Dr. Alexander Chiu
Sleep Apnea
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Evidence & Research
3 items
Manish Raiji, MD - 2024 Pediatric Bariatric Surgery Update Course
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Manish Raiji, MD presents “Ethics of Pediatric Bariatric Surgery” including issues in those with developmental delay at the 2024 Pediatric Bariatric Surgery Update Course.
video15:17 · Feb 2024
Health Equity Collaborative in ENT w/ Dr. Alexander Chiu & Dr. Romaine Johnson | ENT Podcast Ep. 98
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video41:23 · Jun 2026
Ep. 98 Health Equity Collaborative in ENT with Dr. Alexander Chiu and Dr. Romaine Johnson
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In this episode of BackTable ENT, Dr. Gopi Shah, Dr. Romaine Johnson (UT Southwestern), and Dr. Alex Chiu (University of Kansas) discuss health disparities rese
podcast41:15 · Jun 2026
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Ep. 98 Health Equity Collaborative in ENT with Dr. Alexander Chiu and Dr. Romaine Johnson
Equality means giving everyone the same opportunities and access; equity means providing different supports so everyone can reach optimal health.
opinionAlexander Chiu4:36 ↗
The apple-in-the-tree analogy: three people of different heights (6'5", 5'8", 5'3") need different-sized boxes to reach the same fruit (optimal health).
opinionAlexander Chiu5:07 ↗
Much equity work focuses on the individual, but not enough on community, interpersonal relationships, society, and caregiver research.
opinionAlexander Chiu7:40 ↗
Many current articles describe disparities (e.g., Black children have more severe sleep apnea, higher revision rates) using big data or local data, but fewer address interventions to reduce those disparities.
epidemiologicalRomaine Johnson8:29 ↗
At Children's Hospital Dallas, many families were calling or visiting the emergency room post-tonsillectomy due to a language barrier; they did not understand post-op pain medication instructions.
clinicalRomaine Johnson9:28 ↗
After implementing language-preference tracking and better communication, the Dallas team saw fewer emergency room visits and phone calls for simple post-tonsillectomy questions.
clinicalRomaine Johnson9:46 ↗
Data from 2012 (decade-old) show that African American Black patients consent less to head and neck cancer surgery and have poorer outcomes even when case-controlled for tumor stage.
epidemiologicalAlexander Chiu10:40 ↗
A University of Kansas resident is conducting a qualitative study to understand why patients in Kansas City resist head and neck cancer surgery.
clinicalAlexander Chiu10:52 ↗
There is a fair amount of literature describing health disparities on an individual basis, but almost no literature on interventions—especially at the community or societal level.
opinionAlexander Chiu11:25 ↗
The Health Equity Collaborative was started in February 2022 with six institutions: University of Mississippi, Henry Ford, Charles Moore (Atlanta), University of Maryland Baltimore, UT Southwestern, and University of Kansas.
clinicalAlexander Chiu12:07 ↗
The collaborative's initial goal was to agree on data metrics, collect local data, and present it to institutional decision-makers to effect policy change.
clinicalAlexander Chiu13:15 ↗
The collaborative now includes about 20 academic programs with varying degrees of involvement.
clinicalAlexander Chiu20:16 ↗
The master plan is for the American Academy of Otolaryngology to eventually adopt and support the collaborative.
opinionAlexander Chiu22:21 ↗
High-impact journals are reluctant to publish qualitative studies (structured interviews, theme extraction) because they are not observational trials, randomized controlled trials, or systematic reviews.
opinionRomaine Johnson14:32 ↗
Qualitative research is rigorous and difficult: it requires discipline to extract themes from structured interviews of 40 people.
opinionAlexander Chiu15:06 ↗
Mixed methodology (qualitative + quantitative metrics) may have emerged partly to satisfy traditional journal expectations for 'hard data.'
opinionAlexander Chiu16:10 ↗
Community participatory research means doing research that affects the patients you treat, informed by what patients themselves want to see changed.
opinionAlexander Chiu18:13 ↗
The collaborative initially paid people to attend sessions and provided elaborate meals, but that approach 'fell flat.'
clinicalAlexander Chiu19:01 ↗
The American Academy of Otolaryngology (Jim Denaney) has stepped up more than other national societies, recently securing a GSK grant for a 3-year core award to study health disparities.
clinicalAlexander Chiu19:27 ↗
The collaborative meets via Zoom and plans one large in-person meeting annually at the American Academy of Otolaryngology meeting.
clinicalAlexander Chiu22:11 ↗
Dr. Johnson has been tasked with working with the Academy's Regent registry (mostly private practitioners, some universities) to extract data and create an 'equity scorecard' to assess whether care is equitable.
clinicalRomaine Johnson23:43 ↗
Building good data infrastructure and achieving measurable outcomes takes time; early wins for the collaborative included convening stakeholders and gaining Academy support.
opinionRomaine Johnson24:07 ↗
The collaborative has two main foci: research and professional identity/recruitment of underrepresented minorities into otolaryngology.
clinicalAlexander Chiu25:42 ↗
Orthopedic surgery's Nth Dimension program has been more successful than otolaryngology efforts at recruiting people of color over the past 5 years.
epidemiologicalAlexander Chiu25:54 ↗
Financial hurdles remain a barrier to replicating the Nth Dimension model in otolaryngology; larger societies need to fund this work.
opinionAlexander Chiu26:16 ↗
The collaborative is considering developing anti-racism and equity curricula tailored to otolaryngology for residents and medical students.
opinionAlexander Chiu26:31 ↗
Otolaryngology has the least representation of underrepresented minorities among surgical specialties.
epidemiologicalAlexander Chiu29:10 ↗
The ultimate goal is to make health equity a top-three priority (1, 1A, or 1B) for all otolaryngologists, not just those in diverse or high-poverty communities.
opinionAlexander Chiu29:39 ↗
Dr. Chiu tries to be more patient and understanding when patients appear non-compliant, exploring whether there is distrust, a barrier to obtaining medication, or insufficient explanation.
clinicalAlexander Chiu31:33 ↗
When a patient gives 'that look' suggesting they may not follow through, Dr. Chiu now explores the underlying reason rather than assuming forgetfulness or lack of motivation.
clinicalAlexander Chiu32:08 ↗
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