Patient‐reported disease control versus overall symptom severity as global metrics of chronic rhinosinusitis disease status

IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY
Ryan A. Cotter, Jack T. Garcia, Ahmed Alsayed, Sven Schneider, David T. Liu, Julia Eckl‐Dorna, Firas A. Houssein, Robby S. Boparai, Nikhil A. Parail, Matthew M. Chu, Josh C. Meier, Saad Alsaleh, Katie M. Phillips, Ahmad R. Sedaghat
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Abstract

BackgroundOverall 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.MethodsUsing 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.ResultsThe 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.ConclusionsPatients 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.
将患者报告的疾病控制情况与总体症状严重程度作为慢性鼻炎疾病状况的总体衡量标准
背景总体症状严重程度(OSS)和患者报告的慢性鼻炎(CRS)控制情况是CRS的总体测量指标,被认为是CRS疾病控制评估的共识和基本标准。我们试图确定这两个指标之间的功能关系。方法采用国际多中心混合方法设计,招募了 260 名 CRS 患者。采用视觉模拟量表测量 OSS 评分。患者报告的 CRS 控制情况分为 "控制"、"部分控制 "和 "未控制 "三种。12名参与者接受了半结构化访谈,讨论了OSS和患者报告的CRS控制情况。结果大多数受访者认为,OSS和患者报告的CRS控制情况衡量的是不同的概念--OSS只衡量症状,而患者报告的CRS控制情况更全面,不仅包括症状严重程度,还包括药物使用、活动障碍和病情加重等概念。尽管如此,OSS评分与患者报告的CRS控制情况密切相关(ρ = 0.67,p <0.001),并对患者报告的CRS控制情况有很高的预测性。OSS评分为>4(95%置信区间[CI]:1.8-4.2)时,在识别报告CRS未得到控制的患者方面具有74.7%的灵敏度和93.2%的特异性。OSS评分为>6.6(95% 置信区间:4.1-7.1)的患者,其报告CRS未受控制的敏感性为77.0%,特异性为75.9%。22项鼻窦结果测试评分也能预测患者报告的CRS疾病控制情况,但OSS的预测性明显更高。然而,从数量上看,OSS 与患者报告的 CRS 控制率高度相关,这可能反映了两者的冗余性。为便于使用,我们建议患者报告的 CRS 控制情况用 OSS <4 表示受控,4 ≤ OSS < 7 表示部分受控,OSS ≥ 7 表示 CRS 不受控制。
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来源期刊
CiteScore
11.70
自引率
10.90%
发文量
185
审稿时长
6-12 weeks
期刊介绍: International Forum of Allergy & Rhinologyis a peer-reviewed scientific journal, and the Official Journal of the American Rhinologic Society and the American Academy of Otolaryngic Allergy. International Forum of Allergy Rhinology provides a forum for clinical researchers, basic scientists, clinicians, and others to publish original research and explore controversies in the medical and surgical treatment of patients with otolaryngic allergy, rhinologic, and skull base conditions. The application of current research to the management of otolaryngic allergy, rhinologic, and skull base diseases and the need for further investigation will be highlighted.
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