Responsiveness and Convergent Validity 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

“…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.…”

“…At 3 months, Unlike our prior study of patients receiving medical therapy for CRS, the CRS-PRO and its factors did not correlate well with objective endoscopic and CT measures in this patient population. 16 Multiple prior studies have similarly not been able to find a strong correlation between PROMs and objective findings such as a CT scan in presurgical CRS patients. [36][37][38] A possible explanation for the differences seen in our current study are that our prior study correlated changes in the objective measures and the changes in the CRS-PRO in the same patients thus accounting for the variability of individual symptom reporting.…”

“…There were some significant though anticipated differences in the comorbidities and demographics for the CRSsNP and CRSwNP phenotypes, consistent with prior studies. 16,[32][33][34] Baseline mean Lund-Mackay CT score for the group of patients with 3-month follow-up was 12.8 ± 4.8. Baseline mean modified Lund-Kennedy endoscopic score for this group was 3.9 ± 3.1.…”

“…CRSwNP patients had a greater CT score (15.4 ± 4.7) than those with CRSsNP (10.6 ± 3.7) and greater endoscopy score (5.1 ± 3.0 in CRSwNP, 2.9 ± 2.8 in CRSsNP), which was consistent with prior studies. 16…”

“…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.…”