The Sino‐Nasal Outcome Test–22 as a tool to identify chronic rhinosinusitis in adults with cystic fibrosis

ARR Habib, BS Quon, JA Buxton… - … Forum of Allergy & …, 2015 - Wiley Online Library
ARR Habib, BS Quon, JA Buxton, S Alsaleh, J Singer, J Manji, PG Wicox, AR Javer
International Forum of Allergy & Rhinology, 2015•Wiley Online Library
Background Chronic rhinosinusitis (CRS) is becoming increasingly prevalent in adults with
cystic fibrosis (CF), as the median age of survival rises for these individuals. Delayed
identification of CRS may contribute to worsening health‐related quality of life and increased
treatment burden. Our objective was to investigate the utility of the 22‐item Sino‐Nasal
Outcome Test (SNOT‐22) as a tool to identify CRS in adults with CF. Methods In this cross‐
sectional study, participants were sampled from an adult‐specific CF clinic in Vancouver …
Background
Chronic rhinosinusitis (CRS) is becoming increasingly prevalent in adults with cystic fibrosis (CF), as the median age of survival rises for these individuals. Delayed identification of CRS may contribute to worsening health‐related quality of life and increased treatment burden. Our objective was to investigate the utility of the 22‐item Sino‐Nasal Outcome Test (SNOT‐22) as a tool to identify CRS in adults with CF.
Methods
In this cross‐sectional study, participants were sampled from an adult‐specific CF clinic in Vancouver, Canada, between September 2013 and April 2014. CRS was determined by use of standardized diagnostic guidelines. Participants completed the SNOT‐22 and medical charts were reviewed for additional predictor variables. Logistic regression was used to compare the SNOT‐22 as a univariable predictor variable to a multivariable prediction model, in order to best differentiate CRS and non‐CRS participants.
Results
Ninety‐three of 101 adults provided written informed consent. The prevalence of CRS was 56.3% (95% confidence interval [CI], 45.9% to 66.3%). Individuals with CRS reported significantly higher SNOT‐22 scores than non‐CRS participants (mean difference: 13.9; 95% CI, 6.1 to 21.7). The optimal SNOT‐22 score to differentiate CRS was 21 out of 110 (sensitivity: 76%, specificity: 61%, positive predictive value: 71%, likelihood ratio: 1.9).
Conclusion
Compared to the current diagnostic gold standard, SNOT‐22 scores greater than 21 sufficiently identified adults with CF presenting with concomitant CRS. The SNOT‐22 is a simple instrument that can easily be implemented in adult CF clinics to assist care providers identify individuals requiring more detailed assessment or referral to a sinus clinic.
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