Evaluation of the Patient Global Impression of Symptom Severity (PGISS) Score as a Subjective and Objective Measure of Disease Activity in Chronic Rhinosinusitis.
Subin Lim, Daniel Trotier, Matvey Karpov, Joseph Han, Kent Lam
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引用次数: 0
Abstract
Background: The Sino-nasal Outcome Test (SNOT-22) is a 22-question survey that is utilized to evaluate health-related quality of life of patients with chronic rhinosinusitis (CRS). The Patient Global Impression Symptom Severity (PGISS) is a similar yet versatile instrument that combines features of both a Likert scale and a visual analog to assess symptom severity in CRS patients. While previous studies have evaluated the validity of SNOT-22 as an instrument to measure CRS patients' symptom severity, no studies have evaluated PGISS scale's ability to evaluate and guide treatment plans for CRS patients.
Objective: The primary objective of this study was to analyze the clinical utility of PGISS in assessing subjective symptom severity and objective disease status in CRS patients. We additionally aimed to investigate if PGISS scores could serve as predictors for treatment strategies in CRS patients.
Methods: Electronic medical records of CRS patients were retrospectively reviewed between January 2020 and January 2021 from Eastern Virginia Medical School and Sentara Healthcare. Information on demographics, objective disease metrics, treatment, and labs were collected. Statistical analyses were conducted using SAS 9.4 software.
Results: A total of 150 patients were included in our study. A statistically significant positive correlation was found between PGISS and SNOT-22 scores (r(131) = 0.701, P < .0001). Patients with moderate to severe PGISS scores had significantly higher odds of changing their treatment course (odds ratio [OR] = 6.813, P = .001, and OR = 5.491, P = .018, respectively). Additionally, patients with severe PGISS scores had decreased odds of receiving biological intervention (OR = 0.048, P = .043), but they had considerably higher odds of pursuing surgery (OR = 15.939, P = .046). No significant associations were seen between PGISS scores and receiving topical steroids, systematic steroids, nonsteroidal medical treatment, or imaging interventions (P > .05).
Conclusion: Clinicians may consider using the PGISS scale as an alternative method to the SNOT-22 to evaluate subjective symptom severity and guide treatment plans for patients with CRS.
背景：鼻结果测试（SNOT-22）是一项包含22个问题的调查，用于评估慢性鼻窦炎（CRS）患者的健康相关生活质量。患者整体印象症状严重程度（PGISS）是一种类似但多功能的仪器，结合了李克特量表和视觉模拟的特征来评估CRS患者的症状严重程度。虽然已有研究评估了SNOT-22作为衡量CRS患者症状严重程度的工具的有效性，但没有研究评估PGISS量表评估和指导CRS患者治疗方案的能力。目的：本研究的主要目的是分析PGISS在评估CRS患者主观症状严重程度和客观疾病状态中的临床应用。此外，我们旨在调查PGISS评分是否可以作为CRS患者治疗策略的预测因子。方法：回顾性分析2020年1月至2021年1月来自东弗吉尼亚医学院和Sentara Healthcare的CRS患者的电子病历。收集了人口统计学、客观疾病指标、治疗和实验室的信息。采用SAS 9.4软件进行统计学分析。结果：共纳入150例患者。PGISS与SNOT-22评分呈显著正相关(r(131) = 0.701, P P =。001, OR = 5.491, P =。018年,分别)。此外，PGISS评分严重的患者接受生物干预的几率较低（OR = 0.048, P = 0.043），但他们接受手术的几率较高（OR = 15.939, P = 0.046）。PGISS评分与接受局部类固醇、系统类固醇、非类固醇药物治疗或影像学干预之间无显著相关性（P < 0.05）。结论：临床医生可考虑使用PGISS量表替代SNOT-22量表评估CRS患者主观症状严重程度，指导CRS患者的治疗方案。
期刊介绍：
The American Journal of Rhinology & Allergy is a peer-reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials, and review articles.
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