Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Shreveport, Shreveport, LA, USA.
Division of Otolaryngology-Head and Neck Surgery, University of Utah, Salt Lake City, UT, USA.
Ann Otol Rhinol Laryngol. 2021 Nov;130(11):1220-1227. doi: 10.1177/0003489421998213. Epub 2021 Mar 4.
The SNOT-22 is a validated and widely used outcomes tool in chronic rhinosinusitis (CRS). We hypothesized that SNOT-22 scores and response patterns could be used as a diagnostic tool to differentiate between patients with CRS and those who present with CRS-like symptoms but prove not to have CRS.
METHODOLOGY/PRINCIPAL: SNOT-22 measurements were collected from 311 patients who presented with a chief complaint of sinusitis to a tertiary rhinology practice. Following a full diagnostic evaluation, patients were diagnosed with CRS or determined to have non-CRS diagnoses. A response pattern "heatmap" of the SNOT-22 scores for each group was compared. An optimal cutoff point for total SNOT-22 score in predicting CRS was sought using a receiver operating characteristic (ROC) curve.
A total of 109 patients were diagnosed with CRS and 202 patients were assigned to non-CRS. The non-CRS SNOT-22 total score histogram had lower overall scores compared to the CRS group, although there was substantial overlap. The CRS SNOT-22 heatmaps had a distinctive pattern compared to the non-CRS group. As individual measures, 3 of the 4 cardinal symptoms of CRS (nasal congestion, loss of smell, and rhinorrhea) were found to be significantly different between the 2 groups ( < .002). However, the ROC analysis showed the total SNOT-22 score to be a poor instrument to differentiate CRS from non-CRS patients.
Our results cause us to reject our hypothesis and conclude that, while an effective outcomes tool, the SNOT-22 (using total score and response pattern) is a poor differentiator between CRS and non-CRS patients.
SNOT-22 是一种经过验证且广泛应用于慢性鼻鼻窦炎（CRS）的疗效评估工具。我们假设 SNOT-22 评分和应答模式可作为一种诊断工具，以区分 CRS 患者和表现为 CRS 样症状但经证实无 CRS 的患者。
方法/原理：我们从一家三级鼻科诊所因鼻窦炎就诊的 311 例患者中收集了 SNOT-22 评分。在进行全面的诊断评估后，患者被诊断为 CRS 或确定为非 CRS 诊断。比较了两组的 SNOT-22 评分应答模式“热图”。使用受试者工作特征（ROC）曲线寻求预测 CRS 的总 SNOT-22 评分的最佳截断点。
共有 109 例患者被诊断为 CRS，202 例患者被诊断为非 CRS。与 CRS 组相比，非 CRS 的 SNOT-22 总分直方图的总分较低，尽管存在大量重叠。CRS 的 SNOT-22 热图与非 CRS 组有明显的差异。作为单个指标，CRS 的 4 个主要症状中的 3 个（鼻塞、嗅觉丧失和流涕）在两组之间存在显著差异（ < .002）。然而，ROC 分析显示，总 SNOT-22 评分区分 CRS 和非 CRS 患者的效果较差。
我们的结果否定了我们的假设，即 SNOT-22（使用总分和应答模式）虽然是一种有效的疗效评估工具，但它不能很好地区分 CRS 和非 CRS 患者。
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