A framework for quality measurement in the presurgical care of chronic rhinosinusitis: a review from the Quality Improvement Committee of the American Rhinologic Society

Mattos, José L.; Soler, Zachary M.; Rudmik, Luke; Manes, Peter R.; Higgins, Thomas S.; Lee, Jivianne; Schneider, John S.; Setzen, Michael; Parasher, Arjun K.; Smith, Timothy L.; Stokken, Janalee K.

doi:10.1002/alr.22154

Cited by 8 publications

(9 citation statements)

References 36 publications

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“…), safety, or timeliness of care 277 . In 2018, the QI committee of the ARS developed a framework for quality measurement in the presurgical care of CRS termed “CRS Appropriate Presurgical Algorithm (CAPA).” Based on the available evidence, the following quality metrics were supported as part of the presurgical care for CRS: (1) a guideline‐based diagnosis should be verified, (2) appropriate medical management should be attempted, (3) a CT scan should be obtained, and (4) a patient‐centered discussion should take place encompassing risks and benefits of available treatment options, long‐term medical compliance, and patient preferences and expectations 278 . However, actual implementation and validation of this framework is still yet to be determined.…”

Section: General Concepts Of Rhinosinusitismentioning

confidence: 99%

“…The development of a sturdy definition of AMT remains elusive, likely due in part to the significant heterogeneity inherent in RS 278 . While there are numerous studies evaluating the efficacy of individual drug classes in the treatment of CRS, discussed elsewhere in this ICAR‐RS‐2021 document, there are no clinical trials evaluating the optimal combination of drugs.…”

Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

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International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

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414

423

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I. Executive Summary Background The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS.

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Section: General Concepts Of Rhinosinusitismentioning

confidence: 99%

Section: Surgery For Chronic Rhinosinusitismentioning

confidence: 99%

International consensus statement on allergy and rhinology: rhinosinusitis 2021

Orlandi

Kingdom

Smith

et al. 2021

Int Forum Allergy Rhinol

Self Cite

414

423

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“…Although this article focuses on the quality of surgical care for CRS, it is important to include aspects of preoperative care because this already sets the course for high-quality surgical care. The Quality Improvement Committee of the American Rhinologic Society has determined 4 important quality-relevant presurgical components of CRS care [27]. These are diagnosis, adequate medical management, patient-centered discussion of treatment options and appropriate follow-up private practice surgeon surgeon and staff staff private practice/hospital patient selection for surgery.…”

Section: Preoperative Carementioning

confidence: 99%

“…The best evidence exists for topical steroids with a large number of randomized placebo-controlled trials with improvement of subjective symptoms, polyp size and nasal air flow [32]. One article on quality of preoperative treatment identifies the best evidence for saline nasal rinsing and topical steroids [27]. It determines appropriate medical management as a minimum of topical corticosteroid therapy and saline irrigations before surgical intervention should be taken into consideration.…”

Section: Appropriate Medical Treatmentmentioning

confidence: 99%

Qualität in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen

Hildenbrand

Ketterer

2020

Laryngo-Rhino-Otol

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Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 ZusaMMenfassung Die endonasale endoskopische Nasennebenhöhlenchirurgie hat sich als Standard der operativen Therapie bei chronisch entzündlichen Erkrankungen der Nasennebenhöhlen etabliert. Eine Verbesserung der subjektiven Beschwerden und objektiven Befunde konnte in zahlreichen Studien nachgewiesen werden. Aufgrund der häufig beobachteten Diskrepanz zwischen objektiven und subjektiven Ergebnissen nach Nasennebenhöhlenchirurgie kommt der Messung des sog. patient reported outcome eine zunehmende Bedeutung zu. Qualität und Effizienz in der Medizin haben in den letzten Jahren zunehmend an Bedeutung gewonnen. In vielen Ländern und auch länderübergreifend wurden bereits durch Zusammenschluss von Experten, z.T unter Federführung verschiedener Fachgesellschaften, Initiativen zur Verbesserung der Qualität in der chirurgischen Versorgung gegründet.Die vorliegende Arbeit stellt eine Übersicht qualitätsrelevanter Faktoren in der chirurgischen Therapie chronisch entzündlicher Erkrankungen der Nasennebenhöhlen anhand der vorhandenen Literatur, v.a. der Prozess-und Ergebnisqualität, dar. Ein besonderes Augenmerk liegt auf der subjektiven Bewertung der Ergebnisqualität durch den Patienten.absTraCT Endonasal endoscopic surgery of the paranasal sinuses is the gold standard in surgical treatment of chronic inflammatory diseases of the paranasal sinuses. Improvement of subjective complaints and objective findings has been confirmed in numerous studies. Due to the discrepancy between objective and subjective results after paranasal sinus surgery, the assessment of patient reported outcomes has gained importance.Quality and efficiency in medicine became increasingly important during the last years. In many countries and transnationally, the association of experts, partly coordinated by different medical societies, led to initiatives focusing on improvement of the quality of surgical care. The present article represents an overview of quality-related factors in surgical treatment of chronic inflammatory diseases of the paranasal sinuses, summarizing the existing literature and focusing particularly on process and outcomes quality. Particular attention will be paid to the outcome quality individually assessed by the patients. S5Online publiziert: 16.03.2020 Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 Referat < 200 200 -400 Anzahl der Operationen Anzahl der Kliniken in % > 400 57,6 % 38,3 % 36,4 % 12,8 % städtisch/kirchlich/privat Uniklinik Krankenhaus S7 Hildenbrand T et al. Qualität in der chirurgischen … Laryngo-Rhino-Otol 2020; 99: S5-S33 Referat ren < 20 Operationen pro Jahr durch. Zwischen 20 und 50 Operationen werden von 38,4 % der Kliniken durchgeführt und mehr als 50 Operationen geben lediglich 2 % der Kliniken an (▶abb. 2). 83,1 % aller Kliniken gaben an, an einem interdisziplinären Tumorboard teilzunehmen und 68,4 % führen interdisziplinäre Tumoroperationen bei Erkrankungen der Nasennebenhöhle...

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“…Mattos et al . report on the recommendations from the American Rhinologic Society (ARS) Quality Improvement (QI) committee, defining a framework for QI, and also focusing primarily on patient selection and preoperative medical management.…”

mentioning

confidence: 99%