Katie M Phillips1,2, Lloyd P Hoehle1,2, David S Caradonna1,3, Stacey T Gray1,2, Ahmad R Sedaghat1,2,3,4. 1. Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts. 2. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts. 3. Division of Otolaryngology, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 4. Department of Otolaryngology and Communications Enhancement, Boston Children's Hospital, Boston, Massachusetts.
Abstract
OBJECTIVE: To determine the minimal clinically important difference (MCID) of the 22-item Sinonasal Outcome Test (SNOT-22) in individuals undergoing medical management for their chronic rhinosinusitis (CRS). DESIGN: Prospective observational study. SETTING: Academic, tertiary care centre. PARTICIPANTS: A total of 247 adults undergoing medical management for CRS. MAIN OUTCOME MEASURE: At enrolment, participants completed a SNOT-22. At a subsequent follow-up visit, 2-12 months after enrolment, participants also completed a SNOT-22. At follow-up, participants also rated the change in their sinus symptoms and general health as "Much worse," "A little worse," "About the same," "A little better" or "Much better" compared with enrolment; these two questions were used as sinus symptom and general health anchor questions, respectively. The SNOT-22 MCID was calculated using distribution-based, anchor-based and receiver operating characteristic (ROC) curve-based methods. RESULTS: Using the distribution-based method, the SNOT-22 MCID was 11.6. Using the sinus symptom anchor question, the SNOT-22 MCID was 10.5; applying the ROC method to the sinus symptom anchor yielded an MCID of 12.5. In comparison, using the general health anchor question, the SNOT-22 MCID was 8.3; applying the ROC method to the sinus symptom anchor yielded an MCID of 17.5. In all cases, the calculated MCID had a sensitivity of approximately 50-60% and specificity of approximately 80-90%. CONCLUSIONS: Based on our results, we propose a SNOT-22 MCID of 12 in medically managed patients with CRS. The MCID, while specific, was not sensitive for identifying patients with CRS experiencing a noticeable improvement in sinus symptoms or general health.
OBJECTIVE: To determine the minimal clinically important difference (MCID) of the 22-item Sinonasal Outcome Test (SNOT-22) in individuals undergoing medical management for their chronic rhinosinusitis (CRS). DESIGN: Prospective observational study. SETTING: Academic, tertiary care centre. PARTICIPANTS: A total of 247 adults undergoing medical management for CRS. MAIN OUTCOME MEASURE: At enrolment, participants completed a SNOT-22. At a subsequent follow-up visit, 2-12 months after enrolment, participants also completed a SNOT-22. At follow-up, participants also rated the change in their sinus symptoms and general health as "Much worse," "A little worse," "About the same," "A little better" or "Much better" compared with enrolment; these two questions were used as sinus symptom and general health anchor questions, respectively. The SNOT-22 MCID was calculated using distribution-based, anchor-based and receiver operating characteristic (ROC) curve-based methods. RESULTS: Using the distribution-based method, the SNOT-22 MCID was 11.6. Using the sinus symptom anchor question, the SNOT-22 MCID was 10.5; applying the ROC method to the sinus symptom anchor yielded an MCID of 12.5. In comparison, using the general health anchor question, the SNOT-22 MCID was 8.3; applying the ROC method to the sinus symptom anchor yielded an MCID of 17.5. In all cases, the calculated MCID had a sensitivity of approximately 50-60% and specificity of approximately 80-90%. CONCLUSIONS: Based on our results, we propose a SNOT-22 MCID of 12 in medically managed patients with CRS. The MCID, while specific, was not sensitive for identifying patients with CRS experiencing a noticeable improvement in sinus symptoms or general health.
Authors: Rehab Talat; Katie M Phillips; David S Caradonna; Stacey T Gray; Ahmad R Sedaghat Journal: Eur Arch Otorhinolaryngol Date: 2019-07-15 Impact factor: 2.503
Authors: Leigh J Sowerby; Krupal B Patel; Crystal Schmerk; Brian W Rotenberg; Taciano Rocha; Doron D Sommer Journal: J Otolaryngol Head Neck Surg Date: 2021-04-23
Authors: David T Liu; Katie M Phillips; Firas A Houssein; Marlene M Speth; Gerold Besser; Christian A Mueller; Ahmad R Sedaghat Journal: Laryngoscope Date: 2022-03-30 Impact factor: 2.970
Authors: Nadim Saydy; Sami P Moubayed; Marie Bussières; Arif Janjua; Shaun Kilty; François Lavigne; Eric Monteiro; Smriti Nayan; Marilou Piché; Kristine Smith; Doron Sommer; Leigh Sowerby; Marc A Tewfik; Ian J Witterick; Erin Wright; Martin Desrosiers Journal: J Otolaryngol Head Neck Surg Date: 2021-06-16