Medical College of Wisconsin OTO Clinomics

Bringing the field of precision medicine to the field of otolaryngology.

Learn more about department research

Otoclinomics Leadership Team

David Friedland, MD, PhD

Professor & Vice-Chair, Department of Otolaryngology and Communication Sciences

Jazzmyne Adams, MPH

Research Program Director, Department of Otolaryngology and Communication Sciences

About Otoclinomics

Medical practice is undergoing a dramatic shift from focusing on populations, a central tenet of evidence-based medicine, to focusing on the individual patient. There is increasing evidence that even seemingly straight-forward conditions can present and respond very differently from person to person. We are at a time in science when we can identify unique biological factors in an individual that may better inform their treatment options. This is termed precision medicine.

The principal goal of Otoclinomics is to bring precision medicine to the field of Otolaryngology by establishing a department-wide platform for collecting and analyzing demographic, biologic, physiologic, radiographic and disease-related data. In partnership with the Linda T. and John A. Mellowes Center for Genomic Sciences and Precision Medicine we will explore unique biological predictors of disease behavior and response to treatment. This will create person-specific, as opposed to disease-specific, guidelines for the management of common ear, nose, and throat disorders.

Precision Medicine

Areas of Precision Medicine to be explored within the field of Otolaryngology.

Microbiomics
Genetics
Epigenetics
Pharmacogenetics
Radiomics

Microbiomics

The microbiome is the entirety of microbial organisms that live on and within each person. Recent evidence indicates that the microbiome may be a key factor in the development of conditions as disparate as cardiovascular disease and depression. The microbiome may influence the development and response to treatment of ENT conditions, particularly those with an inflammatory component such as sinusitis or otitis media.

Genetics

Many conditions develop or are pre-disposed due to inherited genes and mutations. Many different genes may lead to a common presentation, for example hearing loss, but treatment may be different based on the underlying genetic cause.

Epigenetics

The DNA we are born with changes based upon our life experiences including stressors, activity levels, diet, and other diseases. Acquired modifications of a person’s genetic code may influence their development of ENT disorders and their responses to current treatments.

Pharmacogenetics

There is increasing evidence that a person’s response to medications can be influenced by their genes. Thus, different medications for the same disease may be needed for those with differing genomes. In addition, some ENT disorders, such as hearing loss or imbalance, may be caused by some medications due to an underlying genetic susceptibility.

Radiomics

Advances in imaging technology, computer modelling, and simulation can lead to precision tailoring of surgical treatments for the unique anatomy and biology of the individual patient.

Current Research Projects in Otology

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Impact of Demographics and Clinical Features on Initial Treatment Decision Making in Vestibular Schwannoma

Principal Investigator David Friedland, MD, PhD

In this study, we identify demographic and clinical features impacting initial treatment pathway for vestibular schwannoma.

The Efficacy of CT Angiography in Assessing Vascular Injury in Patients with Temporal Bone Fracture

Principal Investigator Erin Harvey, MD

In this study, we determine the utility of computed tomography angiography (CTA) to assess vascular injury following temporal bone fracture.

Healthcare Utilization Disparities Suggest Differences in Susceptibility to Meniere’s Disease

Principal Investigator Adam Thompson-Harvey, MD
In this project, we clarify whether the lack of racial and ethnic diversity among Meniere’s disease (MD) patients is representative of observer bias or disease susceptibility.

Standardization of Outcome Measures for Intratympanic Steroid Treatment for Idiopathic Sudden Sensorineural Hearing Loss

Principal Investigator David Friedland, MD, PhD

In this study, we compare patient response to intratympanic steroid (IT) treatment using the American Academy of Otolaryngology Head and Neck Surgery (AAO-HNSF) guideline vs other reported criteria.

Cochlear implantation device failure: A comparison of all recall-related and field-action re-implantation outcomes at a single institution

Principal Investigator Erin Harvey, MD

The primary aim of this study is to measure the outcomes of cochlear re-implantation following manufacturer-recalled device failure. We hypothesize that (1) outcomes of adult patients with recall-related implantation and field-action re-implantation will have return to pre-failure speech perception (CNC) scores after re-implantation.