{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T01:07:36Z","timestamp":1771463256398,"version":"3.50.1"},"reference-count":73,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,7,21]],"date-time":"2016-07-21T00:00:00Z","timestamp":1469059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Board Committee on Quality at the Massachusetts Eye and Ear Infirmary"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the cost\u2010effectiveness of endoscopic sinus surgery (ESS) compared to medical therapy for patients with chronic rhinosinusitis (CRS) with and without nasal polyposis (NP).<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cohort\u2010style Markov decision\u2010tree economic model with a 36\u2010year time horizon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two cohorts of 229 CRS patients with and without NP who underwent ESS were compared with a matched cohort of 229 CRS patients from the Medical Expenditures Survey Panel database (Agency for Healthcare Research and Quality, Rockville, MD) who underwent medical management. Utility scores were calculated from sequential patient responses to the EuroQol five\u2010dimensions questionnaire. Decision\u2010tree analysis and a 10\u2010state Markov model utilized published event probabilities and primary data to calculate long\u2010term costs and utility. The primary outcome was the incremental cost per quality\u2010adjusted life year (QALY). Thorough sensitivity analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The reference case for CRS with NP yielded an incremental cost\u2010effectiveness ratio (ICER) for ESS versus medical therapy of $5,687.41\/QALY. The reference case for CRS without NP yielded an ICER of $5,405.44\/QALY. The cost\u2010effectiveness acceptability curve in both cases demonstrated 95% certainty that the ESS strategy was the most cost\u2010effective option at a willingness\u2010to\u2010pay threshold of $20,000\/QALY or higher. These results were robust to one\u2010way and probabilistic sensitivity analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates the cost\u2010effectiveness of ESS compared to medical therapy alone for the management of CRS patients both with and without NP. The presence of nasal polyps was not found to affect the overall cost\u2010effectiveness of ESS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>2C. <jats:italic>Laryngoscope<\/jats:italic>, 127:29\u201337, 2017<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.26169","type":"journal-article","created":{"date-parts":[[2016,7,21]],"date-time":"2016-07-21T06:46:50Z","timestamp":1469083610000},"page":"29-37","source":"Crossref","is-referenced-by-count":39,"title":["Cost utility analysis of endoscopic sinus surgery for chronic rhinosinusitis with and without nasal polyposis"],"prefix":"10.1002","volume":"127","author":[{"given":"George A.","family":"Scangas","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron K.","family":"Remenschneider","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brooke M.","family":"Su","sequence":"additional","affiliation":[{"name":"School of Medicine University of California\u2013San Francisco San Francisco California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark G.","family":"Shrime","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Program in Global Surgery and Social Change Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Metson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Harvard Medical School Boston Massachusetts U.S.A."},{"name":"Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston Massachusetts U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,7,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2007.06.726"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000701"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/00034894041130S502"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25180"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.08.037"},{"key":"e_1_2_6_7_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_8_1","first-page":"1","article-title":"European Position Paper on Rhinosinusitis and Nasal Polyps 2012","volume":"3","author":"Fokkens WJ","year":"2012","journal-title":"Rhinol Suppl"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21697"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24916"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770005-6"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000147917.43615.c0"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-015-0566-5"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11882-014-0427-7"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24715"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25054"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814529536"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/014107689709000803"},{"key":"e_1_2_6_19_1","volume-title":"MEPS HC\u2010079: 2003 Full Year Consolidated Data File November 2005","year":"2005"},{"key":"e_1_2_6_20_1","volume-title":"Sample design of the Medical Expenditure Panel Survey Household Component, 1998\u20132007. 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