{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T19:02:39Z","timestamp":1792782159179,"version":"4.5.0"},"reference-count":65,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T00:00:00Z","timestamp":1504569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Massachusetts Eye and Ear Board on Quality"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The objective of this work was to evaluate the impact of asthma on the cost\u2010effectiveness profile of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis with nasal polyps (CRSwNP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The study design consisted of a cohort\u2010style Markov decision\u2010tree cost utility analysis with a 35\u2010year time horizon. Matched cohorts of CRSwNP patients with (n = 95) and without (n = 95) asthma who underwent ESS were compared with cohorts of patients from the national Medical Expenditures Survey Panel (MEPS) database who underwent medical management for chronic rhinosinusitis (CRS). Baseline, 1\u2010year, and 2\u2010year health utility values were calculated from responses to the EuroQol\u20105 Dimension (EQ\u20105D) instrument in both cohorts. The primary outcome measure was the incremental cost effectiveness ratio (ICER) for each cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The reference cases for CRSwNP patients with and without asthma yielded ICERs for ESS vs medical therapy alone of $12,066 per quality\u2010adjusted life year (QALY) and $7,369 per QALY, respectively. At a willingness\u2010to\u2010pay threshold of $50,000\/QALY, the ICER scatter plots demonstrated 86% and 99% certainty that the ESS strategy was the most cost\u2010effective option for CRSwNP patients with and without asthma, respectively. ESS was not significantly more cost effective for CRSwNP patients without asthma (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.494).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ESS remains cost effective compared to medical therapy for patients both with and without asthma. While the comorbidity of asthma results in an inferior ICER result, it does not result in a statistically significant negative impact on the overall cost effectiveness of ESS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.22013","type":"journal-article","created":{"date-parts":[[2017,9,5]],"date-time":"2017-09-05T12:22:44Z","timestamp":1504614164000},"page":"1035-1044","source":"Crossref","is-referenced-by-count":11,"title":["The impact of asthma on the cost effectiveness of surgery for chronic rhinosinusitis with nasal polyps"],"prefix":"10.1002","volume":"7","author":[{"given":"George A.","family":"Scangas","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School  Boston MA"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron K.","family":"Remenschneider","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School  Boston MA"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke M.","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of California Los Angeles  Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark G.","family":"Shrime","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School  Boston MA"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston MA"},{"name":"Program in Global Surgery and Social Change Harvard Medical School  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Metson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School  Boston MA"},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,5]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-010-0096-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2011.02709.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2015.29.4178"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(99)70117-X"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215110001003"},{"key":"e_1_2_6_7_1","first-page":"79","article-title":"Recurrence rates in endonasal surgery for polyposis","volume":"58","author":"Albu S","year":"2004","journal-title":"Acta Otorhinolaryngol Belg"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21674"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21182"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.13048"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21697"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24916"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24715"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25054"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814529536"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689709000803"},{"key":"e_1_2_6_17_1","volume-title":"Center for Financing, Access, and Cost Trends. 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