Medical Student Columbia University Vagelos College of Physicians & Surgeons New York, New York
Background: Critical review of computed tomography (CT) imaging is essential in preoperative planning for endoscopic sinus surgery. In this study, we use a modified Delphi method to develop an optimized checklist that facilitates preoperative review of sinus CT imaging.
Methods: We performed a systematic review of PubMed, Embase, CINAHL, and Cochrane databases to identify existing checklists used to evaluate sinus CT imaging. An inclusive list of items from these checklists was compiled and the modified Delphi methodology was used to assign ranked priority. The process involved 14 rhinologists and had 3 phases: an initial survey with Likert priority (scale of 1-9) and 2 rounds of live discussion to confirm consensus selections.
Results: Initial literature review identified 81 articles; 29 were selected for full-length review. Ninety-nine possible checklist items were identified from literature review and panelist input. On initial survey, 64 items reached a consensus score of 7+ and 16 items had scores between 6-7; 4 of 16 borderline items were retained. The resulting 68-items were consolidated into a checklist of 35 items and divided into 2 sections: disease (11 items) and anatomy (24 items). Anatomic items were further subdivided based on sinus anatomy (6 subsections: nasal cavity, maxillary, ethmoid, sphenoid, frontal, skull base and orbit). Additionally, panelists identified 8 core facets of patient history to be considered prior to surgery.
Conclusion:A checklist for preoperative sinus CT imaging review with content validity was created based on literature review and a modified Delphi method. Implementation and further validation of the checklist as a resource for residents and medical students is a plausible next step.