Alobid I, Colás C, Castillo J A, Arismendi E, Del Cuvillo A, Gómez-Outes A, Sastre J, Mullol J
Rhinology and Skull Base Unit, Department of Otorhinolaryngology, Hospital Clinic, Barcelona, Spain.
Universitat de Barcelona, Barcelona, Spain.
J Investig Allergol Clin Immunol. 2023 Oct 16;33(5):317-331. doi: 10.18176/jiaci.0910. Epub 2023 Apr 18.
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a highly prevalent and burdensome disease for both individuals and health systems. Its management involves many specialties, including otorhinolaryngology, allergology, pulmonology, primary care, pharmacy, and pediatrics. A multidisciplinary approach and the participation of the patient in decision-making are essential, both for diagnosis and for therapy. The authors of the consensus aim to translate current knowledge into an easy-to-read practical guide and emphasize those aspects requiring further discussion or with unmet needs owing to the lack of appropriate scientific evidence. An iterative approach for the development of an evidence-based systematic review with recommendations was followed using a standard quality assessment approach (Scottish Intercollegiate Guidelines Network [SIGN] and National Institute for Health and Care Excellence [NICE]). The guideline was critically evaluated using the Appraisal of Guidelines for Research and Evaluation (AGREE II) and Recommendation Excellence (AGREE REX) instruments. Consequently, POLINA has been considered a high-quality guideline by an independent agency. The POLINA consensus provides new definitions of control, therapeutic management (including surgery and evaluation of severity), indications for use of biologics, and response. Finally, this guideline focuses on unmet research needs in CRSwNP.
伴鼻息肉的慢性鼻-鼻窦炎（CRSwNP）是一种对个人和卫生系统而言都极为普遍且负担沉重的疾病。其管理涉及多个专科，包括耳鼻咽喉科、变态反应科、肺病科、初级保健科、药学和儿科。多学科方法以及患者参与决策对于诊断和治疗均至关重要。该共识的作者旨在将当前知识转化为一本易于阅读的实用指南，并强调那些因缺乏适当科学证据而需要进一步讨论或存在未满足需求的方面。采用标准质量评估方法（苏格兰校际指南网络[SIGN]和英国国家卫生与临床优化研究所[NICE]），遵循一种迭代方法来制定带有推荐意见的循证系统评价。使用研究与评价指南评估（AGREE II）和推荐卓越性（AGREE REX）工具对该指南进行了严格评估。因此，POLINA已被一个独立机构视为高质量指南。POLINA共识提供了控制、治疗管理（包括手术和严重程度评估）、生物制剂使用指征及反应的新定义。最后，本指南聚焦于CRSwNP中未满足的研究需求。
