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- EPOS2020: development strategy and goals for the latest European Position Paper on RhinosinusitisPublication . Fokkens, W; Desrosiers, M; Harvey, R; Hopkins, C; Mullol, J; Philpott, C; Alobid, I; Lima, W T Anselmo; Bachert, Claus; Baroody, F; Bernal-Sprekelsen, M; von Buchwald, C; Cervin, A; Cohen, Noam; Constantinidis, J.; De Gabory, L.; Douglas, R; Gevaert, P; Hafner, A; Hellings, Peter; Joos, G; Kalogjera, L; Kern, R; Knill, A; Kocks, J; Landis, Basile; Limpens, J.; Lebeer, S.; Lourenço, Olga; Matricardi, P M; Meco, C; O Mahony, L.; Reitsma, S; Ryan, D; Schlosser, R; Senior, B; Smith, T; Teeling, T.; Tomazic, Peter Valentin; Toppila-Salmi, S; Wang, D Y; Wang, D; Zhang, L; Lund, VBackground: The European Position Papers on Rhinosinusitis from 2005, 2007 and 2012 have had a measurable impact on the way this common condition with high impact on quality of life is managed around the world. EPOS2020 will be the latest iteration of the guideline, addressing new stakeholders and target users, presenting a summary of the latest literature and evolving treatment modalities, and formulating clear recommendations based on all available evidence. Methodology: Based on the AGREE II framework, this article demonstrates how the EPOS2020 steering group will address six key areas to ensure consistency in quality and presentation of information in the latest rhinosinusitis clinical practice guideline: scope and purpose; stakeholder involvement; rigour of development; clarity of presentation; recommendations and applicability; editorial independence. Results: By analysing the guidance from AGREE II, we formulated a detailed development strategy for EPOS2020. We identify new stakeholders and target users and ratify the importance of patient involvement in the latest EPOS guideline. New and expanded areas of research to be addressed are highlighted. We confirm our intention to use mixed methodologies, combining evidencebased medicine with real life studies; when no evidence can be found, use Delphi rounds to achieve clear, inclusive recommendations. We also introduce new concepts for dissemination of the guideline, using Internet and social media to improve accessibility. Conclusion: This article is an introduction to the EPOS2020 project, and presents the key goals, core stakeholders, planned methodology and dissemination strategies for the latest version of this influential guideline.
- European Position Paper on Rhinosinusitis and Nasal Polyps 2020Publication . Fokkens, W.J.; Lund, V.J.; Hopkins, C.; Hellings, Peter; Kern, R.; Reitsma, S.; Toppila-Salmi, S.; Bernal-Sprekelsen, M.; Mullol, J.; Alobid, I.; Terezinha Anselmo-Lima, W.; Psaltis, A.; Wagenmann, M.M.; Shkoukani, M.; Pugin, B.; Raftopulos, M.; Rombaux, P.; Sahtout, S.; Sarafoleanu, C.-C.; Searyoh, K.; Rhee, C.-S.; Joos, G.F.; Baroody, F.; Shukuryan, A.K.; Sicak, M.; Smyth, D.; Snidvongs, K.; Kosak, T.S.; Stjarne, P.; Meco, C.; Sutikno, B.; Thanaviratananich, S.; Baudoin, T.; Tran, T.; Urbancic, J.; Valiulis, Arunas; Aparício, C. V. de; Vicheva, D.; Wang, D.Y.; Virkkula, P.M.; Wardani, R.S.; Baban, M.A.; Welge-Lussen, A.; O Mahony, L.; Witterick, I.; Wright, E.; Zabolotniy, D.; Zsolt, B.; Al-Qudah, M.; Zwetsloot, C.P.; Cohen, Noam; Wang, D.; Constantinidis, J.; Zhang, L.; Kalogjera, L.; De Gabory, L.; Desrosiers, M.; Diamant, Z.; Douglas, R.G.; Gevaert, P.H.; Hafner, A.; Harvey, R.J.; Alsaleh, S.; Knill, A.; Kocks, J.H.; Landis, Basile; Limpens, J.; Lebeer, S.; Lourenço, Olga; Elfarouk, A.; Matricardi, P.M.; Philpott, C.M.; Ryan, D.; Schlosser, R.; Senior, B.; Smith, T.L.; Teeling, T.; Grgic, V.; Tomazic, Peter Valentin; Agius, A.M.; Onerci, M.; Ahlstrom-Emanuelsson, C.; Alabri, R.; Albu, S.; Alhabash, S.; Aleksic, A.; Kamel, R.; Aloulah, M.; Balvers, T.; Okano, M.; Battaglia, P.; Hamizan, A.W.; Bedoya, J.D.; Beule, A.; Bofares, K.M.; Braverman, I.; Tshipukane, D.N.; Brozek-Madry, E.; Richard, B.; Karpischenko, S.; Callejas, C.; Kariyawasam, H.H.; Eloy, P.H.; Carrie, S.; Caulley, L.; Chussi, D.; de Corso, E.; Coste, A.; Devyani, L.; El Hadi, U.; Obando-Valverde, A.; Farrokhi, S.; Felisati, G.; Ferrari, M.D.; Fishchuk, R.; Grayson, J.W.; Goncalves, P.M.; Shi, J.; Grdinic, B.; Heinichen, J.V.; Husain, S.; Ping, T.I.; Ivaska, J.; Jakimovska, F.; Jovancevic, L.; Steinsvag, S.; Kakande, E.; Kjeldsen, A.; Cervin, A.; Klimek, L.; Kim, S.W.; Letort, J.J.; Lopatin, A.; Mahdjoubi, A.; Vicente, G.; Netkovski, J.; Ong, Y.K.; von Buchwald, C.; Orlandi, R.; Tantilipikorn, P.; Ouennoughy, K.; Ozkan, M.; Peric, A.; Plzak, J.; Bachert, Claus; Prokopakis, E.; Prepageran, N.; Voegels, R.The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.