PMID- 27377575
OWN - NLM
STAT- MEDLINE
DCOM- 20170804
LR  - 20181113
IS  - 1531-4995 (Electronic)
IS  - 0023-852X (Print)
IS  - 0023-852X (Linking)
VI  - 127
IP  - 1
DP  - 2017 Jan
TI  - Low 22-item sinonasal outcome test scores in chronic rhinosinusitis: Why do 
      patients seek treatment?
PG  - 22-28
LID - 10.1002/lary.26157 [doi]
AB  - OBJECTIVES/HYPOTHESIS: Patients with chronic rhinosinusitis (CRS) who experience 
      minimal reductions in quality of life (QoL) may present for treatment despite QoL 
      scores comparable to controls without CRS. This study seeks to identify cofactors 
      influencing patients with CRS and low 22-item Sinonasal Outcome Test (SNOT-22) 
      scores to seek care. STUDY DESIGN: Prospective, multicenter, observational 
      cohort. METHODS: Patients with CRS were enrolled between April 2011 and September 
      2015. Patients with sinonasal mucocele or unilateral sinus opacification were 
      excluded. Control subjects without CRS were enrolled for comparison. Low-SNOT CRS 
      was defined as a SNOT-22 score < 20. RESULTS: A total of 774 subjects (low-SNOT 
      CRS, n = 38; high-SNOT CRS, SNOT-22 >/= 20, n = 641; controls without CRS, n = 95) 
      were enrolled. Low SNOT scores were identified in 6% of subjects with CRS. After 
      adjustment, low-SNOT CRS and control groups without CRS reported similar baseline 
      average SNOT-22 total scores (P = .879). Unexpectedly, compared to controls, 
      low-SNOT CRS patients had significantly better average psychological (2.1 +/- 2.3 
      vs. 5.8 +/- 6.0; P = .030) and sleep dysfunction (2.7 +/- 3.4 vs. 6.0 +/- 5.2; P = 
      .016) scores. Fourteen of 38 (37%) low-SNOT patients elected to undergo 
      endoscopic sinus surgery (ESS), with a significantly lower likelihood of 
      reporting a minimal clinically important difference (MCID) when compared to 
      high-SNOT patients (43% vs. 82%; P < .001) after a mean follow-up of  approximately 15 months. 
      CONCLUSIONS: Low-SNOT CRS patients represent an outlier population for which 
      measures of QoL fail to identify factors influencing the decision to seek 
      treatment. Low-SNOT CRS patients electing ESS have a decreased likelihood of 
      reporting MCIDs following ESS. Further study is required to identify novel 
      factors associated with treatment-seeking behavior in this population. LEVEL OF 
      EVIDENCE: 3B Laryngoscope, 127:22-28, 2017.
CI  - (c) 2016 The American Laryngological, Rhinological and Otological Society, Inc.
FAU - Levy, Joshua M
AU  - Levy JM
AD  - Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, 
      Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science 
      University, Portland, Oregon, U.S.A.
FAU - Mace, Jess C
AU  - Mace JC
AD  - Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, 
      Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science 
      University, Portland, Oregon, U.S.A.
FAU - Rudmik, Luke
AU  - Rudmik L
AD  - Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, 
      University of Calgary, Calgary, Alberta, Canada.
FAU - Soler, Zachary M
AU  - Soler ZM
AD  - Department of Otolaryngology-Head and Neck Surgery, Medical University of South 
      Carolina, Charleston, South Carolina, U.S.A.
FAU - Smith, Timothy L
AU  - Smith TL
AD  - Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center, 
      Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science 
      University, Portland, Oregon, U.S.A.
LA  - eng
SI  - ClinicalTrials.gov/NCT01332136
GR  - R01 DC005805/DC/NIDCD NIH HHS/United States
GR  - R03 DC013651/DC/NIDCD NIH HHS/United States
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
DEP - 20160705
PL  - United States
TA  - Laryngoscope
JT  - The Laryngoscope
JID - 8607378
SB  - IM
MH  - Chronic Disease
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Patient Acceptance of Health Care
MH  - Patient Reported Outcome Measures
MH  - Prospective Studies
MH  - *Quality of Life
MH  - Rhinitis/*therapy
MH  - *Severity of Illness Index
MH  - Sinusitis/*therapy
PMC - PMC5177462
MID - NIHMS793120
OTO - NOTNLM
OT  - Outcome assessment (health care)
OT  - healthy volunteers
OT  - patient outcome assessment
OT  - quality of life
OT  - therapeutics
COIS- None to report
EDAT- 2016/07/06 06:00
MHDA- 2017/08/05 06:00
PMCR- 2018/01/01
CRDT- 2016/07/06 06:00
PHST- 2016/04/19 00:00 [received]
PHST- 2016/05/23 00:00 [revised]
PHST- 2016/06/01 00:00 [accepted]
PHST- 2016/07/06 06:00 [pubmed]
PHST- 2017/08/05 06:00 [medline]
PHST- 2016/07/06 06:00 [entrez]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.1002/lary.26157 [doi]
PST - ppublish
SO  - Laryngoscope. 2017 Jan;127(1):22-28. doi: 10.1002/lary.26157. Epub 2016 Jul 5.