Loss on Communication Partners and Its Influence on Pursuit of Hearing Evaluation.

Journal Article Ear Hear · 2017 OBJECTIVE: Describe how the burden on the communication partner (CP) from the patient's hearing loss, as perceived by both the patient and their CP, influences a patient's pursuit of hearing evaluation. DESIGN: Cross-sectional design. Demographics, percept ... Full text Link to item Cite

Access to Health Care and Hearing Evaluation in US Adults.

Journal Article Ann Otol Rhinol Laryngol · September 2016 OBJECTIVES: To explore self-reported hearing testing access for adults in a nationally representative survey. METHODS: Demographic and audiologic adult survey respondent variables in the National Health and Nutrition Examination Survey (NHANES) database 20 ... Full text Link to item Cite

National Utilization and Forecasting of Ototopical Antibiotics: Medicaid Data Versus "Dr. Google".

Journal Article Otol Neurotol · September 2016 OBJECTIVES: To forecast national Medicaid prescription volumes for common ototopical antibiotics, and correlate prescription volumes with internet user search interest using Google Trends (GT). STUDY DESIGN: National United States Medicaid prescription and ... Full text Link to item Cite

Factors influencing pursuit of hearing evaluation: Enhancing the health belief model with perceived burden from hearing loss on communication partners.

Journal Article Int J Audiol · July 2016 OBJECTIVE: There is limited application of health behavior-based theoretical models in hearing healthcare, yet other fields utilizing these models have shown their value in affecting behavior change. The health belief model (HBM) has demonstrated appropria ... Full text Link to item Cite

Does an Otolaryngology-Specific Database Have Added Value? A Comparative Feasibility Analysis.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVES: There are multiple nationally representative databases that support epidemiologic and outcomes research, and it is unknown whether an otolaryngology-specific resource would prove indispensable or superfluous. Therefore, our objective was to det ... Full text Link to item Cite

Tonsillectomy Bleed Rates across the CHEER Practice Research Network: Pursuing Guideline Adherence and Quality Improvement.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVES: (1) Compare postoperative bleeding in the CHEER network (Creating Healthcare Excellence through Education and Research) among age groups, diagnoses, and practice types. (2) Report the incidence of bleeding by individual CHEER practice site base ... Full text Link to item Cite

Variation in the Use of Vestibular Diagnostic Testing for Patients Presenting to Otolaryngology Clinics with Dizziness.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVE: We used a national otolaryngology practice-based research network database to characterize the utilization of vestibular function testing in patients diagnosed with dizziness and/or a vestibular disorder. STUDY DESIGN: Database review. SETTING: ... Full text Link to item Cite

Thyroid Disease and Surgery in CHEER: The Nation's Otolaryngology-Head and Neck Surgery Practice-Based Network.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVES: (1) Describe thyroid-related diagnoses and procedures in Creating Healthcare Excellence through Education and Research (CHEER) across academic and community sites. (2) Compare management of malignant thyroid disease across these sites. (3) Prov ... Full text Link to item Cite

Ménière's Disease: A CHEER Database Study of Local and Regional Patient Encounter and Procedure Patterns.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVE: (1) Integrate practice-based patient encounters using the Dartmouth Atlas Medicare database to understand practice treatments for Ménière's disease (MD). (2) Describe differences in the practice patterns between academic and community providers ... Full text Link to item Cite

Evaluation of Compliance for Treatment of Sudden Hearing Loss: A CHEER Network Study.

Journal Article Otolaryngol Head Neck Surg · July 2016 OBJECTIVE: The objective of this study is to describe the presentation and management of sudden sensorineural hearing loss for patients seen in academic and community-based practices within the context of the American Academy of Otolaryngology-Head and Nec ... Full text Link to item Cite

Changes in aerodynamics during vocal cord dysfunction.

Journal Article Comput Biol Med · February 2015 BACKGROUND: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a ... Full text Link to item Cite

Provider and patient drivers of ototopical antibiotic prescription variability.

Journal Article Am J Otolaryngol · 2015 OBJECTIVE: To determine if providers prescribe more affordable topical antibacterial therapy for patients who are economically disadvantaged or come from economically disadvantaged communities. STUDY DESIGN: Prescription drug database review. SETTING: Larg ... Full text Link to item Cite

Impact of Otitis Media Severity on Children's Quality of Life.

Journal Article Otolaryngol Head Neck Surg · August 2014 OBJECTIVE: Children with otitis media (OM) suffer sleep disturbances, loss of appetite, earache, and behavioral problems. Our objective was to quantitate the average burden of OM and to compare the associated impact of tympanostomy tubes on infant health r ... Full text Link to item Cite

Caregiver Quality of Life Is Related to Severity of Otitis Media in Children.

