Health utility outcomes in patients undergoing medical management for chronic rhinosinusitis: a prospective multiinstitutional study.

Background: A health utility value represents an individual's preference for living in a specific health state and is used in cost-utility analyses. This study investigates the impact of continuing medical therapy on health utility outcomes in patients with chronic rhinosinusitis (CRS). Methods: The Medical Outcomes Study Short Form- 6D (SF-6D) questionnaire was administered to patients prospectively enrolled in a longitudinal study examining treatment outcomes for CRS. Patients were prescribed robust, initial medical therapy and then elected to continue with medical therapy (n = 40) or undergo endoscopic sinus surgery (ESS), followed by medical therapy (n = 152). Patients observed through treatment crossover to ESS were also evaluated (n = 20). Health utility values (SF-6D) were generated at baseline, 6-months, and 12-months follow-up for both cohorts and evaluated using repeated measures analysis of variance (ANOVA). Results: Treatment crossover patients were found to have a significantly higher prevalence of previous sinus surgery compared to medical management (χ² = 6.91; p = 0.009) and surgical intervention (χ² = 8.11; p = 0.004) subgroups. Mean baseline utility value for the medical therapy cohort was significantly better compared to the ESS cohort (mean ± standard deviation; 0.76 ± 0.12 vs 0.70 ± 0.15; p = 0.023). Significant improvement in health utility was reported in the ESS cohort (F(2) = 37.69; p < 0.001), whereas values remained stable, without significant improvement, in both themedical therapy cohort (F(2) =0.03; p=0.967) and treatment crossover cohort (F(2) = 2.36; p = 0.115). Conclusion: Patients electing continued medical management report better baseline health utility compared to patients electing ESS. Patients electing ESS show signifi- cant improvement in health utility, whereas those electing continuedmedical management demonstrate stable health utility over 12 months. [ABSTRACT FROM AUTHOR]