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Background: Overall symptom severity (OSS) and patient-reported chronic rhinosinusitis (CRS) control are global measures of CRS identified as consensus, essential criteria for CRS disease control assessment. We sought to determine the functional relationship between these two metrics., Methods: Using an international multicenter mixed-methods design, 260 CRS patients were recruited. OSS score was measured using a visual analog scale. Patient-reported CRS control was measured as "controlled," "partly controlled," and "uncontrolled." Twelve participants underwent semi-structured interviews to discuss OSS and patient-reported CRS control., Results: The majority of interviewed participants felt OSS and patient-reported CRS control measured different constructs-while OSS only measured symptoms, patient-reported CRS control was more global, including not only symptom severity but also concepts such as medication usage, activity impairment, and exacerbations. Nevertheless, OSS score was strongly correlated with (ρ = 0.67, p < 0.001) and highly predictive of patient-reported CRS control. OSS score of >4 (95% confidence interval [CI]: 1.8-4.2) had 74.7% sensitivity and 93.2% specificity in identifying patients reporting their CRS as not controlled. OSS score of >6.6 (95% CI: 4.1-7.1) had 77.0% sensitivity and 75.9% specificity in identifying patients reporting their CRS as uncontrolled. The 22-item Sinonasal Outcome Test score was also predictive of patient-reported CRS disease control but OSS was significantly more predictive., Conclusions: Patients conceptually view patient-reported CRS control as a more global measure that subsumes OSS. Quantitatively, however, OSS is highly correlated with patient-reported CRS control, possibly reflecting their redundancy. For ease of use, we recommend patient-reported CRS control be reflected by OSS <4 for controlled, 4 ≤ OSS < 7 for partly controlled, and OSS ≥7 for uncontrolled CRS., (© 2024 The Author(s). International Forum of Allergy & Rhinology published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngic Allergy and American Rhinologic Society.)

Objective: To identify predictors of chronic rhinosinusitis (CRS) in patients presenting with the chief complaint of nasal allergies., Study Design: Cross-sectional study., Setting: Tertiary care, academic center., Methods: Clinical and demographic characteristics were collected from participants who were patients presenting with the chief complaint of nasal allergies. From all participants, a 22-item Sinonasal Outcome Test (SNOT-22) was collected, and a modified Lund-Kennedy endoscopy score was calculated from nasal endoscopy. Association was sought between having CRS and variables of clinical and demographic characteristics, SNOT-22, and endoscopy score., Results: A total of 219 patients were recruited and 91.3% were diagnosed with allergic rhinitis; 45.2% were also diagnosed with CRS. Approximately half of the patients with CRS reported no intranasal corticosteroid usage. Having CRS was associated with male sex (odds ratio [OR] = 2.29, 95% confidence interval [CI]: 1.30-4.04, P = .004), endoscopy score (OR = 1.96, 95% CI: 1.59-2.42, P < .001), and the SNOT-22 nasal subdomain score (OR = 1.07, 95% CI: 1.03-1.11, P = .001) related to SNOT-22 items: "need to blow nose," "thick nasal discharge," "sense of taste/smell," and "blockage/congestion of nose." At least moderate (item score ≥3) "blockage/congestion of nose" or "thick nasal discharge," mild "need to blow nose" (item score ≥2) or very mild decreased "sense of taste/smell" (item score ≥1), and any nasal endoscopy findings (endoscopy score ≥1) were statistically significant predictors of CRS., Conclusion: Moderate or more severe nasal obstruction or discharge symptoms, any decreased sense of smell/taste, or positive nasal endoscopy findings in patients believing they have allergic rhinitis should prompt further evaluation of CRS to avoid delays in treatment., (© 2024 The Authors. Otolaryngology–Head and Neck Surgery published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Objective: Previous work has shown the chemosensory dysfunction item of the 22-item Sinonasal Outcome Test (SNOT-22) that assesses problems with "taste/smell" has poor psychometric performance compared with other items on the SNOT-22, which we have hypothesized is due to the simultaneous assessment of two different senses. Our aim was to determine whether distinct smell and taste items in the SNOT-22 would improve psychometric performance., Methods: One hundred and eighty-one CRS patients were recruited and completed the SNOT-22. Additional items querying problems with the senses of "smell" and "taste," using the same response scale and recall period were given to study participants. Item response theory (IRT) was used to determine IRT parameters, including item discrimination, difficulty, and information provided by each SNOT-22 item., Results: Confirming previous studies, the chemosensory item of the SNOT-22 (reflecting "taste/smell") had poor psychometric performance. Use of a distinct smell or taste item instead of the combined "taste/smell" item did not improve psychometric performance. However, a dedicated smell question resulted in a left shift of threshold parameters, showing that the dedicated smell item better captures moderate CRS disease burden than the original taste/smell item of the SNOT-22, which by virtue of near-identical IRT parameters appears to more greatly reflect problems with taste., Conclusions: A dedicated smell- or taste-specific item, rather than the combined "taste/smell" item currently in the SNOT-22 does not provide significantly greater psychometric performance. However, a dedicated smell item may better capture moderate CRS disease burden compared with the current chemosensory item on the SNOT-22. Laryngoscope, 132:1644-1651, 2022., (© 2022 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

