HEAD 2007 Committee HEAD Highlights Deck O ne of the key functions of the Academy is the organization and management of committees. Committees covering many areas contribute to the growth of the specialty, from the creation of educational materials for AcademyUTM and patient information leaflets, to the development of policy statements. The November 2007 issue of the Bulletin listed the rosters for 66 committees, along with the new steering committee structure. On the following pages are brief summaries of actions taken by many of the committees over the past year. The committee application process is now open. As you read these reports, if you see a project or initiative where you feel you can contribute your expertise, consider applying to sit on that committee. To apply, visit www.entnet.org/ keyword/committee. The deadline to apply is February 1, 2008. 28 AAO-HNS Bulletin ||||||||||||||| december 2007 Allergy and Immunology Chair: Richard C. Haydon, MD The committee updated the clinical indicators on allergy testing for allergic rhinitis, re-endorsed the AAO-HNS policy statements for Remote Practice of Allergy, and provided the General Otolaryngology Education Committee with proposed language for the inclusion of allergy in the 2008 update for the Primary Care Otolaryngology book. BOG Big On Goals Committee Chair: Jay S. Youngerman, MD The committee enlarged their charge to include fundraising efforts attached to specific projects. Bob Olson, AAOHNS Development Director, presented current fundraising efforts, including Legacy Circle, Millennium Society, the Adams Center campaign, and Physicians Network. BOG Chair, Pablo Stolovitzky, MD, noted that direct volunteerism would be the major goal this year. The newely formed Spanish- and Portuguese-speaking Advisory Group (SPAG) BOG Legislative Representatives Committee Chair: Rick G. Love, MD During the 2007 legislative session, the committee has been active in supporting AAO-HNS efforts to advocate for bills related to the specialty. At the September 2007 meeting, Charles Della Santina, MD, and Gavin Setzen, MD, past president of the Maryland Society of Otolaryngology—Head and Neck Surgery, and president of the New York State Society of Otolaryngology, respectively, spoke about their societies’ successful efforts to defeat inappropriate scope-of-practice bills. Committee members also heard updates on other state and federal legislation, the ENT PAC, and the Academy’s advocacy networks. BOG Rules and Regulations Committee Chair: Jacquelyn A. Going, MD Committee members reviewed the numerous delinquent societies, noting that in several cases, entire states were lacking representation. A letter has been sent to all BOG societies, encouraging participation and offering Academy assistance in becoming more involved. Revised Practitioner Excellence and Model Society Awards criteria were adopted. Chair, Jacquelyn Going, MD, reminded attendees that because the Carrier Relations Committee was inactive and duplicative of other Academy committees, it had been disbanded. BOG Socioeconomic and Grassroots Committee Chair: Gavin Setzen, MD During the 2007 annual meeting, the committee heard updates on Physicians Quality Reporting Initiative (PQRI) from AAO-HNS staff member, Jenissa Haidari, while Dr. Setzen reported on radiological certification, which led to a discussion on scope-of-practice issues on both federal and state levels. The committee recommended that Academy members follow closely those issues in their states and take appropriate action on the federal level. Also discussed was an overview of the Emergency Medical Treatment Active Labor Law (EMTALA). Due to the confusion on the issue, the committee appointed Dr. Love, as chair of an EMTALA Task Force, to develop a tool kit. Complementary and Integrative Medicine Committee Chair: Michael D. Seidman, MD The committee is kicking off this year by re-engaging members and reaching out to those active in the field. An article in the July 2007 Bulletin on curcumin and cancer was well received, and another article on the role of multidisciplinary management of head and neck cancer was published in November. Development is under way for two miniseminars, one exploring advances for treatment of conditions like sinusitis, cold and flu, and tinnitus. The other looks to secure a well-renowned speaker for complementary and integrative medicine to present the latest trends. AAO-HNS Bulletin ||||||||||||||| december 2007 29 CORE Study Section Chairs: Marion E. Couch, MD, PhD, and Lawrence R. Lustig, MD The committee discussed the 2008 CORE grants program and identified the 39 grants that will be made available, totaling over $700,000. The program has begun accepting letters of intent as of late October; all are due by December 15, 2007, and full applications are due January 15, 2008. Endocrine Surgery Committee Chair: Robert E. Sofferman, MD The committee reviewed the thyroid clinical indicator, the new thyroid patient leaflet, thyroid images for the website, the COOL thyroid module, and is reviewing the National Resident Online Study Guide’s endocrine section. It gave input to the American Thyroid Association (ATA) Thyroid Cancer