1 Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
2 Department of Otolaryngology-Head and Neck Surgery, University of South Florida, Tampa, Florida, USA.
Otolaryngol Head Neck Surg. 2019 Mar;160(3):556-558. doi: 10.1177/0194599818811328. Epub 2018 Nov 6.
Large cohort studies of chronic rhinosinusitis (CRS) prevalence often include patients who have been inappropriately diagnosed with the disease. In this investigation, new patients presenting to a tertiary rhinology practice completed a screening questionnaire that included questions about self-reported CRS status, demographic information, and symptomatology. Treating rhinologists evaluated patients according to clinical practice guideline criteria for CRS; 91 patients were ultimately diagnosed with CRS. The sensitivity of self-report for CRS was 84%; the specificity was 82%; and the estimated negative predictive value ranged from 97% to 99%. Prior sinus surgery or oral steroid use correlated with CRS self-report, and a concurrent self-report of nasal polyps or nasal steroid use improved the positive predictive value of CRS self-report. Self-report of CRS status may represent an effective and relatively inexpensive screening mechanism for CRS in large cohort studies, particularly when combined with other associated diagnostic features that improve performance parameters of self-report.
大量的慢性鼻-鼻窦炎（CRS）患病率的队列研究通常包括被误诊的患者。在这项研究中，向一个三级鼻科实践中的新患者提供了一份筛选问卷，其中包括关于自我报告的 CRS 状态、人口统计学信息和症状的问题。根据 CRS 的临床实践指南标准，治疗性鼻科医生对患者进行评估；最终诊断为 91 例 CRS 患者。自我报告的 CRS 的敏感性为 84%；特异性为 82%；估计的阴性预测值范围为 97%至 99%。鼻窦手术或口服类固醇的使用与 CRS 的自我报告相关，同时报告鼻息肉或鼻用类固醇的使用则可提高 CRS 自我报告的阳性预测值。自我报告的 CRS 状态可能代表了一种有效的、相对便宜的大规模队列研究中 CRS 的筛查机制，尤其是与其他改善自我报告性能参数的相关诊断特征相结合时。
