In:
International Forum of Allergy & Rhinology, Wiley, Vol. 7, No. 2 ( 2017-02), p. 128-134
Kurzfassung:
Responsiveness, or sensitivity to clinical change, is important when selecting patient‐reported outcome measures (PROMs) for research and clinical applications. This study compares responsiveness of PROMs used in chronic rhinosinusitis (CRS) to inform the future development of a highly responsive instrument that accurately portrays CRS patients’ symptom experiences. Methods Adult CRS patients initiating medical therapy (MT; n = 143) or undergoing endoscopic sinus surgery after failing MT (ESS; n = 123) completed the 22‐item Sino‐Nasal Outcome Test (SNOT‐22), European Position Statement on Rhinosinusitis (EPOS) visual analog scale (VAS), and 29‐item Patient‐Reported Outcomes Measurement Information System (PROMIS‐29) at baseline and 3 months after treatment. Cohen's d and paired t statistics were used to evaluate the responsiveness of each measure. Results Fifty‐two (36.4%) subjects and 42 (34.1%) subjects in the MT and ESS groups, respectively, completed baseline and 3‐month questionnaires. Subjects with and without 3‐month data were similar with respect to baseline demographics, VAS scores, and SNOT‐22 scores ( p 〉 0.05). In MT patients, CRS‐specific measures, like VAS ( d = −0.58, p 〈 0.01; t = −1.81, p 〉 0.05) and SNOT‐22 ( d = −0.70, p 〈 0.01; t = −3.29, p 〈 0.05) scores, were more responsive than PROMIS‐29 general health domains ( p 〉 0.05 for Cohen's d ). In ESS patients, VAS ( d = −1.97; t = −9.63, both p 〈 0.01) and SNOT‐22 ( d = −1.56; t = −9.99, both p 〈 0.01) scores were similarly more responsive, although changes in PROMIS‐29 domains of Fatigue ( d = −0.82, p = 0.01; t = −4.63, p 〈 0.01), Sleep Disturbance ( d = −0.83; t = −3.77, both p 〈 0.01), and Pain Intensity ( d = −1.0; t = −5.67, both p 〈 0.01) were significant. All 22 individual SNOT‐22 items differed significantly after surgery, whereas only 8 items were consistently responsive after MT. Conclusions For both MT and ESS patients, CRS‐specific PROMs are more responsive to posttreatment clinical changes than general health measures. Still, the SNOT‐22 contains items that likely decrease its overall responsiveness. Our findings also indicate that existing PROMs had a greater response to ESS than MT.
Materialart:
Online-Ressource
ISSN:
2042-6976
,
2042-6984
DOI:
10.1002/alr.2017.7.issue-2
Sprache:
Englisch
Verlag:
Wiley
Publikationsdatum:
2017
ZDB Id:
2604059-1
