Spanish consensus on the management of chronic rhinosinusitis with nasal polyps (POLIposis NAsal / POLINA 2.0).

Abstract

Chronic rhinosinusitis with nasal polyps (CRSwNP) is a high prevalent and burdensome disease for individuals and health systems which management involves many specialties: otorhinolaryngology, allergology, pulmonology, primary care, pharmacy, and paediatrics. A multidisciplinary approach and the participation of the patient in decision making are essential, both for the diagnosis and for the therapeutic strategy. The authors of the consensus aim to translate the current knowledge into an easy-to-read practical guide and emphasize those aspects in which there is still discussion or unmet needs due to the lack of proper scientific evidence. An iterative approach for the development of an evidence-based systematic review with recommendations was used, using a standard quality assessment scheme (Scottish Intercollegiate Guidelines Network -SIGN- and National Institute for Health and Care Excellence -NICE-), and a critical evaluation of the guideline has been carried out through the instrument Appraisal of Guidelines for Research and Evaluation (AGREE II) and Recommendation Excellence (AGREE REX). Based on the foregoing, the POLINA has been considered a guideline of good quality by an independent agency. The POLINA consensus contributes with new schemes for the definition of control, therapeutic management including severity evaluation and surgery, and indications for biologic use and response. Finally, this guideline focuses on the research unmet needs in CRSwNP.