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. Acute rhinosinusitis (ARS) is mostly, apart from allergic etiology, caused by a viral infection and, in some cases (30–50%), 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 1465 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.

Identification of provider and patient characteristics associated with antibiotic prescription in the treatment of acute sinusitis

“…This study identified the gap between antibiotic prescribing guidelines and the clinical practice for treatment of acute sinusitis treatment in outpatient settings. Based on these findings, the antibiotic prescription rate among acute sinusitis cases is higher (90.8%) than reported in previous studies (Ginzburg et al, 2018;Hart et al, 2021;Hughes et al, 2020). Providers did not consistently adhere to the antibiotic prescribing guidelines for acute sinusitis.…”

“…This RCR found that 90.8% of acute sinusitis cases received an antibiotic prescription. Previous studies found that more than 80% of adult acute sinusitis cases received antibiotics (Hart et al, 2021; Hughes et al, 2020; & Ginzburg et al, 2018).…”

“…Approximately 90%–98% of acute sinusitis cases are viral (Seybold & Tse, 2020; Hughes et al, 2020). However, several studies demonstrated that antibiotics are prescribed in more than 80% of acute sinusitis cases (Hart et al, 2021; Hughes et al, 2020). Appropriate antibiotic prescribing for acute sinusitis treatment is crucial to mitigate antibiotic resistance threats.…”