management guidelines for the ATA meeting in October 2007, and will submit miniseminar proposals for ATA on airway management, nerve monitoring, and/or management of invasive disease. Marc D. Coltrera, MD, demonstrated the new endocrine surgery database. A work group of Dr. Coltrera, Gregory M. Randolph, MD, and David J. Terris, MD, will unveil the final database in spring 2008. For the 2008 annual meeting, a miniseminar will be submitted on parathyroid surgery, or on sameday surgery. The American Academy of Endocrine Surgeons Journal of Surgery carries a joint letter: “AAES-ORL Time for a Change,” by Dr. Randolph and Gerald B. Healy, MD. Equilibrium Committee Chair: Michael E. Hoffer, MD The committee has continued to promote, study, and evaluate the diseases that produce equilibratory disturbances. The committee is in the process of updating all vestibular testing CPT codes, vestibular diagnostic codes, and rewriting the Ménière’s disease criteria. Committee members are also in the process of writing a preliminary statement on the endorsement of micro-pressure devices. Facial Nerve Disorders Committee Chair: Jeffrey Vrabec, MD The committee completed its research and evaluation of facial nerve grading 30 AAO-HNS Bulletin ||||||||||||||| december 2007 scales (FNGS). Recognizing that a perfect scale is an impossible goal, the committee ultimately voted to revise the existing FNGS to address some of the common criticisms. Development of any facial movement scale is incomplete without some form of validation. Therefore, a direct comparison of the grading scales was performed to provide data on the inter-observer agreement of the revised scale. It is currently before the Boards to be acknowledged as an improved grading tool. Geriatric Otolaryngology Committee Chair: Ara Chalian, MD Efforts to incorporate geriatrics material, and to present topics such as balance and hearing within a geriatrics context, have been the main focus of committee efforts. Cross-participation with other committees’ geriatrics-related work, the creation of geriatrics-specific education material, placement of geriatrics content on ABO board exams, and use of committee members as manuscript reviewers are some of the strategies. Responses to SRF survey indicate that more geriatrics course content has been noticed by residents. Other initiatives include developing a geriatrics miniseminar, giving greater visibility to PQRI fall measures, submitting papers to other specialty societies, disseminating grant information, continuing the visibility of Geriatric Care Otolaryngology Online, and collaborating on the AMA’s “Safety and the Older Driver” publication. Head & Neck Surgery and Oncology Chair: Daniel Deschler, MD This year was highlighted by the second annual Head & Neck Cancer and Oncology Resident Review Course, a standing-room-only event at the annual meeting. The committee is in the final stages of updating the “Neck Dissection Staging” monograph, due out in 2008. Participation in Head and Neck Cancer Awareness Week grew again, and there are talks with the World Health Organization (WHO) about endorsing the campaign in the future. Hearing Committee Chair: Barry Hirsch, MD In addition to reviewing and updating policy statements on hearing aids and implantable hearing devices during the past year, the committee has been active in reviewing patient leaflet information and reviewing the Acute Otitis Externa/Otitis Media with Effusion performance measures. During the annual meeting, the committee reviewed and updated other policy statements, including cochlear implants. The committee is currently undertaking an update of each of the auditory system clinical indicators. History and Archives Committee Chair: John House, MD Over the past year, the committee worked to establish guidelines and procedures for management of the Otolaryngology Historical Society. They successfully instituted a submission and evaluation process for potential presentations and organized a well-attended reception, tour of the Adams Center, and dinner for the September 2007 meeting. They will submit a miniseminar proposal for the 2008 annual meeting and will work to obtain previous OHS presentations for use on the Adams Center website. Humanitarian Efforts Committee Chair: James E. Saunders, MD The committee resolved to launch an international scholars program for rising academics from developing countries to study in the U.S. and attend the annual meeting. Suha N. Ghossaini, MD, Nazaneen N. Grant, MD, Stephen L. Goudy, MD, and Selina E. Heman-Ackah, MD, formed a website task force to upgrade humanitarian content. The committee resolved to donate AcademyU subscriptions to Iraq training programs, which G. Richard Holt, MD, reports are in dire need. The Medical Alliance for Iraq plans training missions to Erbil and Basra. Dr. Grant, William B. Lewis, MD, and Merry E. Sebelik, MD, will survey training program directors to assess challenges such as study leave, legal aspects, and reporting cases. Nominations for the 2008 Distinguished Award for Humanitarian Efforts must be in by February 1, 2008. To support the IFOS “Hearing for All” campaign, the committee presented a FAMS