The burden of chronic rhinosinusitis (CRS) symptomatology is frequently measured with the 22-item Sinonasal Outcome Test (SNOT-22). In some situations, such as when there is need for frequent sampling, a full SNOT-22 may be impractical, and an abbreviated measure may be useful. Herein, we study 4 questions reflecting the 4 SNOT-22 subdomains as accurate reflections of SNOT-22 content. In total, 250 patients with CRS completed a SNOT-22 and answered 4 questions about their total nasal symptoms, poor sleep quality, ear/facial pain, and mood (reflecting SNOT-22 subdomains) using visual analog scales (VASs). The 4 SNOT-22 subdomain VAS scores each correlated strongly with the corresponding SNOT-22 subdomain scores. The sum of the 4 subdomain question VAS scores was highly correlated with the total SNOT-22 score ( r = 0.77, P < .001). This preliminary study suggests information from the SNOT-22 may be ascertained through 4 questions reflecting the 4 SNOT-22 subdomains, although further validation is needed.

Objectives: Recently, a set of consensus criteria and near‐consensus criteria for the evaluation of chronic rhinosinusitis (CRS) disease control was identified by an international multidisciplinary panel of key stakeholders. The objective of this study is to evaluate patient perspectives on these disease control criteria. Methods: This is a qualitative phenomenological study using constant comparative methodology. Twenty‐one one‐on‐one interviews, ranging from 6 to 15 min and based on a standardized semi‐structured script, with CRS patients from diverse backgrounds were performed. The authors analyzed transcripts of the interviews to identify recurrent themes in patient responses. Conclusions were drawn based on these themes. Results: All participants agreed with the consensus criteria (overall symptom severity, nasal obstruction severity, patients' self‐assessed CRS control, and need for CRS‐related oral corticosteroids), and most participants agreed with near‐consensus criteria (nasal endoscopy, smell loss and nasal drainage severities, impairment of day‐to‐day activities, and overall quality of life) identified by the international multidisciplinary panel. Some patients disagreed with inclusion of smell loss due to common etiologies—such as post‐viral or iatrogenic causes—that would not necessarily be an indicator of active sinonasal inflammation. One theme that emerged was the need for a facial pain/pressure criterion to be added. Conclusions: CRS patients overwhelmingly affirmed recently described consensus and near‐consensus criteria for CRS disease control with the caveat that a question asking about facial pain/pressure should be included as well. Recently, identified consensus criteria for CRS disease control should be interpreted within the context of patient perspectives. [ABSTRACT FROM AUTHOR]

Background: Existing patient-reported outcome measures (PROMs) for chronic rhinosinusitis (CRS) use a variety of recall periods and response scales to assess CRS symptom burden. Global perspectives of CRS patients regarding optimal recall periods and response scales for CRS PROMs are unknown. Methods: This was a multi-center, cross-sectional study recruiting 461 CRS patients from sites across the United States, Saudi Arabia, New Zealand, and Austria. Participants chose which CRS symptom recall period (1 day, 2 weeks, 1 month, >1 month) was most reflective of their current disease state and upon which to best base treatment recommendations (including surgery). Participants also chose which of six response scales (one visual analogue scale and five Likert scales ranging from four to eight items) was easiest to use, understand, and preferred. Results: A plurality of participants (40.0%) felt their CRS symptoms' current state was best reflected by a 1-month recall period. However, most patients (56.9%) preferred treatment recommendations to be determined by symptoms experienced over a >1 month period. The four- and five-item Likert scales were the easiest to understand (26.0% and 25.4%, respectively) and use (23.4% and 26.7%, respectively). The five-item (26.4% rating it most preferred and 70.9% rating it preferred) and four-item Likert (22.3% rating it most preferred and 56.4% rating it preferred) response scales were most preferred. Conclusion: Future PROMs for CRS should consider assessment of symptoms over a 1-month period and use a four- or five-itemLikert response scale to reflect global patient preferences. These findings also inform interpretation of current CRS PROMs. [ABSTRACT FROM AUTHOR]