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Minimal clinically important difference for the 22‐item Sinonasal Outcome Test in medically managed patients with chronic rhinosinusitis
Author(s) -
Phillips Katie M.,
Hoehle Lloyd P.,
Caradonna David S.,
Gray Stacey T.,
Sedaghat Ahmad R.
Publication year - 2018
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13177
Subject(s) - minimal clinically important difference , medicine , chronic rhinosinusitis , receiver operating characteristic , physical therapy , observational study , prospective cohort study , sinus (botany) , randomized controlled trial , surgery , botany , biology , genus
Objective To determine the minimal clinically important difference (MCID) of the 22‐item Sinonasal Outcome Test (SNOT‐22) in individuals undergoing medical management for their chronic rhinosinusitis (CRS). Design Prospective observational study. Setting Academic, tertiary care centre. Participants A total of 247 adults undergoing medical management for CRS. Main outcome measure At enrolment, participants completed a SNOT‐22. At a subsequent follow‐up visit, 2‐12 months after enrolment, participants also completed a SNOT‐22. At follow‐up, participants also rated the change in their sinus symptoms and general health as “Much worse,” “A little worse,” “About the same,” “A little better” or “Much better” compared with enrolment; these two questions were used as sinus symptom and general health anchor questions, respectively. The SNOT‐22 MCID was calculated using distribution‐based, anchor‐based and receiver operating characteristic (ROC) curve‐based methods. Results Using the distribution‐based method, the SNOT‐22 MCID was 11.6. Using the sinus symptom anchor question, the SNOT‐22 MCID was 10.5; applying the ROC method to the sinus symptom anchor yielded an MCID of 12.5. In comparison, using the general health anchor question, the SNOT‐22 MCID was 8.3; applying the ROC method to the sinus symptom anchor yielded an MCID of 17.5. In all cases, the calculated MCID had a sensitivity of approximately 50‐60% and specificity of approximately 80‐90%. Conclusions Based on our results, we propose a SNOT‐22 MCID of 12 in medically managed patients with CRS. The MCID, while specific, was not sensitive for identifying patients with CRS experiencing a noticeable improvement in sinus symptoms or general health.