Soly Baredes

Cortical Representation of Swallowing in Normal Adults: Functional Implications

Objective: Dysphagia of neurogenic or postsurgical origin presents management and therapeutic challenges to the otolaryngologist. Improvements in management and therapeutic approaches may be facilitated by understanding how the central nervous system controls swallowing. The purpose of this investigation was to utilize functional magnetic resonance imaging to determine patterns of cortical activity during swallowing in normal, healthy adult subjects.

The use of the h-index in academic otolaryngology†

The h‐index is an objective and easily calculable measure that can be used to evaluate both the relevance and amount of scientific contributions of an individual author. Our objective was to examine how the h‐index of academic otolaryngologists relates with academic rank.

Gender Disparities in Scholarly Productivity within Academic Otolaryngology Departments

Objective To examine whether there are gender disparities in scholarly productivity within academic otolaryngology departments, as measured by academic rank and the h-index, a published, objective measure of research contributions that quantifies the number and significance of papers published by a given author. Study Design and Setting Analysis of bibliometric data of academic otolaryngologists. Methods Faculty listings from academic otolaryngology departments were used to determine academic rank and gender. The Scopus database was used to determine h-index and publication range (in years) of these faculty members. In addition, 20 randomly chosen institutions were used to compare academic otolaryngologists to faculty members in other surgical specialties. Results Mean h-indices increased through the rank of professor. Among academic otolaryngologists, men had significantly higher h-indices than women, a finding also noted on examination of faculty members from other specialties. Men had higher research productivity rates at earlier points in their career than women did. The productivity rates of women increased and equaled or surpassed those of men later in their careers. Men had higher absolute h-index values at junior academic ranks. Women academic otolaryngologists of senior rank had higher absolute h-indices than their male counterparts. Conclusions The h-index measures research significance in an objective manner and indicates that although men have higher overall research productivity in academic otolaryngology, women demonstrate a different productivity curve. Women produce less research output earlier in their careers than men do, but at senior levels, they equal or exceed the research productivity of men.

Readability Assessment of Patient Education Materials from the American Academy of Otolaryngology—Head and Neck Surgery Foundation

Objective Americans are increasingly turning to the Internet as a source of health care information. These online resources should be written at a level readily understood by the average American. This study evaluates the readability of online patient education information available from the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNSF) professional Web site using 7 different assessment tools that analyze the materials for reading ease and grade level of its target audience. Study Design and Setting Analysis of Internet-based patient education material from the AAO-HNSF Web site. Methods Online patient education material from the AAO-HNSF was downloaded in January 2012 and assessed for level of readability using the Flesch Reading Ease, Flesch-Kincaid Grade Level, SMOG grading, Coleman-Liau Index, Gunning-Fog Index, Raygor Readability Estimate graph, and Fry Readability graph. The text from each subsection was pasted as plain text into Microsoft Word document, and each subsection was subjected to readability analysis using the software package Readability Studio Professional Edition Version 2012.1. Results All health care education material assessed is written between an 11th grade and graduate reading level and is considered “difficult to read” by the assessment scales. Conclusions Online patient education materials on the AAO-HNSF Web site are written above the recommended 6th grade level and may need to be revised to make them more easily understood by a broader audience.

Is NIH funding predictive of greater research productivity and impact among academic otolaryngologists

The h‐index is an accurate and reliable indicator of scholarly productivity that takes into account relevance, significance, and influence of research contributions. As such, it is an effective, objective bibliometric that can be used to evaluate academic otolaryngologists for decisions regarding appointment and advancement. In this study, we evaluate the impact of NIH funding on scholarly productivity in otolaryngology.

Readability assessment of patient education materials on major otolaryngology association websites.

