Measuring Success in Chronic Rhinosinusitis (AMW)
2021 AAO-HNSF Annual Meeting & OTO Experience
Despite the classic characterization of chronic rhinosinusitis (CRS) by sinonasal symptomatology, opportunities for success in the treatment of CRS can come in many forms, based on the many ways that CRS affects a patient. As an uncurable chronic inflammatory condition, CRS should be managed longitudinally with the goal of maintaining CRS control, i.e., keeping the manifestations of CRS within acceptable limits. Treatment decisions for CRS—including the need for escalation to endoscopic sinus surgery or the use of recently approved biological medications—are made in real-time based on a judgment of the degree of control of a patient’s CRS. Comprehensive knowledge of the many manifestations of CRS, as well as their sequelae, maximizes the likelihood of achieving treatment success by allowing the provider to measure, treat and improve the full breadth of CRS. Beyond sinonasal complaints, CRS disease manifestations are numerous—and can be measured with patient-centered outcomes, medically-informed (physician-driven) outcomes, and even societal/economic outcomes. Reflected by metrics of CRS disease burden—which include extra-nasal symptoms, systemic medication usage, acute exacerbation frequency and lost productivity—CRS disease manifestations reflect the truly “shared” nature of CRS disease perception. In this presentation, we will summarize the most up to date literature on discrete CRS disease manifestations that would be considered independent outcome measures and independent goals of treatment for CRS. We will discuss the significance of these independent outcome measures from the perspective of the patient from maximizing patient satisfaction and quality of life, the perspective of medical necessity and the perspective of society at large. By summarizing the full spectrum of CRS disease manifestations as goals of treatment, this lecture will increase the attendee’s potential for achieving success in treatment of CRS by illustrating the full breadth of outcomes that can be considered, targeted and judged by the provider during therapeutic intervention for CRS.
Credits
CME:1.0, MOC:1.0