@article {Stankiewicz:July-August 2002:1050-6586:199,
	author = "Stankiewicz, James A.",
	author = "Chow, James M.",
	title = "A Diagnostic Dilemma for Chronic Rhinosinusitis: Definition Accuracy and Validity",
	journal = "American Journal of Rhinology",
	volume = "16",
	year = "July-August 2002",
	abstract = "<P></P><B>Background:</B> The current definition of chronic rhinosinusitis is a symptom-based definition with minimal reliance on objective information. Based on this definition, patients are diagnosed and treated with medical therapy. A computed tomography (CT) scan is obtained only if the patient is not improved after medical therapy. No study is available evaluating in an evidence-based manner the accuracy of the current definition and its impact on diagnosis and treatment. <P></P><B>Methods:</B> This study represents 78 patients evaluated in a prospective fashion who met the subjective criteria for the definition of chronic rhinosinusitis. All patients underwent a complete history with a questionnaire evaluating symptom severity, a physical exam including anterior rhinoscopy and endoscopy, and a CT scan obtained on the day of their initial visit. Objective CT scan findings were compared with the subjective findings and related to the ultimate diagnosis of chronic sinusitis. <P></P><B>Results:</B> Only 37/78 (47%) had a positive (+) CT scan, indicating demonstrable sinusitis. There also was no real difference in symptom severity between patients with positive (+) and negative (-) CT scanning. <P></P><B>Conclusion:</B> The current symptom-based definition of chronic sinusitis poorly predicts whether a patient truly has chronic sinusitis and needs reevaluation.",
	pages = "199-202(4)",
	url = "http://www.ingentaconnect.com/content/ocean/ajr/2002/00000016/00000004/art00004"
}