Objective Various otolaryngology associations provide Internet-based patient education material (IPEM) to the general public. However, this information may be written above the fourth- to sixth-grade reading level recommended by the American Medical Association (AMA) and National Institutes of Health (NIH). The purpose of this study was to assess the readability of otolaryngology-related IPEMs on various otolaryngology association websites and to determine whether they are above the recommended reading level for patient education materials. Study Design and Setting Analysis of patient education materials from 9 major otolaryngology association websites. Methods The readability of 262 otolaryngology-related IPEMs was assessed with 8 numerical and 2 graphical readability tools. Averages were evaluated against national recommendations and between each source using analysis of variance (ANOVA) with post hoc Tukey’s honestly significant difference (HSD) analysis. Mean readability scores for each otolaryngology association website were compared. Results Mean website readability scores using Flesch Reading Ease test, Flesch-Kincaid Grade Level, Coleman-Liau Index, SMOG grading, Gunning Fog Index, New Dale-Chall Readability Formula, FORCAST Formula, New Fog Count Test, Raygor Readability Estimate, and the Fry Readability Graph ranged from 20.0 to 57.8, 9.7 to 17.1, 10.7 to 15.9, 11.6 to 18.2, 10.9 to 15.0, 8.6 to 16.0, 10.4 to 12.1, 8.5 to 11.8, 10.5 to 17.0, and 10.0 to 17.0, respectively. ANOVA results indicate a significant difference (P < .05) between the websites for each individual assessment. Conclusion The IPEMs found on all otolaryngology association websites exceed the recommended fourth- to sixth-grade reading level.

Analysis of the readability of patient education materials from surgical subspecialties

Patients are increasingly using the Internet as a source of information on medical conditions. Because the average American adult reads at a 7th‐ to 8th‐grade level, the National Institutes of Health recommend that patient education material be written between a 4th‐ and 6th‐grade level. In this study, we assess and compare the readability of patient education materials on major surgical subspecialty Web sites relative to otolaryngology.

Comparison of scholarly impact among surgical specialties: An examination of 2429 academic surgeons

The h‐index, a bibliometric indicator that objectively characterizes the impact of an authors scholarship, is an effective tool that may be considered by academic departments for decisions related to hiring and faculty advancement. Our objective was to characterize the scholarly productivity of academic surgeons from different specialties relative to otolaryngologists.

Readability assessment of online patient education materials from academic otolaryngology–head and neck surgery departments☆☆☆

PURPOSE The aim of this study was to compare the readability of online patient education materials among academic otolaryngology departments in the mid-Atlantic region, with the purpose of determining whether these commonly used online resources were written at a level readily understood by the average American. METHODS A readability analysis of online patient education materials was performed using several commonly used readability assessments including the Flesch Reading Ease Score, the Flesch-Kincaid Grade Level, Simple Measure of Gobbledygook, Gunning Frequency of Gobbledygook, the New Dale-Chall Test, the Coleman-Liau Index, the New Fog Count, the Raygor Readability Estimate, the FORCAST test, and the Fry Graph. RESULTS Most patient education materials from these programs were written at or above an 11th grade reading level, considerably above National Institutes of Health guidelines for recommended difficulty. CONCLUSIONS Patient educational materials from academic otolaryngology Web sites are written at too difficult a reading level for a significant portion of patients and can be simplified.

Otologic and audiologic evaluation of human immunodeficiency virus-infected patients

PURPOSE To quantify the incidence of ear disease in patients infected with human immunodeficiency virus (HIV). MATERIALS AND METHODS This is a descriptive case series of HIV-positive patients, with data collected using an otologic questionnaire. otologic examination, audiologic evaluation, and chart review. The study was performed at an urban University Hospitals outpatient Infectious Disease and Otolaryngology clinics. A consecutive sample of 50 HIV-infected patients volunteered for this study. Ten subjects refused. Almost all patients received public assistance for medical care. Descriptive results were tabulated. Audiometric data were analyzed for ear, Centers for Disease Control (CDC) group, otologic complaint, and age effects. Data were compared with established norms. RESULTS Twenty-three men and 27 women with a mean age of 40 years and mean duration of HIV disease of 3.5 years were studied. Eighteen percent of patients were in category CDC-A, 38% in CDC-B, and 44% in CDC-C. Otologic complaints were more prevalent than expected: 34% of patients reported aural fullness, 32% dizziness, 29% hearing loss, 26% tinnitus, 23% otalgia, and 5% otorrhea. Results of the neuro-otologic examination were abnormal in 33%. Tympanometric examination was abnormal in 21%. A significant degree of high-frequency sensorineural hearing loss was observed. CDC-B and CDC-C patients had worse hearing than CDC-A patients at 3 frequencies. Patients who complained of hearing loss had significantly worse otoacoustic emission results and hearing results than patients who did not, at all frequencies except 1,000 Hz. Patients in their 30s had better hearing in the speech frequencies than did all other patients. CONCLUSIONS Ear disease affects up to 33% of HIV-infected patients. Otitis media is a frequent finding. Sensorineural hearing loss is more severe in patients with more severe HIV infection. Patients with ear complaints have demonstrable otopathology. Continuation of this preliminary descriptive work is necessary.