Establishment of a duration criterion for acute exacerbations of chronic rhinosinusitis through qualitative analysis of patient experiences

Walters, Zoe A.; Sedaghat, Ahmad R.; Phillips, Katie

doi:10.1002/alr.23119

Cited by 3 publications

(1 citation statement)

References 12 publications

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“…In the past, AECRS have been studied using surrogate measures, such as frequency of patient-reported sinus infections or frequency rescue medication usage (95,97) , which has also been validated as a reflection CRS burden on QOL (98) . More recent qualitative studies of patients' experiences and perceptions of AECRS have led to a proposed definition of AECRS as "a flare up of symptoms beyond day-to-day variation, lasting at least 3 days, and to which a distinct negative impact on a patient's QOL or functionality can be attributed" (99,100) . This definition of AECRS has also been adopted in an EPOS2020/EUFOREA expert opinion on disease states in CRSwNP (101) .…”

Section: Acute Exacerbations Of Chronic Rhinosinusitismentioning

confidence: 99%

Outcome measures for chronic rhinosinusitis with nasal polyps

Sedaghat,

Campbell,

Douglas

et al. 2024

Rhin

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Background: With the recent proliferation of novel therapeutics for chronic rhinosinusitis with nasal polyps (CRSwNP), there is an immediate need for comprehensive means to assess CRSwNP disease status as well as to determine treatment efficacy. Outcome measures exist in different forms. Patient-reported outcome measures (PROMs) allow patients to provide direct input about their condition that is not possible to obtain in any other way. Common constructs that are measured using PROMs include quality of life or the burden of disease manifestations (e.g., symptom severity). Outcomes may also include the results of objective diagnostic testing/measurement of clinical signs or measured using psychophysical tests. Biomarkers represent an emerging class of outcome measures for CRSwNP and are chosen to directly reflect the active pathophysiologic processes of CRSwNP in the peripheral blood, sinus/polyp tissues, and sinonasal mucus. Methods: Narrative review of the literature, identifying and describing outcome measures that may be used in the evaluation of CRSwNP and for assessment of treatment responses. Results: In this review, we identify many different outcome measures for CRSwNP that fall under the categories of PROM, objective test, psychophysical test or biomarker. We describe the history of each - including seminal studies - and demonstrate the formal validation, psychometric performance, and limitations of each. Conclusions: PROMs, objective tests, psychophysical tests and biomarkers represent different classes of outcome measures that are complementary means of assessing CRSwNP disease status and treatment efficacy. The choice or interpretation of a CRSwNP outcome measure should be undertaken with full knowledge of its formal validation, psychometric performance, and limitations.

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Section: Acute Exacerbations Of Chronic Rhinosinusitismentioning

confidence: 99%

Outcome measures for chronic rhinosinusitis with nasal polyps

Sedaghat,

Campbell,

Douglas

et al. 2024

Rhin

View full text Add to dashboard Cite

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A cost utility analysis for the management of acute exacerbations of chronic rhinosinusitis

Chu,

Garcia,

Sedaghat

et al. 2024

Int Forum Allergy Rhinol

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BackgroundThe management of acute exacerbations of chronic rhinosinusitis (AECRS) is understudied and the most cost‐effective management of AECRS has not been previously investigated. The aim of this study is to determine the most cost‐effective strategy for the initial management of AECRS.MethodsThe study design consisted of a decision‐tree economic model comparing three different initial strategies for managing a patient perceived AECRS: observation, upfront rescue medications, or clinic visit with diagnostic nasal endoscopy (DNE). The primary study outcome was the disease burden of a single AECRS, which was determined by the health utility value and the duration of symptoms. Strategies with an incremental cost‐effectiveness ratio < $50,000/quality‐adjusted life year (QALY) or equivalently < $137/quality‐adjusted life day (QALD) were considered cost‐effective.ResultsObservation was the most cost‐effective strategy at a willingness to pay of $137 per QALD. One‐way sensitivity analysis demonstrated that observation was more effective than upfront rescue medications when the probability of bacterial infection as the cause of AECRS was <24.0%. Upfront rescue medications wer more cost effective than observation when the probability of bacterial infection exceeded 49.0%. Clinic visit with DNE was the most effective strategy to manage an AECRS, but it was not considered cost‐effective.ConclusionObservation is the most cost‐effective strategy for the initial management of AECRS when there is a low likelihood of bacterial infection. When the probability of bacterial etiology of AECRS exceeds 49.0%, upfront rescue medications proved to be the most cost‐effective strategy.

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Chronic Rhinosinusitis

Sedaghat

2024

Infections of the Ears, Nose, Throat, and Sinuses

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Establishment of a duration criterion for acute exacerbations of chronic rhinosinusitis through qualitative analysis of patient experiences

Abstract: How to cite this article: Walters ZA, Sedaghat AR, Phillips KM. Establishment of a duration criterion for acute exacerbations of chronic rhinosinusitis through qualitative analysis of patient experiences.

Cited by 3 publications

References 12 publications

Outcome measures for chronic rhinosinusitis with nasal polyps

Outcome measures for chronic rhinosinusitis with nasal polyps

A cost utility analysis for the management of acute exacerbations of chronic rhinosinusitis

Chronic Rhinosinusitis

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