Many people have blocked, stuffy and runny noses. Many are due to chronic rhinosinusitis (CRS). In 2015 the National Institute for Health Research (NIHR) in the UK identified CRS as a priority area and approached Cochrane ENT with a view to the group preparing (or updating) a suite of reviews addressing the most important topics in this area. Their proposal involved a fixed time period and fixed budget. The challenge for Cochrane ENT was to decide which reviews were the most important and how ‘big’ (or small) these were likely to be. Without this information it was difficult to estimate how many reviews could be prepared with the resources available. We were also aware that we had some reviews in this area already, and that many of these would need updating.
This presented a great opportunity to produce a suite of up-to-date reviews addressing the most important, highest priority uncertainties in a major clinical area.
In response to this request we undertook a scoping exercise over a period of two months and produced a document for the funders that contained a prioritised list of reviews, with a line drawn part way down the list. The six reviews above the line were prioritised and completed to the NIHR funding deadline. We have subsequently completed a further two reviews, with the most recent (on biologics) being undertaken as a 'living systematic review':
- Different types of intranasal steroids for chronic rhinosinusitis (2016)
- Intranasal steroids versus placebo or no intervention for chronic rhinosinusitis (2016)
- Saline irrigation for chronic rhinosinusitis (2016)
- Short-course oral steroids alone for chronic rhinosinusitis (2016)
- Short-course oral steroids as an adjunct therapy for chronic rhinosinusitis (2016)
- Systemic and topical antibiotics for chronic rhinosinusitis (2016)
- Topical and systemic antifungal therapy for chronic rhinosinusitis (2018)
- Biologics for chronic rhinosinusitis (2020 - living systematic review)
Further priority chronic rhinosinusitis reviews may include topical decongestants, antileukotriene antagonists, capsaicin and antihistamines.