Evidence map›Paper›PMID 37095527›Full record

ArticleJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2023

Canadian multidisciplinary expert consensus on the use of biologics in upper airways: a Delphi study.

Andrew V Thamboo, Melissa Lee, Mohit Bhutani, Charles Chan, Yvonne Chan, Ken R Chapman, Christopher J Chin, Lori Connors, Del Dorscheid, Anne K Ellis and 26 more

Open access · goldAbstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.8field-weighted citation impact, top 9% 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

7 citing papers in PubMed, 16 citations in OpenAlex.

  1. Oral corticosteroid overexposure: characterizing oral corticosteroid use in patients with chronic rhinosinusitis with nasal polypS in Canada (ACTIONS) results.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2025
    Article
  2. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Review
  3. Review
  4. Diagnosis and management of chronic rhinosinusitis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025
    Review
  5. Article
  6. Biologics in the Treatment of Chronic Rhinosinusitis with Nasal Polyposis in Canada: Current Trends and Practice Patterns.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
    Article
  7. Psychological Distress in Patients with Long-lasting COVID-19 Olfactory Dysfunction.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
    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

36 authors at 16 institutions in 1 country.

Andrew V ThambooDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, St. Paul Sinus Center, University of British Columbia, 2600-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. athamboo4@providencehealth.bc.ca.
Melissa LeeDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, St. Paul Sinus Center, University of British Columbia, 2600-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Mohit BhutaniDepartment of Respirology, University of Alberta, Edmonton, AB, Canada.
Charles ChanDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Yvonne ChanDepartment of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
Ken R ChapmanDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Christopher J ChinDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Lori ConnorsDepartment of Medicine, Dalhousie University, Halifax, NS, Canada.
Del DorscheidDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Anne K EllisDivision of Allergy and Immunology, Department of Medicine, Queen's University, Kingston, ON, Canada.
Richard M GallDepartment of Otolaryngology-Head and Neck Surgery, University of Manitoba, Winnipeg, MB, Canada.
Krystelle GodboutDepartment of Medicine, Laval University, Quebec City, QC, Canada.
Arif JanjuaDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, St. Paul Sinus Center, University of British Columbia, 2600-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Amin JaverDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, St. Paul Sinus Center, University of British Columbia, 2600-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.
Shaun KiltyDepartment of Otolaryngology-Head and Neck Surgery, The University of Ottawa and The Ottawa Hospital, Ottawa, ON, Canada.
Harold KimDivision of Clinical Immunology and Allergy, Department of Medicine, Western University, London, ON, Canada.
Gordon KirkpatrickDivision of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada.
John M LeeDepartment of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
Richard LeighDepartment of Medicine, University of Calgary, Calgary, AB, Canada.
Catherine LemiereDepartment of Medicine, CIUSS du Nord de l'île de Montreal, Université de Montreal, Montreal, QC, Canada.
Eric MonteiroDepartment of Medicine, University of Toronto, Toronto, ON, Canada.
Helen NeighbourDivision of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Paul K KeithDivision of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada.
George PhilteosLakeridge Health, Ajax, ON, Canada.
Jaclyn QuirtDivision of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Brian RotenbergDepartment of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.
Juan C RuizDivision of Clinical Immunology and Allergy, University of Calgary, Calgary, AB, Canada.
John R ScottDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, Dalhousie University, Halifax, NS, Canada.
Doron D SommerDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Leigh SowerbyDepartment of Otolaryngology-Head and Neck Surgery, Western University, London, ON, Canada.
Marc TewfikDepartment of Otolaryngology-Head and Neck Surgery, McGill University, Montreal, QC, Canada.
Susan WasermanDivision of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Ian WitterickDepartment of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.
Erin D WrightDivision of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada.
Cory YamashitaDepartment of Medicine, Western University, London, ON, Canada.
Martin DesrosiersDivision of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montreal, Montreal, QC, Canada.
University of Toronto · CAMcMaster University · CAWestern University · CADalhousie University · CASt. Paul's Hospital · CAUniversity of British Columbia · CAUniversity of Alberta · CAUniversity of Calgary · CACentre Hospitalier de l’Université de Montréal · CACentre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l'Île-de-Montréal · CALakeridge Health · CAMcGill University · CAQueen's University · CAUniversité Laval · CAUniversity of Manitoba · CAUniversity of Ottawa · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChronic rhinosinusitis with nasal polyposis (CRSwNP) often coexists with lower airway disease. With the overlap between upper and lower airway disease, optimal management of the upper airways is undertaken in conjunction with that of the lower airways. Biologic therapy with targeted activity within the Type 2 inflammatory pathway can improve the clinical signs and symptoms of both upper and lower airway diseases. Knowledge gaps nevertheless exist in how best to approach patient care as a whole. There have been sixteen randomized, double-blind, placebo-controlled trails performed for CRSwNP targeted components of the Type 2 inflammatory pathway, notably interleukin (IL)-4, IL-5 and IL-13, IL- 5R, IL-33, and immunoglobulin (Ig)E. This white paper considers the perspectives of experts in various disciplines such as rhinology, allergy, and respirology across Canada, all of whom have unique and valuable insights to contribute on how to best approach patients with upper airway disease from a multidisciplinary perspective.

methodsA Delphi Method process was utilized involving three rounds of questionnaires in which the first two were completed individually online and the third was discussed on a virtual platform with all the panelists. A national multidisciplinary expert panel of 34 certified specialists was created, composed of 16 rhinologists, 7 allergists, and 11 respirologists who evaluated the 20 original statements on a scale of 1-9 and provided comments. All ratings were quantitively reviewed by mean, median, mode, range, standard deviation and inter-rater reliability. Consensus was defined by relative interrater reliability measures-kappa coefficient ([Formula: see text]) value > 0.61.

resultsAfter three rounds, a total of 22 statements achieved consensus. This white paper only contains the final agreed upon statements and clear rationale and support for the statements regarding the use of biologics in patients with upper airway disease.

conclusionThis white paper provides guidance to Canadian physicians on the use of biologic therapy for the management of upper airway disease from a multidisciplinary perspective, but the medical and surgical regimen should ultimately be individualized to the patient. As more biologics become available and additional trials are published we will provide updated versions of this white paper every few years.

Indexed as

Biological ProductsNasal PolypsRhinitisSinusitisCanadaChronic DiseaseConsensusDelphi TechniqueHumansReproducibility of ResultsBiological ProductsAsthmaBiologicsChronic rhinosinusitisChronic rhinosinusitis with nasal polyposisLower airway diseaseType 2 inflammationUpper airway disease

Identifiers

PMID37095527
PMCPMC10127402
OpenAlexW4366814631

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.