Development and Preliminary Validation of a New Patient-Reported Outcome Measure for Chronic Rhinosinusitis (CRS-PRO)

Responsiveness and convergent validity of the chronic rhinosinusitis patient‐reported outcome (CRS‐PRO) measure in CRS patients undergoing endoscopic sinus surgery

“…These estimates were relatively convergent and we propose a CID of 6.0 because it represents the midpoint. Interestingly, we note this estimate of a CID of 6.0 was similar to an anchor-based estimate obtained in the study by Ghadersohi et al 15,16 but was not expounded upon due to smaller sample size in the study.…”

“…The responsiveness of the CRS-PRO total to ESS was observed to be at least as large as those observed with the SNOT-22. Compared to the changes we observed in the study by Ghadersohi et al, 15,16 larger effect sizes were noted following ESS than those with medical therapy (ESS ES: 1.44 vs. medical therapy ES: 0.95). This is consistent with the well-described overall quality of life improvement noted by patients following ESS and prior studies demonstrating that ESS generally results in larger symptomatic improvements than nonbiologic medical therapy for CRS.…”

“…In item selection, we prioritized elimination of highly duplicative items that were similar either conceptually or metrically and items not reported at significant burden to the CRS population. 15 Similar to prior studies, 2 we found that although the CRS-PRO captures both disease-specific and general health items important to CRS patients, it is more responsive than a general health measure such as the PROMIS domains.…”

“…This domain of the SNOT-22 also contains multiple items targeting the same concepts (i.e., "need to blow nose," "thick nasal discharge," and "runny nose") and uses items with compound descriptors (e.g., blockage/congestion of nose) potentially inflating the subdomain effect size. 15 We further note the CRS-PRO is also just over half the length of the SNOT-22, and is therefore a more convenient instrument for patients, researchers, and healthcare providers. It also has a shorter time frame of symptom assessment than the SNOT-22 (1 vs. 2 weeks, respectively), 11 and thus may be more appropriate for measuring acute exacerbations and symptom changes.…”

“…Modifications of existing PRO instruments also require patient involvement with cognitive interviews and item development. 14 To overcome the developmental limitations of the SNOT-22 and its predecessors, Ghadersohi et al 15,16 described the development of the CRS-PRO instrument, which extensively utilized patient input from patients with well-characterized CRSsNP and CRSwNP and included both patients who did or did not have prior sinus surgery to capture the full spectrum of disease severity. The CRS-PRO was subsequently shown to be valid and responsive in assessing symptom changes in medically treated CRS patients.…”