Identifying the most important outcomes for systematic reviews of interventions for rhinosinusitis in adults: working with Patients, Public and Practitioners*

Introduction: Promoting the assessment of health interventions using outcomes that matter to patients and practitioners is a key principle of Cochrane. Cochrane UK therefore commissioned the OMIPP project: Outcomes that are Most Important for Patients, Public and Practitioners to identify the outcomes they felt most important and should be evaluated in Cochrane reviews of health interventions for Chronic Rhinosinusitis (CRS).
Methodology: Using direct emailing, social media and printed cards, an online survey was distributed to a wide range of people involved in the care of patients with CRS. Patients and practitioners were asked to list the 3 outcomes from treatments most important to them. Responses were analysed through development of a thematic framework based on the data.
Results: Two hundred and thirty-five people completed the survey; 155 practitioners and 80 patients. Respondents provided 653 suggestions of important outcomes. 73% concerned symptoms of CRS, (nasal discharge or drip, facial pain, nasal blockage, headache, impaired sense of smell, congestion and breathing difficulties); 9% concerned quality of life, 4% reducing the need for further treatment and 4% side effects of treatment. Objective measurements of disease formed only 3% of responses. There was high level of agreement between patients and practitioners. Of 10 current Cochrane reviews on CRS, 9 include symptomatic outcomes identified by our survey as most important to patients and healthcare practitioners.
Conclusions: We have identified outcomes that both patients and their doctors consider should be included in reviews evaluating treatments of rhinosinusitis. We recommend that primary outcomes in future reviews focus on symptom-based outcomes. The ability to extract these data from relevant trials is dependent upon their inclusion in trials, and so it is important that building on this work a core outcome set for rhinosinusitis research is developed.


Claire Hopkins1, Carl Philpott2, Sally Crowe3, Sandra Regan3, Aneeka Degun4, Iliatha Papachristou5, Anne G.M. Schilder4

1 Guy’s & St Thomas’ NHS Trust, King’s College London, United Kingdom
2 University East Anglia, Norwich and James Paget Hospital, Great Yarmouth, United Kingdom
3 Crowe Associates, Thame, United Kingdom
4 UCL Ear Institute, Royal National Throat, Nose and Ear Hospital, London, United Kingdom
5 Department of Applied Health Research, UCL, United Kingdom


Journal: Rhinology
Volume: 54
Issue: 1
Pages: 20 - 26
Year: 2016
DOI: 10.4193/Rhino15.199

Further Study Information

Current Stage: Not Applicable
Funding source(s):

Health Area

Disease Category: Ear, nose, & throat

Disease Name: Rhinosinusitis

Target Population

Age Range: 18 - 100

Sex: Either

Nature of Intervention: Any

Stakeholders Involved

- Clinical experts
- Patient/ support group representatives

Study Type

- Recommendations made for systematic reviews


- Survey
- Systematic review

Online survey to gather the outcomes for Cochrane Reviews in chronic rhinosinusitis that are important for patients, public and practitioners. The survey was developed following a review of the literature on outcomes used in chronic rhinosinusitis, and informed by the team’s experience with developing similar surveys for James Lind Alliance prioritisation projects. The survey was tested in a small group of practitioners and patients and modified to minimise respondent burden and to ensure acceptability to both. There were no predefined codes or prompts given to guide responses.

Patients and practitioners were asked to list the 3 outcomes from treatments most important to them. Responses were analysed through development of a thematic framework based on the data.