{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T21:59:57Z","timestamp":1791583197709,"version":"4.3.4"},"reference-count":71,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,3,11]],"date-time":"2016-03-11T00:00:00Z","timestamp":1457654400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Appropriate indications for endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS) are currently poorly defined. The lack of clear surgical indications for ESS likely contributes to the large geographic variation in surgical rates and contributes to reduced quality of care. The objective of this study was to define appropriateness criteria for ESS during management of adult patients with uncomplicated CRS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The RAND\/UCLA appropriateness methodology was performed. An international, multidisciplinary panel of 10 experts in CRS was formed and completed 2 rounds of a modified Delphi ranking process along with a face\u2010to\u2010face meeting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 624 clinical scenarios were ranked, 312 scenarios each for CRS with and CRS without nasal polyps. For adult patients with uncomplicated CRS with nasal polyps, ESS can be appropriately offered when the CT Lund\u2010Mackay score is \u2265 1 and there has been a minimum trial of a topical intranasal corticosteroid plus a short\u2010course of systemic corticosteroid with a post\u2010treatment total SNOT\u201022 score \u2265 20. For adult patients with uncomplicated CRS without nasal polyps, ESS can be appropriately offered when the CT Lund\u2010Mackay score is \u2265 1 and there has been a minimum trial of a topical intranasal corticosteroid plus either a short\u2010course of a broad spectrum\/culture\u2010directed systemic antibiotic or the use of a prolonged course of systemic low\u2010dose anti\u2010inflammatory antibiotic with a post\u2010treatment total SNOT\u201022 score \u2265 20.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study has developed and reported of list of appropriateness criteria to offer ESS as a treatment \u201coption\u201d during management of uncomplicated adult CRS. The extent or technique of ESS was not addressed in this study and will depend on surgeon and patient factors. Furthermore, these criteria are the minimal threshold to make ESS a treatment \u201coption\u201d and do not imply that all patients meeting these criteria require surgery. The decision to perform ESS should be made after an informed patient makes a preference\u2010sensitive decision to proceed with surgery. Applying these appropriateness criteria for ESS may optimize patient selection, reduce the incidence of unwarranted surgery, and assist clinicians in providing high\u2010quality, patient\u2010centered care to patients with CRS<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21769","type":"journal-article","created":{"date-parts":[[2016,3,12]],"date-time":"2016-03-12T19:20:42Z","timestamp":1457810442000},"page":"557-567","source":"Crossref","is-referenced-by-count":61,"title":["Defining appropriateness criteria for endoscopic sinus surgery during management of uncomplicated adult chronic rhinosinusitis: a RAND\/UCLA appropriateness study"],"prefix":"10.1002","volume":"6","author":[{"given":"Luke","family":"Rudmik","sequence":"first","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery, Department of Surgery University of Calgary  Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary M.","family":"Soler","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus Surgery, Department of Otolaryngology\u2013Head and Neck Surgery Medical University of South Carolina  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Hopkins","sequence":"additional","affiliation":[{"name":"Department of ENT Guy's and St Thomas\u2019 NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodney J.","family":"Schlosser","sequence":"additional","affiliation":[{"name":"Ralph H. Johnson VA Medical Center  Charleston SC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju","family":"Peters","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Northwestern University Allergy Division  Chicago IL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew A.","family":"White","sequence":"additional","affiliation":[{"name":"Division of Allergy and Immunology Scripps Clinic  La Jolla CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard R.","family":"Orlandi","sequence":"additional","affiliation":[{"name":"Division of Otolaryngology\u2013Head and Neck Surgery University of Utah  Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wytske J.","family":"Fokkens","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Academic Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Douglas","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Auckland  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy L.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology\u2013Head and Neck Surgery Oregon Health and Science University  Portland OR"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,3,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.7835"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0266462300002774"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815572097"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhino12.000"},{"issue":"2","key":"e_1_2_6_6_1","first-page":"S99","article-title":"Canadian clinical practice guidelines for acute and chronic rhinosinusitis","volume":"40","author":"Desrosiers M","year":"2011","journal-title":"J Otolaryngol Head Neck Surg"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21695"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.7544"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin14.077"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin13.217"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814565606"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.5935\/1808-8694.20130055"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24135"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21366"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21065"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2009.10.009"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20777"},{"key":"e_1_2_6_18_1","unstructured":"ENT\u2010UK\u2013The Royal College of Surgeons of England. Commissioning Guide: Rhinosinusitis 2013.http:\/\/www.rcseng.ac.uk\/healthcare\u2010bodies\/docs\/published\u2010guides\/rhinosinusitus. Accessed February 12 2016."},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815602679"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25314"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.17"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)61215-5"},{"key":"e_1_2_6_23_1","first-page":"CD006991","article-title":"Surgical versus medical interventions for chronic rhinosinusitis with nasal polyps","volume":"12","author":"Rimmer J","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_24_1","first-page":"CD006990","article-title":"Surgical interventions for chronic rhinosinusitis with nasal polyps","volume":"11","author":"Sharma R","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1038\/oby.2009.78"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.01.061"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzi047"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181da8685"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.81B2.8871"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510400036028"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(99)00519-0"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otot.2009.10.001"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21181"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24584"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.08.037"},{"issue":"11","key":"e_1_2_6_36_1","first-page":"1","article-title":"Ambulatory surgery in the United States, 2006","author":"Cullen KA","year":"2009","journal-title":"Natl Health Stat Report"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21601"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2005.07.003"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20101"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25180"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.10.012"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25318"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25108"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2001.119324"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000192284.22703.04"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.02.004"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21382"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21394"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240501900116"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1186\/1710-1492-7-2"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-154-5-201103010-00003"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318149224d"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-014-0427-7"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2013.27.3897"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.1177\/194589240501900601"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21847"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21182"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21364"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25656"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24916"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2012.07.002"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2011.581"},{"key":"e_1_2_6_63_1","article-title":"VHS Sinus Panel Report: Appropriateness Criteria for Sinus Surgery","volume":"13","author":"Dana S.","year":"1994","journal-title":"Bulletin of the AAO\u2010HNS"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.10.011"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.10.009"},{"key":"e_1_2_6_66_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21496"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.11.019"},{"key":"e_1_2_6_68_1","doi-asserted-by":"publisher","DOI":"10.2500\/105065898781390019"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0000000000000125"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/6.3.251"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.309.6956.730"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2010.24.3430"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.21769","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.21769","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T20:49:20Z","timestamp":1696538960000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.21769"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,3,11]]},"references-count":71,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1002\/alr.21769"],"URL":"https:\/\/doi.org\/10.1002\/alr.21769","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,11]]}}}