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The usefulness of routine histopathology of bilateral nasal polyps – a systematic review, meta-analysis, and cost evaluation

Overview of attention for article published in Journal of Otolaryngology -- Head & Neck Surgery, November 2015
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Title
The usefulness of routine histopathology of bilateral nasal polyps – a systematic review, meta-analysis, and cost evaluation
Published in
Journal of Otolaryngology -- Head & Neck Surgery, November 2015
DOI 10.1186/s40463-015-0100-8
Pubmed ID
Authors

Jay SM Wong, Stephanie Hoffbauer, David H Yeh, Brian Rotenberg, Michael Gupta, Doron D Sommer

Abstract

Controversy regarding the usefulness of routine histopathological examination of bilateral nasal polyps removed during endoscopic sinus surgery to identify occult diagnoses still exists. There is a paucity of high-level evidence in the literature. A systematic review and meta-analysis was conducted. Two independent reviewers were used. Pooled proportions and numbers needed to screen were calculated. A cost per life year model was generated based on varying survival benefits and compared to other Canadian screening programs to provide financial context. Six studies (n = 3772 patients) were included. Of the 3772 patients, 3751 had a pre-operative clinical and post-operative pathological diagnosis of inflammatory nasal polyps. Agreement proportion was 99.44 %. There were 18 unexpected benign and three unexpected malignant diagnoses identified. This translated to a proportion of 0.48 and 0.08 % respectively. Number needed to screen was 210 and 1258 respectively. Pooled proportion for expected findings using a random effect model was 0.99 (95 % CI = 0.99-1). Pooled proportion for unexpected benign findings using a random effect model was 0.00522 (95 % CI = 0.00133-0.01). Pooled proportion for unexpected malignant findings using a random effect model was 0.00107 (95 % CI = 0.000147-0.00283). The cost to pick up one unexpected benign diagnosis was $14557.2. The cost to pick up 1 unexpected malignant diagnosis was $87204.56. Cost per quality life year calculated ranged from 3211.83 to $64677.58 based on varying assumptions on the survival benefits of identifying an unexpected malignancy. Routine pathological examination in screening for neoplasia may be low yield, however, no compelling evidence was found to cease such practice. Surgeons should exercise individual judgment in requesting routine examination.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 27 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 27 100%

Demographic breakdown

Readers by professional status Count As %
Student > Doctoral Student 4 15%
Student > Master 3 11%
Student > Postgraduate 2 7%
Researcher 2 7%
Lecturer 1 4%
Other 5 19%
Unknown 10 37%
Readers by discipline Count As %
Medicine and Dentistry 12 44%
Unspecified 1 4%
Psychology 1 4%
Pharmacology, Toxicology and Pharmaceutical Science 1 4%
Chemistry 1 4%
Other 1 4%
Unknown 10 37%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 July 2016.
All research outputs
#6,083,793
of 8,019,263 outputs
Outputs from Journal of Otolaryngology -- Head & Neck Surgery
#154
of 199 outputs
Outputs of similar age
#168,919
of 244,562 outputs
Outputs of similar age from Journal of Otolaryngology -- Head & Neck Surgery
#14
of 14 outputs
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So far Altmetric has tracked 199 research outputs from this source. They receive a mean Attention Score of 1.8. This one is in the 14th percentile – i.e., 14% of its peers scored the same or lower than it.
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We're also able to compare this research output to 14 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.