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Aggregate evidence quality: B; overwhelmingly consistent evidence from observational studies.
Benefit Avoids exposure to radiation and costs of studies. Avoids unnecessary therapy for false-positive diagnoses. 
Harm None. 
Cost Avoids cost of imaging. 
Benefits-harm assessment Exclusive benefit. 
Value judgments Concern for unnecessary radiation and costs. 
Role of patient preference Limited. Parents may value a negative study and avoidance of antibiotics as worthy of radiation but panel disagrees. 
Intentional vagueness None. 
Exclusions Patients with complications of sinusitis. 
Strength Strong recommendation. 
Aggregate evidence quality: B; overwhelmingly consistent evidence from observational studies.
Benefit Avoids exposure to radiation and costs of studies. Avoids unnecessary therapy for false-positive diagnoses. 
Harm None. 
Cost Avoids cost of imaging. 
Benefits-harm assessment Exclusive benefit. 
Value judgments Concern for unnecessary radiation and costs. 
Role of patient preference Limited. Parents may value a negative study and avoidance of antibiotics as worthy of radiation but panel disagrees. 
Intentional vagueness None. 
Exclusions Patients with complications of sinusitis. 
Strength Strong recommendation. 
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