评估 Sinonasal Outcomes Test-22 在垂体手术中的有效性：一项多中心前瞻性试验。
Assessment of the Validity of the Sinonasal Outcomes Test-22 in Pituitary Surgery: A Multicenter Prospective Trial.
机构信息
Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona, U.S.A.
Department of Neurosurgery and Brain Tumor and Neuro-Oncology Center, Cleveland Clinic Foundation, Cleveland, Ohio, U.S.A.
出版信息
Laryngoscope. 2021 Nov;131(11):E2757-E2763. doi: 10.1002/lary.29711. Epub 2021 Jul 1.
OBJECTIVES/HYPOTHESIS: Sinonasal Outcomes Test-22 (SNOT-22) is used widely as a patient-reported sinonasal quality-of-life (QOL) instrument for endoscopic endonasal pituitary surgery. However, it has never been validated in this population. This study explores the psychometric validity of SNOT-22 to determine if it is a valid scale in patients undergoing endoscopic pituitary surgery.
STUDY DESIGN
Multicenter prospective trial.
METHODS
Adult patients (n = 113) with pituitary tumors undergoing endoscopic surgery were enrolled in a multicenter study. Patient-reported QOL was assessed using SNOT-22 and the Anterior Skull Base Nasal Inventory-12. Face validity, internal consistency, responsiveness to clinical change, test-retest reliability, and concurrent validity were determined using standard statistical methods.
RESULTS
Internal consistency using Cronbach's alpha at baseline and 2 weeks postoperatively were 0.911 and 0.922, indicating SNOT-22 performed well as a single construct. Mean QOL scores were significantly worse at 2 weeks than baseline (16.4 ± 15.1 vs. 23.1 ± 16.4, P < .001), indicating the scale is responsive to clinical change. However, only 11/22 items demonstrated significant changes in mean scores at 2 weeks. Correlation between scores at 2 and 3 weeks was high, suggesting good test-retest reliability, r(107) = 0.75, P < .001. Factor analysis suggests the five-factor solution proposed for the SNOT-22 in rhinosinusitis patients is not valid in pituitary surgery patients.
CONCLUSIONS
The SNOT-22 is a valid QOL instrument in patients undergoing endoscopic pituitary surgery. However, because it includes 22 items, can be applied only as a single construct, 50% of the items do not demonstrate changes after surgery, and is not as sensitive to change as other scales, shorter instruments developed specifically for this patient population may be preferable.
LEVEL OF EVIDENCE
2 Laryngoscope, 131:E2757-E2763, 2021.
目的/假设：鼻窦结局测试 22 项（SNOT-22）被广泛用作内镜经鼻垂体手术患者报告的鼻窦生活质量（QOL）工具。然而，它从未在这一人群中得到验证。本研究探讨了 SNOT-22 的心理测量有效性，以确定它是否是内镜垂体手术患者的有效量表。
研究设计
多中心前瞻性试验。
方法
纳入了 113 例接受内镜手术的垂体瘤成年患者进行多中心研究。采用 SNOT-22 和前颅底鼻量表-12 评估患者报告的 QOL。使用标准统计方法确定 SNOT-22 的表面效度、内部一致性、对临床变化的反应性、重测信度和同时效度。
结果
基线和术后 2 周时 Cronbach's alpha 的内部一致性分别为 0.911 和 0.922，表明 SNOT-22 作为单一结构表现良好。与基线相比，术后 2 周时 QOL 评分明显更差（16.4±15.1 比 23.1±16.4，P<0.001），表明该量表对临床变化敏感。然而，只有 11/22 个项目在术后 2 周时的平均评分有显著变化。在第 2 周和第 3 周的评分之间相关性较高，表明重测信度良好，r（107）=0.75，P<0.001。因子分析表明，针对鼻窦炎患者提出的 SNOT-22 的五因素解决方案在垂体手术患者中无效。
结论
SNOT-22 是内镜垂体手术患者 QOL 的有效工具。然而，由于它包含 22 个项目，只能作为单一结构应用，50%的项目在手术后没有变化，并且不如其他量表敏感，因此针对这一患者群体开发的更短的工具可能更可取。
证据水平
2 级喉镜，131：E2757-E2763，2021。
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