xRead - Nasal Obstruction (September 2024) Full Articles

20426984, 2021, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22741 by Stanford University, Wiley Online Library on [01/07/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

246

International consensus statement on rhinosinusitis

FIGURE III-1 Results of a PubMed search for the terms “sinusitis” or “rhinosinusitis” by year of publication. The dotted line represents the cut-off for evidence considered in the ICAR-RS-2016 document. Nearly 7000 RS articles have been published since that time.

patient solely based on what is written in this or any other similar document. The recommendations are based on the evidence from the study populations, which may or may not apply to the particular patient the provider is treating. The clinician must recognize the tremendous variability both between subsets of RS and within each subset, espe cially CRS. Patients with CRS can be mildly symptomatic or highly symptomatic; they may have limited findings on endoscopy or CT or complete involvement of all sinuses; they may be presenting for diagnosis and management for the first time or after many failed treatments or even after multiple surgeries. To assume that 1 patient is just like the other – and to apply the findings in this document under such an assumption – is not consistent with the practice of evidence-based medicine. Lastly, the recommendations herein should not be viewed as static. As new and stronger evidence emerges, they will necessarily have to undergo reevaluation and possibly change. This ICAR-RS-2021 update of the ICAR RS-2016 represents just such a reevaluation. We continue to hope that this summary will guide all who care for RS patients, empowering all of us with the knowledge we need to provide our patients with the best possible outcome.

FIGURE III-2 The practice of evidence-based medicine. Adapted from: Armstrong EC, Harnessing new technologies while preserving basic values, Fam Sys and Health . 21:351-355, 2003.

standard of care nor do they define medical necessity. Health care providers or any others should not assume that a particular treatment is or is not indicated in an individual