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Chronic Rhinosinusitis

We have been studying the epidemiology of chronic rhinosinusitis (CRS) in Geisinger's patients. This is a chronic condition with a significant patient and population disease burden. It has many links to environmental exposures. The EHI at Geisinger, in collaboration with Northwestern University, The University of Chicago and the Johns Hopkins Bloomberg School of Public Health, has been awarded a program project grant (PO1) by the NIH to study the epidemiology, genetics and pathobiology of chronic rhinosinusitis. The collaborative group, collectively known as the Chronic Rhinosinusitis Integrative Studies Program (CRISP), is the only PO1 recipient in the United States studying this common but poorly understood disease. Program project grants are more complex in scope and budget than individual research grants, and are made available to a group of several investigators with differing areas of expertise who wish to collaborate in research by pooling their talents and resources. These resources will fund continued studies examining the genetic, environmental, molecular and immunologic underpinnings of CRS in order to discover new means of treating this disease. Project 1 of the CRISP is focused on the epidemiology of CRS, using both electronic health records and new primary data collection consisting of surveys, sinus CT scans and sinus endoscopy in patients with nasal and sinus symptoms. This will allow us to develop new approaches to understanding the diagnosis, treatment, natural history and risk factors for this common, disabling condition. For more information on the NIH grant, see the abstract.


  • Cole M, Bandeen-Roche K, Hirsch AG, Kuiper JR, Sundaresan AS, Kern RC, Tan BK, Schleimer RP, Schwartz BS. Longitudinal evaluation of clustering of sinonasal and related symptoms using exploratory factor analysis. Allergy 2018; May 5.

  • Kuiper JR, Hirsch AG, Bandeen-Roche K, Sundaresan AS, Tan BK, Schleimer RP, Kern RC, Stewart WF, Schwartz BS. Prevalence and risk factors for acute exacerbations of nasal and sinus symptoms: a population-based, longitudinal cohort study in Pennsylvania. Allergy 2018, Jun;73(6):1244-53.

  • Sundaresan AS, Hirsch AG, Young AJ, Tan BK, Schleimer RP, Kern RC, Kennedy TL, Greene JS, Stewart WF, Bandeen-Roche K, Schwartz BS. Longitudinal evaluation of chronic rhinosinusitis symptoms in a population-based sample. J Allergy Clin Immunol Pract 2017, Jul 1;6(4):1327-35.

  • Stevens WW, Peters AT, Hirsch AG, Nordberg CM, Schwartz BS, Mercer DG, Mahdavinia M, Grammer LC, Hulse KE, Kern RC, Avila P, Schleimer RP. Clinical characteristics of patients with chronic rhinosinusitis with nasal polyps, asthma, and aspirin-exacerbated respiratory disease. J Allergy Clin Immunol Pract 2017; 5: 1061-1070.

  • Hirsch AG, Stewart WF, Sundaresan AS, Young AJ, Kennedy TL, Greene JS, Feng W, Tan BK, Schleimer RP, Kern RC, Lidder A, Schwartz BS. Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy2017; 72: 274-281.

  • Hirsch AG, Yan XS, Sundaresan AS, Tan BK, Schleimer RP, Kern RC, Kennedy TL, Greene JS, Schwartz BS. Five‐year risk of incident disease following a diagnosis of chronic rhinosinusitis. Allergy2015; 70: 1613-21.

  • Sundaresan A, Hirsch AG, Storm M, Tan BK, Kennedy TL, Greene JS, Schwartz BS. Occupational and environmental risk factors for chronic rhinosinusitis: a systematic review. Int Forum Allerg Rhinol2015; 5: 996-1003.

  • Ference EH, Stubbs V, Lidder AK, Chandra RK, Conley D, Avila PC, Hirsch AG, Min JY, Shintani Smith S, Kern RC, Tan BK. Measurement and comparison of health utility assessments in chronic rhinosinusitis. International forum of allergy & rhinology2015; 5: 929-936.

  • Lam K, Hirsch AG, Tan BK. The association of premorbid diseases with chronic rhinosinusitis with and without polyps. Current opinion in otolaryngology & head and neck surgery. 2014; 22: 231.

  • Tan BK, Chandra RK, Pollak J, Kato A Conley DB, Peters AT, Grammer LC, Avila PC, Kern RC, Stewart WF, Schwartz BS. Incidence and associated premorbid diagnosis of patients with chronic rhinosinusitis. J Allergy Clinical Immunology 2013; 131: 1350-60. 

  • Tan BK, Kern RB, Schleimer RP, Schwartz BS. Chronic rhinosinusitis - the unrecognized epidemic [editorial]. AJRCCM 2013; 188: 1275-7. 

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