symposium, “Global Strategies for Hearing Loss Prevention,” and distributed 800 related CDs. Implantable Hearing Devices Subcommittee Chair: Barry Hirsch, MD In response to an increasing number of meningitis deaths in children who had cochlear implants but were not properly vaccinated, the subcommittee has been working with the Academy over the past year to gain approval to develop a poster and other materials for public distribution. Discussion during the meeting focused primarily on developing additional ideas for an educational campaign, and ways to engage cochlear implant companies in the project. The subcommittee also considered an updated policy statement on cochlear implants, which was sent to the Hearing Committee for review. International Otolaryngology Committee Chair: Peter J. Koltai, MD The committee resolved to work with the Humanitarian Efforts Committee on the international scholars proposal. Development staff seeks Academy international leaders to contact or “open doors” to foundations, corporations, and philanthropic individuals. Dr. Holt noted the Medical Alliance mission to Erbil, Iraq, in 2008 and urged Academy members to speak at the ARABFOS, Lebanon, and Middle East Update in Dubai. Professor Jan Grote, MD, IFOS Secretary-General, reported progress for the 2009 IFOS World Congress, successes of the “Hearing for All” initiative, and WHO’s listing of pneumococcal vaccine and its inclusion of Hearing Loss in the Global Program for Aging. WHO urges integration of ear care into primary healthcare. Antonio de la Cruz, MD, succeeds president-elect David W. Kennedy, MD, as IFOS regional coordinator for North America and the Caribbean. Jaffar Al-Bareeq, MD, presented a proposal for member and meeting promotion. Professor Manuel Pais-Clemente, MD, proposed to expand the SPAG concept to regional advisory groups for Europe, the Pacific Rim, and the Middle East. Media Relations and Public Education Committee Chair: Arlis Hibbard, MD Dr. Hibbard highlighted the PR program during WAC, naming the three presenters as outstanding examples of success in media relations. The committee will enhance the media database, documenting member relationships with the media that could promote the Academy, as needed. A Bulletin article by Anita Jackson, MD, on establishing relationships with the media will promote the activity. A miniseminar with the BOG on socio-political relationships in both patient care and specialty advocacy will be submitted by Jeffrey Spiegel, MD, and BOG liaison, Rick Love, MD. Patient information will continue as a responsibility of the committee. A slide show developed by Susan Cordes, MD, Cyndi Go, MD, Christine Franzese, MD, Priya Krishna, MD, Gordy Siegel, MD, and Jeffrey Spiegel, MD, to promote otolaryngology will be made available to all. Medical Devices and Drugs Committee Chair: Maurice Roth, MD The committee completed policy statements on laser surgery (submitted to the American College of Surgeons) and on the different types of tonsillectomy procedures. The committee was also asked by the Board of Directors to develop a policy statement that deals with the roles that physicians play in working with corporations in developing, testing, and implementing new devices. Medical Informatics Committee Chair: Howard S. Kotler, MD The committee is dedicated to educating otolaryngologists on the uses and benefits of health information technologies to enhance the effectiveness and efficiency of our practices. Over the next year, the committee will be working to develop an EMR survey of Academy members, to enhance educational opportunities through health information technology content on the Academy’s website, and to develop specialty-specific EMR criteria to be integrated into the national Certification Commission for Health Information Technology (CCHIT) certification process. Microvascular Committee Chair: Brian Burkey, MD The committee recently updated five NROSG modules, and has begun working on new content for AcademyU. Theodor Teknos, MD, is working on a Microvascular Fellows survey. The committee will submit a miniseminar abstract for 2008, dealing with osteonacrosis and reconstruction after bizfosfamates. Neurolaryngology Committee Chair: Albert L. Merati, MD Over the past year, the Neurolaryngology committee pilot tested web-based patient and physician pod-casts or audio digests, completed a threat analysis for neurolaryngology, commented on proposed changes to ICD-9 codes relating to hearing loss and speech-language pathology, and published a white journal article on voice and laryngeal dysfunction in stroke. In the coming year, the committee will submit a number of miniseminar applications, use the threat analysis to develop a manuscript calling for improved quality and reporting standards for laryngeal procedures, and work with the Speech, Voice, and Swallowing committee to refocus the charges of the two committees so that a clear distinction can be made between Voice and Laryngology and Swallowing and Esophagology. Outcomes Research and EvidenceBased Medicine Committee Chair: Edward M. Weaver, MD, MPH This year the committee completed the adult and pediatric tonsillectomy study– TO TREAT (a