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Sleep Apnea
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Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
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Children as young as 7 or 8 years of age require assent, especially for invasive procedures. — Manish Raiji, Manish Raiji, MD - 2024 Pediatric Bariatric Surgery Update Course · 9:45
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
Expert statements from the recordings in this collection.
Health Equity Collaborative in ENT w/ Dr. Alexander Chiu & Dr. Romaine Johnson | ENT Podcast Ep. 98
Equity requires providing different levels of support based on individual circumstances to achieve optimal health, unlike equality which provides the same resources to all.
Alex Chiu4:45
African American black patients consent less to surgery for head and neck cancer and have poorer outcomes when case-controlled for tumor staging, based on data published in 2012.
Host summaryAlex Chiu summarizes what Dr. Romaine Johnson said — not the host's own clinical position10:48
Current otolaryngology literature focuses heavily on documenting disparities (e.g., Black children having more severe sleep apnea and higher revision rates) but lacks intervention studies to reduce these disparities.
Romaine Johnson9:02
Language barriers contribute to increased emergency room visits and phone calls after pediatric tonsillectomy when post-operative instructions are not provided in the patient's preferred language.
Romaine Johnson9:36
Implementing language-preference tracking and providing instructions in preferred languages reduced emergency room visits and phone calls after tonsillectomy at Children's Hospital Dallas.
Romaine Johnson9:54
The Health Equity Collaborative was founded in February 2022 with six initial institutions including University of Mississippi, Henry Ford, Atlanta Georgia, University of Maryland Baltimore, and University of Kansas.
Alex Chiu12:15
The collaborative now includes approximately 20 academic programs with varying degrees of involvement.
Alex Chiu20:24
Qualitative research using structured interviews is difficult and requires discipline to identify themes across 40 participants.
High-impact journals show reluctance to publish qualitative studies despite their value in understanding patient and trainee experiences.
Mixed methodology papers combining qualitative and quantitative data were developed partly as a response to editorial preferences for hard data.
Caregiver research for medically complex conditions is woefully understudied despite its potential impact on patient outcomes.
Community participatory research requires talking to patients to understand what they want from research and how it will impact them locally.
Alex Chiu18:21
The American Academy of Otolaryngology received a grant from GSK to fund a core award for three years of health disparities research.
Alex Chiu19:40
Otolaryngology has the least representation of underrepresented minorities among medical specialties.
Alex Chiu29:18
Orthopedic surgery's Nth Dimension program has been more successful than otolaryngology initiatives in recruiting people of color over the past five years.
Alex Chiu26:03
Patient non-compliance with medications or treatment recommendations often stems from distrust, access barriers, or inadequate explanation rather than forgetfulness or unwillingness.
Alex Chiu32:05
Public health departments and family medicine have more developed infrastructure for equity work than otolaryngology and can provide expertise in participatory research methods.
Research shows that individuals who achieve elite status tend to become more interested in maintaining that status over time rather than maintaining their original idealistic goals.
Host summaryRomaine Johnson summarizes what Dr. Alex Chiu said — not the host's own clinical position37:15
The collaborative's initial funding strategy of paying participants for their time and providing elaborate meals was not effective.
Structured interview questions used in residency applicant selection can assess work ethic, communication skills, problem-solving ability, and resilience to adversity better than board scores and letters of recommendation.
Manish Raiji, MD - 2024 Pediatric Bariatric Surgery Update Course
Children on Medicare and Medicaid are up to 2 times more likely to suffer from obesity, but comprise just over a third of patients obtaining bariatric services.
Manish Raiji9:00
There is a large mismatch between the number of bariatric centers per state versus the prevalence of obesity in those states.
Manish Raiji9:20
Children as young as 7 or 8 years of age require assent, especially for invasive procedures.
Most guidelines suggest no age limits for the performance of bariatric surgery.
Children with intellectual and developmental delays are 1.5 to 2 times more likely to have obesity because of medications, behavioral issues, and dietary issues.
Manish Raiji10:05
Bariatric surgery should be thought of as a very effective strategy and more as a primary therapy rather than an endpoint to a spectrum of failed other options.
Clinical practice guidelines intend to offer bariatric therapy when it's available, not when everything else has been tried.
Bariatric surgery is a safe procedure in children and is certainly safer than not operating on them.
Obesity disproportionately affects vulnerable populations that don't have the same kind of insurance access.
Addressing disparities in bariatric surgery access involves state and federal level advocacy.