Department of Otolaryngology-Head and Neck Surgery, University of California, Los Angeles, California, U.S.A.
Department of Otolaryngology-Head and Neck Surgery, Columbia University, New York, New York, U.S.A.
Laryngoscope. 2024 Sep;134(9):3965-3973. doi: 10.1002/lary.31438. Epub 2024 Apr 18.
The 22-question SinoNasal Outcome Test (SNOT-22) assesses chronic rhinosinusitis (CRS) severity. We aimed to identify predictors of SNOT-22 score improvement following highly effective modulator therapy (HEMT) initiation and to corroborate the SNOT-22 minimal clinically important difference (MCID) in adults with cystic fibrosis (CF).
Prospective observational data was pooled from four studies across 10 US centers investigating people with CF (PwCF) and CRS. Three studies evaluated HEMT's impact on CRS. For participants enrolled prior to HEMT initiation, SNOT-22 scores were obtained at baseline and after 3-6 months of HEMT. Multivariate regression identified predictors of improvement. Cronbach's alpha and four distribution-based methods were used to assess internal consistency and calculate the MCID of the SNOT-22.
A total of 184 PwCF participated with mean baseline SNOT-22 scores ranging from 18.1 to 56.7. Cronbach's alpha was ≥0.90 across sites. Participants at sites with pre- and post-HEMT data reported improvement in SNOT-22 scores after initiating HEMT (all p < 0.05). Worse baseline SNOT-22 score (odds ratio (OR): 1.05, p < 0.001, 95% CI: 1.02-1.08), F508del homozygosity (OR: 4.30, p = 0.040, 95% CI: 1.14-18.99), and absence of prior modulator therapy (OR: 4.99, p = 0.017, 95% CI: 1.39-20.11) were associated with greater SNOT-22 improvement. The mean MCID calculated via distribution-based methods was 8.5.
Worse baseline sinonasal symptoms, F508del homozygosity, and absence of prior modulator therapy predicted greater improvement after HEMT initiation. The mean MCID for SNOT-22 in PwCF is 8.5 points, similar to non-CF individuals with CRS, and provides a threshold specifically for PwCF. The SNOT-22 has strong internal consistency in PwCF.
3 Laryngoscope, 134:3965-3973, 2024.
22 项鼻鼻窦结局测试（SNOT-22）评估慢性鼻-鼻窦炎（CRS）的严重程度。我们旨在确定在开始高效调节剂治疗（HEMT）后 SNOT-22 评分改善的预测因素，并在囊性纤维化（CF）成人中证实 SNOT-22 的最小临床重要差异（MCID）。
前瞻性观察性数据来自四个研究，这些研究在美国 10 个中心调查了囊性纤维化患者（PwCF）和 CRS。三项研究评估了 HEMT 对 CRS 的影响。对于在 HEMT 开始前入组的参与者，在基线和 HEMT 开始后 3-6 个月时获得 SNOT-22 评分。多变量回归确定了改善的预测因素。克朗巴赫的 α和四种基于分布的方法用于评估内部一致性并计算 SNOT-22 的 MCID。
共有 184 名 PwCF 参与，平均基线 SNOT-22 评分范围为 18.1 至 56.7。在各个站点，克朗巴赫的α值均≥0.90。在有 HEMT 前后数据的参与者中，在开始 HEMT 后报告 SNOT-22 评分改善（均 p<0.05）。更差的基线 SNOT-22 评分（比值比（OR）：1.05，p<0.001，95%CI：1.02-1.08）、F508del 纯合性（OR：4.30，p=0.040，95%CI：1.14-18.99）和缺乏先前的调节剂治疗（OR：4.99，p=0.017，95%CI：1.39-20.11）与更大的 SNOT-22 改善相关。通过分布基础方法计算的平均 MCID 为 8.5。
更差的基线鼻-鼻窦症状、F508del 纯合性和缺乏先前的调节剂治疗预测了 HEMT 启动后更大的改善。SNOT-22 在 PwCF 中的平均 MCID 为 8.5 分，与患有 CRS 的非 CF 个体相似，为 PwCF 提供了一个特定的阈值。SNOT-22 在 PwCF 中具有很强的内部一致性。
3 级喉镜，134:3965-3973，2024。