Journal Article Otolaryngol Head Neck Surg · August 2014 OBJECTIVE: Otitis media (OM) in children is the most frequent reason for physician visits in developed countries and burdens caregivers, society, and the child. Our objective was to describe the impact of OM severity on parent/caregiver quality of life (Qo ... Full text Link to item Cite

An analysis of registered clinical trials in otolaryngology from 2007 to 2010: ClinicalTrials.gov.

Journal Article Otolaryngol Head Neck Surg · November 2013 OBJECTIVE: To describe the conditions studied, interventions used, study characteristics, and funding sources of otolaryngology clinical trials from the ClinicalTrials.gov database; compare this otolaryngology cohort of interventional studies to clinical v ... Full text Link to item Cite

Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents.

Journal Article Med Educ Online · October 29, 2013 INTRODUCTION: Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of ... Full text Link to item Cite

Physician allocation of Medicare resources for patients with advanced cancer.

Journal Article J Palliat Med · August 2013 BACKGROUND: Little is known about what patients and physicians value in end-of-life care, or how these groups would craft a health plan for those with advanced cancer. OBJECTIVE: The study objective was to assess how otolaryngology, head and neck surgery ( ... Full text Link to item Cite

Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents.

Journal Article Med Educ Online · January 2013 Introduction Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of ... Full text Link to item Cite

Consumer assessment of healthcare providers and systems surgical care survey: benefits and challenges.

Journal Article Otolaryngol Head Neck Surg · October 2012 OBJECTIVE: To describe the feasibility and initial results of the implementation of a continuous quality improvement project using the newly available Consumer Assessment of Healthcare Providers and Systems Surgical Care Survey (S-CAHPS), in a small cohort ... Full text Link to item Cite

Practice-Based Research in Your Practice.

Conference Otolaryngol Head Neck Surg · August 2012 Full text Link to item Cite

The Otology Data Collection project: report from the CHEER network.

Journal Article Otolaryngol Head Neck Surg · October 2011 OBJECTIVE: To describe and communicate data collected in the CHEER (Creating Healthcare Excellence through Education and Research) infrastructure proof-of-concept study to facilitate understanding of the potential capabilities of practice-based research ne ... Full text Link to item Cite

Implementation and testing of research infrastructure for practice-based research in hearing and communication disorders.

Journal Article Otolaryngol Head Neck Surg · October 2011 OBJECTIVE: To describe site capability and experience of the CHEER network (Creating Healthcare Excellence through Education and Research) to rapidly collect descriptive data on patients with tinnitus and dizziness visiting participating CHEER sites. STUDY ... Full text Link to item Cite

Studying Life Effects & Effectiveness of Palatopharyngoplasty (SLEEP) study: subjective outcomes of isolated uvulopalatopharyngoplasty.

Journal Article Otolaryngol Head Neck Surg · April 2011 OBJECTIVE: To test the hypothesis that uvulopalatopharyngoplasty (UPPP) improves sleep apnea-related quality of life (measured on the Functional Outcomes of Sleep Questionnaire [FOSQ]) at 3-month follow-up. Secondary objectives were to test (1) the stabili ... Full text Link to item Cite

The PedsQL™ Infant Scales: feasibility, internal consistency reliability, and validity in healthy and ill infants.

Journal Article Qual Life Res · February 2011 OBJECTIVE: The PedsQL™ (Pediatric Quality of Life Inventory™) is a modular instrument designed to measure health-related quality of life (HRQOL) and disease-specific symptoms in children and adolescents ages 2-18. The new PedsQL™ Infant Scales were designe ... Full text Link to item Cite

Transparent and accurate reporting increases reliability, utility, and impact of your research: reporting guidelines and the EQUATOR Network.

Journal Article BMC Med · April 26, 2010 Although current electronic methods of scientific publishing offer increased opportunities for publishing all research studies and describing them in sufficient detail, health research literature still suffers from many shortcomings. These shortcomings ser ... Full text Link to item Cite

Building a national research network for clinical investigations in otology and neurotology.

Journal Article Otol Neurotol · February 2010 BACKGROUND: Practice-based research networks (PBRNs) are the preferred research setting for descriptive/epidemiologic studies and studies that explore the effectiveness of treatments for disease that are managed in community settings, away from the rubric ... Full text Link to item Cite

Assessment of acute otitis externa and otitis media with effusion performance measures in otolaryngology practices.

Journal Article Otolaryngol Head Neck Surg · October 2008 OBJECTIVE: To evaluate the acute otitis externa and otitis media with effusion performance measure sets in a clinical setting and provide preliminary data on measure compliance. STUDY DESIGN AND SETTING: Quality improvement study. SUBJECTS AND METHODS: Con ... Full text Link to item Cite