Katie M Phillips1,2, Lloyd P Hoehle3, David S Caradonna1,4, Stacey T Gray1,2, Ahmad R Sedaghat1,2,4,5. 1. Department of Otolaryngology, Harvard Medical School, Boston, MA. 2. Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boston, MA. 3. Edward Via College of Osteopathic Medicine-Carolinas, Spartanburg, SC. 4. Division of Otolaryngology, Beth Israel Deaconess Medical Center, Boston, MA. 5. Department of Otolaryngology and Communications Enhancement, Boston Children's Hospital, Boston, MA.
Abstract
BACKGROUND: The minimal clinically important difference (MCID) of the 22-item Sino-Nasal Outcome Test (SNOT-22) is specific but not sensitive for identifying patients experiencing noticeable improvement in symptoms of chronic rhinosinusitis (CRS). It is unclear why some patients with less than 1 MCID change in SNOT-22 score nevertheless report noticeable improvement in their CRS symptoms. METHODS: This investigation was a retrospective study of 247 CRS patients undergoing medical management who completed SNOT-22 surveys in 2 consecutive visits 2-12 months apart. The validated nasal, sleep, ear/facial discomfort, and emotional SNOT-22 subdomain scores were calculated. At the second visit, patients reported their global change in CRS symptoms on a 5-item transition rating scale as: "Much worse"; "A little worse"; "About the same"; "A little better"; or "Much better." Patient-reported improvement in symptoms (at least "A little better") was tested for association with changes in SNOT-22 subdomain scores. RESULTS: In the entire cohort, patient-reported improvement in CRS symptoms was associated with improvement in all SNOT-22 subdomain scores (p < 0.001). In patients with less than 1 MCID (12 points) of change in the SNOT-22, only the nasal subdomain (adjusted odds ratio, 0.89; 95% confidence interval [CI], 0.79-0.99; p = 0.042) was associated with patient-reported improvement in CRS symptoms. Changes in none of the other SNOT-22 subdomain scores were associated with patient-reported improvement in CRS symptoms. CONCLUSIONS: Among patients with less than 1 MCID change in the SNOT-22, improvement in only nasal symptoms-but not extranasal symptoms-of CRS is associated with those who nevertheless report improvement of their CRS symptoms.
BACKGROUND: The minimal clinically important difference (MCID) of the 22-item Sino-Nasal Outcome Test (SNOT-22) is specific but not sensitive for identifying patients experiencing noticeable improvement in symptoms of chronic rhinosinusitis (CRS). It is unclear why some patients with less than 1 MCID change in SNOT-22 score nevertheless report noticeable improvement in their CRS symptoms. METHODS: This investigation was a retrospective study of 247 CRSpatients undergoing medical management who completed SNOT-22 surveys in 2 consecutive visits 2-12 months apart. The validated nasal, sleep, ear/facial discomfort, and emotional SNOT-22 subdomain scores were calculated. At the second visit, patients reported their global change in CRS symptoms on a 5-item transition rating scale as: "Much worse"; "A little worse"; "About the same"; "A little better"; or "Much better." Patient-reported improvement in symptoms (at least "A little better") was tested for association with changes in SNOT-22 subdomain scores. RESULTS: In the entire cohort, patient-reported improvement in CRS symptoms was associated with improvement in all SNOT-22 subdomain scores (p < 0.001). In patients with less than 1 MCID (12 points) of change in the SNOT-22, only the nasal subdomain (adjusted odds ratio, 0.89; 95% confidence interval [CI], 0.79-0.99; p = 0.042) was associated with patient-reported improvement in CRS symptoms. Changes in none of the other SNOT-22 subdomain scores were associated with patient-reported improvement in CRS symptoms. CONCLUSIONS: Among patients with less than 1 MCID change in the SNOT-22, improvement in only nasal symptoms-but not extranasal symptoms-of CRS is associated with those who nevertheless report improvement of their CRS symptoms.
Authors: Marlene M Speth; Katie M Phillips; Lloyd P Hoehle; David S Caradonna; Stacey T Gray; Ahmad R Sedaghat Journal: Eur Arch Otorhinolaryngol Date: 2019-07-19 Impact factor: 2.503
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: 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: David T Liu; Martin Schally; Sven Schneider; Julia Eckl-Dorna; Katie M Phillips; Christian A Mueller; Ahmad R Sedaghat; Gerold Besser Journal: Eur Arch Otorhinolaryngol Date: 2021-04-20 Impact factor: 2.503