Clinical decision support system RHINA in the diagnosis and treatment of acute or chronic rhinosinusitis

Abstract

Background: Rhinosinusitis is an inflammation of the sinonasal cavity which affects roughly one in seven people per year. Upper respiratory tract infection (RTI) is mostly, apart from allergic etiology, caused by a viral infection and, in some cases (0.2 - 2 %), by a bacterial superinfection. Antibiotics, indicated only in rare cases according to EPOS guidelines, are nevertheless prescribed in more than 80% of ARS cases, which increases the resistant bacterial strains in the population. Methods: We have designed a clinical decision support system (CDSS), RHINA, based on a web application created in HTML 5, using JavaScript, jQuery, CCS3 and PHP scripting language. The presented CDSS RHINA helps general physicians to decide whether or not to prescribe antibiotics in patients with rhinosinusitis.Results: In a retrospective study of a total of 1,465 patients with rhinosinusitis, the CDSS RHINA presented a 90.2% consistency with the diagnosis and treatment made by the ENT specialist. Conclusion: Patients assessed with the assistance of our CDSS RHINA would decrease the over-prescription of antibiotics, which in turn would help to reduce the bacterial resistance to the most commonly prescribed antibiotics.