The chronic rhinosinusitis practice parameter.

Area of Science:

• Allergy and Immunology
• Otolaryngology
• Pulmonology

Background:

• Chronic rhinosinusitis with nasal polyposis (CRSwNP) and aspirin-exacerbated respiratory disease (AERD) are complex conditions requiring evidence-based management strategies.
• The Allergy-Immunology Joint Task Force on Practice Parameters has developed new guidelines utilizing the GRADE framework.

Framework:

• The guidelines employ the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework to assess evidence quality and strength of recommendations.
• Recommendations focus on intranasal corticosteroids (INCS), biologics for CRSwNP, and aspirin therapy after desensitization (ATAD) for AERD.

Implementation:

• Conditional recommendations favor INCS over no INCS (low certainty evidence) and biologics over no biologics (moderate certainty evidence).
• Conditional recommendation favors ATAD over no ATAD (moderate certainty evidence) for AERD management.
• Guidelines detail patient-important outcomes, shared decision-making considerations, and comparative effectiveness of different treatment modalities.

Implications:

• Highlights the need for further research, including randomized controlled trials comparing treatment modalities.
• Emphasizes patient-centered care by detailing factors for shared decision-making regarding treatment efficacy, cost, and adverse effects.
• Provides a framework for clinicians managing CRSwNP and AERD, focusing on current evidence and future research directions.