{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T14:40:25Z","timestamp":1780584025964,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,4,26]],"date-time":"2020-04-26T00:00:00Z","timestamp":1587859200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000241","name":"Physicians' Services Incorporated Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000241","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To compare costs and quality\u2010adjusted life years of patients receiving endoscopic polypectomy in the clinic those receiving endoscopic sinus surgery from the perspective of Canada's health system.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We developed a Markov model to simulate costs and quality\u2010adjusted life years among a cohort of patients with chronic rhinosinusitis with polyps who received endoscopic polypectomy in clinic or endoscopic sinus surgery, over a patient's lifetime. Our study focused on patients with chronic rhinosinusitis with polyps who have the predominant symptom of bilateral nasal obstruction. Cost data were obtained from Canadian sources. Health utility values were derived from Sino\u2010nasal Outcome Test (SNOT\u201022) scores reported in the published literature. A cycle length of six months was used. Both costs and quality\u2010adjusted life years were discounted using an annual rate of 1.5%. We conducted one\u2010way and probabilistic sensitivity analyses to assess the robustness of the study findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Endoscopic polypectomy in clinic was a cost\u2010saving option as it had a lower cost (C$736 vs. C$6,728) and produced more quality\u2010adjusted life years (13.85 vs 13.06) compared to endoscopic sinus surgery. Our findings were, however, highly sensitive to health utility values. Results from probabilistic sensitivity analysis showed that endoscopic polypectomy in clinic had a lower cost and was more effective compared to endoscopic sinus surgery in 99.86% of iterations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>From the perspective of the publicly funded healthcare system, endoscopic polypectomy in clinic was economically attractive compared to endoscopic sinus surgery for chronic rhinosinusitis with polyps patients who have a primary symptom of bilateral nasal obstruction. The cost\u2010effectiveness results are, however, highly dependent on the relative impact of endoscopic polypectomy in the clinic and endoscopic sinus surgery on post\u2010surgery health utility values.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.13533","type":"journal-article","created":{"date-parts":[[2020,3,30]],"date-time":"2020-03-30T09:39:12Z","timestamp":1585561152000},"page":"477-485","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Cost\u2010effectiveness of Endoscopic Polypectomy in Clinic compared to Endoscopic Sinus Surgery: A modelling study"],"prefix":"10.1111","volume":"45","author":[{"given":"Srishti","family":"Kumar","sequence":"first","affiliation":[{"name":"Ottawa Hospital Research Institute The Ottawa Hospital Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4738-8447","authenticated-orcid":false,"given":"Kednapa","family":"Thavorn","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute The Ottawa Hospital Ottawa ON Canada"},{"name":"School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada"},{"name":"Institute of Clinical and Evaluative Sciences University of Ottawa Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasha","family":"van Katwyk","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute The Ottawa Hospital Ottawa ON Canada"},{"name":"School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lasso","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute The Ottawa Hospital Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaun J","family":"Kilty","sequence":"additional","affiliation":[{"name":"Ottawa Hospital Research Institute The Ottawa Hospital Ottawa ON Canada"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Ottawa Ottawa ON Canada"},{"name":"Dr. S. Kilty Medicine Prof Corp Ottawa ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,4,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200307000-00016"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2500\/aap.2013.34.3675"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000701"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.08.037"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.21053\/ceo.2015.01053"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4193\/Rhin17.115"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12473"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1997.01900060037006"},{"key":"e_1_2_10_10_1","volume-title":"Guidelines for the economic evaluation of health technologies: Canada","author":"Canadian Agency for Drugs & Technologies in Health","year":"2017"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24213"},{"key":"e_1_2_10_12_1","unstructured":"Statistics Canada. 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