Evidence map›Paper›PMID 28776718›Full record

Trial reportThe Laryngoscope2018

Analysis of factors associated with electing endoscopic sinus surgery.

Adam S DeConde, Jess C Mace, Vijay R Ramakrishnan, Jeremiah A Alt, Timothy L Smith

Abstract readClinical TrialMulticenter StudyObservational Study
In one paragraph

Trial report in The Laryngoscope, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Observational
  3. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

Adam S DeCondeDepartment of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California-San Diego, San Diego, California, U.S.A.
Jess C MaceDivision of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery; Oregon Health and Science University, Portland, Oregon, U.S.A.
Vijay R RamakrishnanDepartment of Otolaryngology, University of Colorado, Aurora, Colorado, U.S.A.
Jeremiah A AltDivision of Otolaryngology-Head and Neck Surgery, Rhinology-Sinus and Skull Base Surgery Program, Department of Surgery, University of Utah, Salt Lake City, Utah, U.S.A.
Timothy L SmithDivision of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery; Oregon Health and Science University, Portland, Oregon, U.S.A.ORCID 0000-0002-6424-7083
Oregon Health & Science University · USUniversity of Colorado Denver · USUniversity of San Diego · USUniversity of Utah · US

Funding

DETERMINANTS OF SURGICAL OUTCOMES IN CHRONIC SINUSITISR01DC005805 · NIDCD · OREGON HEALTH & SCIENCE UNIVERSITY · PI SMITH, TIMOTHY L, SOLER, ZACHARY M · 2004 to 2020
$7.6M
University of Utah Center for clinical and Translational ScienceKL2TR001065 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$1.1M
NCATS NIH HHS KL2 TR001065NIDCD NIH HHS R01 DC005805
6 · The paper itself

Abstract

objectiveMedically refractory chronic rhinosinusitis (CRS) can be managed with appropriate continued medical therapy (CMT) or surgery followed by CMT. Patients who initially elect CMT and do not experience adequate symptom resolution may "cross over" to endoscopic sinus surgery (ESS). Our objective was to identify patient covariates associated with this subset of patients who elect this change in treatment modality. STUDY

designRetrospective analysis of a prospective, multi-center cohort of adult patients with CRS enrolled between March 2011 and June 2015 in academic, tertiary referral clinics.

methodsSubjects who initially elected CMT were followed up to 18 months, provided a comprehensive medical history, and completed the 22-item SinoNasal Outcome Test (SNOT-22) at baseline and during 6-month follow-up intervals. Hazard regression modeling was used to identify covariates associated with elective change in treatment modality.

resultsOne hundred seventy-nine subjects were followed for an average 15.1 (standard deviation ± 4.6) months. Subjects who elected ESS (55 of 179) had significantly worse average endoscopy scores and reported worse SNOT-22 sleep dysfunction scores at baseline (P ≤ 0.026). For each single increasing (worsening) point of Lund-Kennedy endoscopy score, the hazard ratio (HR) of crossover increased by ∼6%. Similarly, for every point of worsening in baseline SNOT-22 total score, the hazard of treatment crossover increased by ∼2%. After covariate adjustment, only baseline SNOT-22 sleep dysfunction scores were associated with an increased risk of treatment crossover (HR = 1.07; 95% confidence interval: 1.02-1.11; P = 0.003).

conclusionBaseline total SNOT-22 and endoscopy scores are associated with treatment crossover, but reported sleep dysfunction is the only significant independent predictor of treatment crossover. LEVEL OF EVIDENCE: 2c. Laryngoscope, 128:304-310, 2018.

Indexed as

AdultAgedChronic DiseaseCohort StudiesCross-Over StudiesElective Surgical ProceduresEndoscopyFemaleFollow-Up StudiesHumansMaleMiddle AgedParanasal SinusesProspective StudiesRetrospective StudiesRhinitischronic diseaseendoscopyoutcome assessment (health care)Sinusitistherapeutics

Identifiers

PMID28776718
PMCPMC5771886
OpenAlexW2743800035

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.