Clinical epidemiology aims to better understand health care delivery. It can identify potential problems with underutilization or overutilization of services and can be used to establish priorities for future studies or interventional trials. Defining geographic variation of utilization is an important part of clinical epidemiology. Theoretically, the care delivered to patients should be similar in different regions. However, regions can also have important differences in population characteristics that justify variation. Differences in supply may also contribute to variation, ie, supply sensitive variation. Services with a low level of evidence are also expected to have geographic variation based on patient and clinician preferences, ie, preference sensitive variation. Overall, variation is sometimes warranted and other times unwarranted.1
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Kerber KA. Geographic Variation in the Use of Audiovestibular Testing—Too Much or Too Little? JAMA Otolaryngol Head Neck Surg. Published online December 19, 2019. doi:10.1001/jamaoto.2019.3950
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