Journal
JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY
Volume 136, Issue 6, Pages 1532-+Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jaci.2015.10.012
Keywords
Chronic rhinosinusitis; sinusitis; patient-reported outcome measure; quality of life; systematic review; evidence-based medicine
Categories
Funding
- Acclarent
- Baxter
- Greer
- National Institute of Health/NIDCD [DC005805]
- Olympus
- Meda
- Entellus
- Intersect ENT
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Background: With a focus on patient-centered care, there is increasing policy interest in patient-reported outcome measures (PROMs) to inform improvements in health care delivery. Given the importance of understanding patient-reported outcomes during the management of chronic rhinosinusitis (CRS), PROMs will play an essential role in informing and tailoring the right intervention to the right patient. Objective: The objective of this systematic review was to identify and assess the quality of PROMs being used for adults with CRS. Methods: A systematic review of Ovid MEDLINE (R) (1947-May 2015), Embase, and the Cochrane databases was performed using the following key terms: [chronic'' AND *sinusitis''] AND [PROM OR patient reported outcome measure* OR quality of life OR questionnaire OR survey OR valid* OR develop*]. An unlimited truncation strategy (placement of *) was used to capture all variations of terms used. The quality of each PROM was assessed and reported using standardized criteria from the COnsensus-based Standards for the selection of health status Measurement INstruments checklist. Results: A total of 15 PROMs validated for use in adult patients with CRS were identified. Fourteen instruments were specific to adults with CRS, and one was a generic quality-of-life instrument (EuroQol five-dimensional questionnaire [EQ-5D]). There was significant variation in the quality of development and reporting of psychometric properties. Overall, the highest quality validated PROMs for adults with CRS were (1) the 22-item Sinonasal Outcome Test (19 points), (2) the Questionnaire of Olfactory Disorders (14 points), (3) the Sinusitis Control Test (14 points), and (4) the EQ-5D (13 points). Most of the PROMs were developed for research purposes such as determining changes in health-related quality of life or symptoms after an intervention as opposed to improving clinical decision making. Conclusions: Based on quality assessment, the 22-item Sinonasal Outcome Test, the Questionnaire of Olfactory Disorders, and the Sinusitis Control Test provided the highest quality CRS-specific PROMs, whereas the EQ-5D provided the highest quality generic quality-of-life instrument. Future CRS PROMs will need to incorporate clinical domains that assess common comorbid diseases along with patient values and preferences to improve clinical decision making.
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