Evidence map›Paper›PMID 36586318›Full record

ArticleAmerican journal of otolaryngology

Cost-effectiveness analysis comparing in-office posterior nasal nerve ablation to surgical therapies.

Anirudh Saraswathula, Lekha Yesantharao, Christine G Gourin, Nicholas R Rowan, Kevin D Frick

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of otolaryngology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 29% 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

1 citing paper in PubMed, 6 citations in OpenAlex.

  1. Posterior Nasal Neurectomy for Allergic and Non-Allergic Rhinitis: Efficacy, Safety, and Predictive Factors.ORL; journal for oto-rhino-laryngology and its related specialties · 2026
    Article
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 2 institutions in 1 country.

Anirudh SaraswathulaDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America. Electronic address: asarasw2@jhmi.edu.
Lekha YesantharaoJohns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Christine G GourinDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Armstrong Institute for Patient Safety and Quality, Johns Hopkins University, Baltimore, MD, United States of America.
Nicholas R RowanDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Kevin D FrickCarey Business School, Johns Hopkins University, Baltimore, MD, United States of America; Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America.
Johns Hopkins University · USJohns Hopkins Medicine · US

Funding

RESEARCH TRAINING IN OTOLARYNGOLOGYT32DC000027 · NIDCD · JOHNS HOPKINS UNIVERSITY · PI CAREY, JOHN PATRICK · 1989 to 2023
$5.5M
NIDCD NIH HHS T32 DC000027
6 · The paper itself

Abstract

backgroundRecently, in-office posterior nasal nerve ablation (PNA) devices have offered a new tool to treat refractory chronic rhinitis, but their cost-effectiveness relative to traditional interventions such as vidian neurectomy (VN) and posterior nasal neurectomy (PNN) remains unexplored.

objectiveTo compare the cost-effectiveness of these interventions in patients with refractory chronic rhinitis.

methodsA decision tree with embedded Markov models was created to compare the cost-effectiveness of PNN, VN, and PNA, measured in quality-adjusted life years (QALYs) over a 30-year time horizon with a $100,000/QALY willingness-to-pay threshold. One- and two-way sensitivity analyses were completed.

resultsSensitivity analysis found that in-office PNA became cost-effective compared to VN when patients undergoing PNA were less than 20 % more likely than VN to have symptoms recur; this value was assumed to be twice as likely in the base case. In the base case, however, VN and in-office PNA were more effective and less expensive than PNN, while VN was cost-effective when compared to in-office PNA (incremental cost-effectiveness ratio $11,616.24/QALY). Other assumptions were not found to considerably impact incremental cost-effectiveness.

conclusionAlthough highly limited by currently available data, PNA may be cost-effective compared to VN as long-term outcomes on the durability of its effects emerge. These data should not be used by payers considering coverage or utilization since long-term data is still nascent. However, that as new technologies emerge for rhinitis, it will be important to monitor longer-term outcomes to identify high value care, but based on limited data PNA devices may meet this standard.

Indexed as

Cost-Effectiveness AnalysisRhinitisCost-Benefit AnalysisHumansChronic rhinitisCost effectivenessCryoablationHealthcare costRadiofrequency ablationRhinitisRhinology

Identifiers

PMID36586318
PMCPMC10033428
OpenAlexW4312222097

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.