Yim Michael T, Smith Kristine A, Alt Jeremiah A, Orlandi Richard R
Department of Otolaryngology - Head and Neck Surgery Louisiana State University Shreveport Shreveport Louisiana USA.
Section of Otolaryngology - Head and Neck Surgery University of Manitoba Winnipeg Canada.
Laryngoscope Investig Otolaryngol. 2021 Jan 23;6(1):58-63. doi: 10.1002/lio2.523. eCollection 2021 Feb.
Chronic rhinosinusitis (CRS) is a disease with significant impacts at both a societal and personal level. There has been an increase in emphasis on patient-centered care and patient outcomes, with value becoming a commonplace concept in health care systems. This review seeks to better define the value that endoscopic sinus surgery (ESS) provides in the treatment of CRS.
PubMed literature review.
A review of published literature related to ESS and its effects on CRS patients from multiple perspectives (quality outcomes, patient satisfaction, cost-effectiveness) was integrated and analyzed through the viewpoint of a value equation.
ESS provides long-term quality outcomes in both patient-reported outcome measures (PROMs) as well as in objective metrics for patients refractory to medical therapy. The vast majority undergoing ESS are satisfied both in the short and long-term with their decision to pursue surgery. Treatment of CRS with ESS is generally more cost-effective than continued medical therapy (CMT), especially in refractory patients. Taken together, the combination of improved outcomes as well as patient satisfaction after ESS in relation to the costs of surgery provides significant quantifiable value to CRS patients.
ESS clearly provides value in the treatment of CRS. Understanding both quality and outcome metrics along with patient expectations and priorities will assist providers in generating a more personalized and value-based approach to patients with CRS.
慢性鼻-鼻窦炎（CRS）是一种在社会和个人层面均产生重大影响的疾病。以患者为中心的医疗护理及患者治疗效果越来越受到重视，价值已成为医疗保健系统中一个常见的概念。本综述旨在更好地界定鼻内镜鼻窦手术（ESS）在CRS治疗中所提供的价值。
PubMed文献综述。
从价值等式的角度，对已发表的有关ESS及其对CRS患者影响的文献进行综述，这些文献从多个角度（质量效果、患者满意度、成本效益）进行了综合分析。
ESS在患者报告结局指标（PROMs）以及对药物治疗无效的患者的客观指标方面均提供了长期的质量效果。绝大多数接受ESS的患者在短期和长期内都对其接受手术的决定感到满意。与持续药物治疗（CMT）相比，ESS治疗CRS通常更具成本效益，尤其是在难治性患者中。综合来看，ESS术后改善的治疗效果以及患者满意度与手术成本相结合，为CRS患者提供了显著的可量化价值。
ESS在CRS治疗中显然具有价值。了解质量和结局指标以及患者的期望和优先事项，将有助于医疗服务提供者为CRS患者制定更个性化且基于价值的治疗方法。
5级。