future supplement in the journal). We are entering the concluding phases of the SLEEP study analysis, and the kick-off of SMILE, a post-radiation dry mouth study on the effectiveness of evoxac. An exciting advance in the BEST ENT network is the deployment of other research study types, broadening beyond clinical trials. For example, a pilot study was launched on the AOE/OME guidelines and the group was also accepted as an NIH PROMIS collaborator. (continued on next page) AAO-HNS Bulletin ||||||||||||||| december 2007 31 Patient Safety and Quality Improvement Chair: Michael G. Glenn, MD Over the past year, the committee has disseminated awareness within the Academy of patient safety and quality improvement issues. During the 2007 annual meeting, Dr. Glenn and others presented a miniseminar entitled, “Bulletproofing Your Practice for the Quality Invasion.” Dr. Rahul Shah, member of the committee, has been writing monthly patient safety and quality improvement articles for the Bulletin. Plastic and Reconstructive Surgery Committee Chair: Becky McGraw-Wall, MD The committee reaffirmed a policy statement on plastic surgery, reviewed the content of two patient leaflets, and updated the clinical indicators. They will develop a miniseminar proposal for the 2008 annual meeting and seek to update facial trauma CPT codes. Physician Resources Committee Chair: Ira D. Papel, MD Over the past year, the Physician Resources committee monitored and advised workforce issues for the Academy. Three committee members were recommended for appointment to the Council on Graduate Medical Education (COGME) to represent the constituency area of National Physician Organizations. The Academy signed-on to a letter by the Association of American Medical Colleges (AAMC) urging Secretary Spellings to increase the aggregate combined Stafford loan limit for health professions students to $233,793. In the coming year, they will use the biennial socioeconomic survey to collect membership data on workforce issues. reporting standards for acoustic neuroma treatment outcomes, starting with primary tumors. The committee also plans to present a miniseminar at the 2008 annual meeting, on the various pain syndromes of the head and neck. Sleep Disorders Committee Chair: Edward M. Weaver, MD, MPH Over the past year, the Sleep Disorders committee assisted in submitting two Category I CPT applications (radiofrequency tongue reduction and tongue suspension) that will be reviewed in late September. If approved, changes would likely go into effect January 2009. The committee continued to spread the word about sleep certification to Academy members, through email (The News), the Bulletin, and a miniseminar at this year’s Annual Meeting. Over the coming year, the committee will request changes to several AAO-HNS policy statements and increase sleep medicine education opportunities for members. Spanish- and Portuguese-speaking Advisory Group (SPAG) Chair: Roy R. Casiano, MD SPAG now has status as a committee, taking part in the International Committee cluster headed by past president, KJ Lee, MD, Coordinator for International Affairs. SPAG members advised having more speakers of Spanish at the Academy booth in the OTO EXPO and at Academy headquarters. The new website should have a contact option for Spanish speakers, and should post instructions in Spanish for the annual meeting Call for Papers. As official liaison to the Pan-American Association, the SPAG works closely to promote its next Congress, June 4–7, 2008, in Quito, Ecuador. Skull Base Surgery Committee Speech, Voice, and Swallowing Committee Chair: Douglas D. Backous, MD The committee, discussing the need for unified standards for head and neck surgery, is working on designing a core curriculum training program for endoscopic skull base surgery, to include benchmarks and standard nomenclature for both basic and advanced training. They will also begin to develop Chair: Robert T. Sataloff, MD Over the past year, the Speech, Voice, and Swallowing committee remained active in their support of outreach, education, and socioeconomic issues. They provided comment on voluntary guidelines for laryngeal fellowships, physician specialty measures on GERD, and proposed changes to ICD- 32 AAO-HNS Bulletin ||||||||||||||| december 2007 9 codes relating to hearing loss and speech-language pathology. They created a new policy statement, “The Performance and Interpretation of Strobovideolaryngoscopy,” addressing patient safety concerns, which was adopted by the Boards of Directors in March, 2007, and updated Academy patient leaflets on hoarseness and sore throats. Over the coming year, the committee will submit a number of miniseminar applications, continue to support World Voice Day, assist with a potential CPT application for officebased fiberoptic laryngeal procedures, and review the Laryngoscopy/ Nasopharyngoscopy Clinical Indicators (last updated in 2000) show changes in clinical opinion. In response to these changes, the Speech, Voice, and Swallowing Committee will work with the Neurolaryngology committee to refocus tasks based on a better differentiation between Voice and Laryngology and Swallowing and Esophagology. B