PMID- 28556611
OWN - NLM
STAT- MEDLINE
DCOM- 20180426
LR  - 20181113
IS  - 2042-6984 (Electronic)
IS  - 2042-6976 (Print)
IS  - 2042-6976 (Linking)
VI  - 7
IP  - 8
DP  - 2017 Aug
TI  - Defining the minimal clinically important difference for olfactory outcomes in 
      the surgical treatment of chronic rhinosinusitis.
PG  - 821-826
LID - 10.1002/alr.21964 [doi]
AB  - BACKGROUND: Olfactory dysfunction is a common and defining symptom of chronic 
      rhinosinusitis (CRS). Many measures of olfactory dysfunction in CRS are limited 
      by scoring criteria defined within general populations with interpretations of 
      statistical significance to infer clinically meaningful improvement. In this 
      investigation we define a minimal clinically important difference (MCID) for the 
      Brief Smell Identification Test (BSIT) in CRS patients electing endoscopic sinus 
      surgery (ESS). METHODS: A multicenter cohort of 290 adult patients electing ESS 
      for medically recalcitrant CRS were prospectively enrolled between March 2011 and 
      June 2015 and completed BSIT evaluations before and after ESS. Distribution and 
      anchor-based analytic approaches were utilized to define MCID values of the BSIT 
      across patient cofactors. RESULTS: A total of 92 ( reverse similar32%) patients were found to 
      have preoperative olfactory dysfunction (BSIT <9), significantly associated with 
      nasal polyposis (chi(2) = 35.0; p < 0.001). The effect-size distribution-based 
      approach identified 1.0 as a MCID criterion value between "small" and "medium" 
      effect (range, 0.61-1.52) overall. Significant mean postoperative change (DeltaM) was 
      reported for patients with olfactory dysfunction (DeltaM = 2.28; p < 0.001), both 
      with (n = 54; DeltaM = 2.52; p < 0.001) and without (n = 38; DeltaM = 1.95; p < 0.001) 
      nasal polyposis, significantly exceeding the MCID criterion. Anchor-based 
      approaches with regression modeling confirmed associations between MCID values 
      and postoperative changes to olfactory-specific survey responses (p < 0.001). 
      CONCLUSION: Clinically meaningful change in BSIT scores may be defined as an 
      absolute value difference of at least 1.0 unit for heterogeneous patients 
      electing ESS for CRS. Significantly exceeding this criterion may be restricted to 
      CRS patients with baseline olfactory dysfunction, regardless of nasal polyposis.
CI  - (c) 2017 ARS-AAOA, LLC.
FAU - Levy, Joshua M
AU  - Levy JM
AD  - Department of Otolaryngology-Head &, Neck Surgery, Sinus, Nasal &, Allergy 
      Center, Emory University School of Medicine, Atlanta, GA.
FAU - Mace, Jess C
AU  - Mace JC
AD  - Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and 
      Skull Base Surgery, Oregon Health &, Science University, Portland, OR.
FAU - Bodner, Todd E
AU  - Bodner TE
AD  - Department of Psychology, Portland State University, Portland, OR.
FAU - Alt, Jeremiah A
AU  - Alt JA
AD  - Department of Surgery, Division of Otolaryngology-Head &, Neck Surgery, 
      University of Utah, Salt Lake City, UT.
FAU - Smith, Timothy L
AU  - Smith TL
AD  - Department of Otolaryngology-Head and Neck Surgery, Division of Rhinology and 
      Skull Base Surgery, Oregon Health &, Science University, Portland, OR.
LA  - eng
GR  - KL2 TR001065/TR/NCATS NIH HHS/United States
GR  - R01 DC005805/DC/NIDCD NIH HHS/United States
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
DEP - 20170526
PL  - United States
TA  - Int Forum Allergy Rhinol
JT  - International forum of allergy & rhinology
JID - 101550261
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Chronic Disease
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Nasal Polyps/*surgery
MH  - Paranasal Sinuses/*surgery
MH  - Rhinitis/*surgery
MH  - Sinusitis/*surgery
MH  - *Smell
MH  - Young Adult
PMC - PMC5544549
MID - NIHMS874861
OTO - NOTNLM
OT  - chronic disease
OT  - olfaction
OT  - olfactory test
OT  - patient outcome assessment
OT  - quality of life
OT  - sinus surgery
OT  - sinusitis
COIS- Potential Conflicts of Interest: None
EDAT- 2017/05/31 06:00
MHDA- 2018/04/27 06:00
PMCR- 2018/08/01
CRDT- 2017/05/31 06:00
PHST- 2017/02/14 00:00 [received]
PHST- 2017/04/20 00:00 [revised]
PHST- 2017/05/04 00:00 [accepted]
PHST- 2017/05/31 06:00 [pubmed]
PHST- 2018/04/27 06:00 [medline]
PHST- 2017/05/31 06:00 [entrez]
PHST- 2018/08/01 00:00 [pmc-release]
AID - 10.1002/alr.21964 [doi]
PST - ppublish
SO  - Int Forum Allergy Rhinol. 2017 Aug;7(8):821-826. doi: 10.1002/alr.21964. Epub 
      2017 May 26.