Disease Remission: A Scoping Review With Thematic Analysis of the Scientific Literature With Implications for Chronic Rhinosinusitis

Background Remission, a term used to describe a goal of treatment for some chronic diseases, has recently been proposed for chronic rhinosinusitis (CRS). However, it is unclear what remission means for CRS and why it should serve as a goal in the present‐day treatment of CRS. Methods Systematic literature search of PubMed, Embase, Scopus, and CINAHL databases for definitions of remission for chronic nonneoplastic diseases derived through consensus studies or society‐sponsored position papers. Remission definitions were extracted and common themes identified. Results Thirty‐nine definitions of remission were identified, the majority (29/39) of which were for inflammatory diseases. Remission uniformly was a term describing a state of completely inactive or minimally active disease, often defined by criteria including patient‐reported outcomes, clinician‐reported outcomes, and results from physical examination or serological, histologic, imaging findings, or other disease‐specific testing. Definitions varied in specifying different categories/levels of remission. However, most definitions stipulated a specific purpose for remission as providing a unique positive prognostic benefit to patients, commonly as cessation of end‐organ damage/disease progression. Diseases that also utilized control as an outcome differentiated remission as a state of lesser disease activity. Conclusions Commonalities from previously described remission definitions can be applied to define CRS remission as a state of minimal‐to‐no disease activity characterized by criteria reflecting the CRS disease process, the achievement of which would provide specific prognostic, future benefit to the patient. However, evidence is still lacking to support the utility or an exact definition of a remission construct for CRS.