Sinusitis Algorithm

A nice Algorithm for the treatment of sinusitis.  Trouble is .. how to diagnose it?

As our friends across the pond remind us:

The clinical bottom line is that we don't have adequate diagnostic methods.

Tonight (this morning) I'm up finishing off a review of the literature for fpin on sinusitis. 

Alas, Medscape's review of sinusitis is written by a specialist - and is nearly 5 years old.  Specialists think differently about things  .. yet in fact the see less of this than we do.  Sinusitis accounts for roughly 1 million office visits a year in this country - most of them to primary care physicians.  We're the experts .. not the "experts."

Physician specialty is associated with differences in the evaluation and management of acute bacterial rhinosinusitis.

Otolaryngologists use more health care resources to diagnose and treat ABRS than primary care physicians despite an absence of evidence that such tests and treatments lead to better outcomes.

Writing the "Clinical Inquiry" has been MUCH harder than I anticipated.  I know the literature well, but it's been quite hard for me to 'find my voice.'  I think I'll stick with the less formal writing on the medlog.