Evidence map›Paper›PMID 41091528›Full record

ArticleInternational forum of allergy & rhinology2026

Machine Learning-Enhanced Clinical Decision Support for Diagnosing Sinusitis With Nasal Endoscopy.

Dipesh Gyawali, Thomas Mundy, Majid Hosseini, Morteza Bodaghi, Akio Fujiwara, Sejal Shyam Bhatia, Kayla Baker, Elena Bartolone, Dhara Patel, Henry Chu and 3 more

Abstract read
In one paragraph

Article in International forum of allergy & rhinology, 2026. 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
–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

3 citing papers in PubMed.

  1. Artificial Intelligence in Rhinology: A State-of-the-Art Review of Clinical Readiness and Implementation Pathways.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
    Review
  2. Article
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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

13 authors.

Dipesh GyawaliDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.ORCID https://orcid.org/0009-0001-3734-6000
Thomas MundyOchsner Clinical School, University of Queensland, New Orleans, Louisiana, USA.
Majid HosseiniInformatics Research Institute, University of Louisiana at Lafayette, Lafayette, Louisiana, USA.
Morteza BodaghiInformatics Research Institute, University of Louisiana at Lafayette, Lafayette, Louisiana, USA.
Akio FujiwaraDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.
Sejal Shyam BhatiaDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.
Kayla BakerDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.
Elena BartoloneDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.
Dhara PatelDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.
Henry ChuInformatics Research Institute, University of Louisiana at Lafayette, Lafayette, Louisiana, USA.
Raju GottumukkalaInformatics Research Institute, University of Louisiana at Lafayette, Lafayette, Louisiana, USA.
Jonathan BidwellDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.
Edward D McCoulDepartment of Otorhinolaryngology, Ochsner Health, New Orleans, Louisiana, USA.ORCID https://orcid.org/0000-0003-1812-2105

Funding

Eye, Ear, Nose, and Throat Foundation EE220702/EE220802
6 · The paper itself

Abstract

backgroundSinusitis is a prevalent disease for which nasal endoscopy (NE) is an optimal diagnostic modality. However, NE accuracy is limited by inter-operator variability in landmark identification and localization of mucus that is necessary for sinusitis diagnosis. We sought to develop a novel multi-class machine learning (ML) framework that detects anatomical landmarks and structures for sinusitis assessment as supported by clinical best practices.

methodsA total of 3513 NE images from 452 patients were manually annotated by four physicians for three classes: middle turbinate (MT), inferior turbinate (IT), and mucus. A YOLOv11-nano model was trained for multi-class detection and segmentation. We developed a rule-based logic for middle meatus localization, implementing a clinical algorithm that applies anatomy Intersection over Union (IoU) and conditional logic for sinusitis diagnosis. The system was validated on 178 images from 50 patients with chronic rhinosinusitis without polyps (CRSsNP) with benchmarking of real-time performance.

resultsThe multi-class detection and segmentation model achieved > 75% F1 score for detecting turbinates with mucus. The clinical algorithm achieved 75.0% sensitivity, 76.0% specificity, and 75.2% accuracy for sinusitis classification, with a F1 score of 81.8%, approaching the accuracy of a trained otolaryngologist. The framework achieved near real-time performance at > 20fps on GPU device, demonstrating suitability for integration into live clinical workflows.

conclusionThis novel ML-driven diagnostic framework with a rule-based clinical algorithm enhances decision-making for diagnosing sinusitis with NE. By reducing inter-operator variability, achieving performance comparable to otolaryngologists, and enabling real-time processing for non-specialists, this work holds potential for standardizing care and improving patient outcomes. Future research will focus on expanding to different sinusitis phenotypes and prospective real-time implementation in clinical settings.

Indexed as

Decision Support Systems, ClinicalEndoscopyMachine LearningSinusitisAlgorithmsFemaleHumansMaleRhinitisTurbinatesartificial intelligencediagnosismachine learningnasal endoscopyrhinosinusitis

Identifiers

PMID41091528
PMCPMC12863022

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LicenceCC BY
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Registered trials

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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.