Comment on the European position paper on diagnostic tools in rhinology â€" computational fluid dynamics.

We read with interest the excellent paper authored by Rimmer et al. (1) entitled The European Position Paper on Diagnostic Tools in Rhinology. The authors are to be commended for their comprehensive, up-to-date and thorough summary of available tests in the assessment of rhinologic function. The paper describes traditional tools used in nasal airway obstruction (NAO); including subjective patient reported outcome measure questionnaires (PROMs) such as the NOSE scale; tests that are subjective to the clinician, such as clinical examination, nasendoscopy and imaging; and objective tests such peak nasal inspiratory flow (PNIF), rhinomanometry (RM) and acoustic rhinometry (AR). Unfortunately, each of these readily available, traditional tools fail to meet several accepted criteria of an ideal diagnostic test (Table 1), as outlined (2,3). In our opinion, these limitations restrict the capacity of Rhinology to develop as a discipline founded on sound evidence-based science.