Evidence map›Paper›PMID 39302214›Full record

ArticleInternational forum of allergy & rhinology2025

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

Matthew M Chu, Jack T Garcia, Ahmad R Sedaghat, George A Scangas, Katie M Phillips

Abstract read
In one paragraph

Article in International forum of allergy & rhinology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Acute Exacerbations of Chronic Rhinosinusitis.Current allergy and asthma reports · 2025
    Review
  2. 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.

Matthew M ChuDepartment of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Jack T GarciaDepartment of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.
Ahmad R SedaghatDepartment of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.ORCID 0000-0001-6331-2325
George A ScangasDepartment of Otolaryngology, Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts, USA.
Katie M PhillipsDepartment of Otolaryngology, Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.

Funding

KL2 Training ProgramKL2TR001426 · NCATS · UNIVERSITY OF CINCINNATI · PI ZELLER, MARGARET H · 2015 to 2024
$6.8M
NCATS NIH HHS KL2 TR001426
6 · The paper itself

Abstract

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.

Indexed as

RhinitisSinusitisAcute DiseaseChronic DiseaseCost-Benefit AnalysisDecision TreesEndoscopyHumansModels, EconomicQuality-Adjusted Life YearsRhinosinusitisacute exacerbationsAECRSantibioticschronic rhinosinusitiscorticosteroidscost‐effectivenessmanagementtreatment

Identifiers

PMID39302214
PMCPMC11785155

What OpenQuestion holds

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LicenceCC BY-NC
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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.