Section of Allergy and Immunology, Department of Internal Medicine, Saint Louis University School of Medicine, Saint Louis, Mo.
Dr. Kiran C. Patel College of Allopathic Medicine, Nova Southeastern University, Fort Lauderdale, Fla.
J Allergy Clin Immunol Pract. 2024 Oct;12(10):2574-2582. doi: 10.1016/j.jaip.2024.06.049. Epub 2024 Jul 14.
Patient-reported outcome measures (PROMs) are valuable in the assessment and management of rhinitis and chronic rhinosinusitis (CRS). They measure outcomes that may include symptoms, disease control, well-being, and health-related quality of life (QOL). PROMs for rhinitis and rhinosinusitis are often used before and after an intervention, for example, medication, therapeutic procedure, or, in allergic rhinitis (AR), allergen immunotherapy. Although widely used in clinical trials for AR and conjunctivitis, symptom score PROMs are less validated than disease control or QOL measures. The best validated PROM for AR is the Rhinitis Quality of Life Questionnaire, but there is no universally accepted criterion standard for symptom and disease control PROMs. For CRS, at least 15 different criteria have been used to assess disease control in clinical studies, but what CRS disease control means and how it should be measured are concepts in evolution. The most used QOL measure for CRS is the 22-item Sinonasal Outcome Test. The use of PROMs to support clinical decisions and for shared decision-making for rhinitis and rhinosinusitis still has many challenges, including the selection of the preferred instrument, when and how to administer, the impact of comorbidities, and questionnaire fatigue for both patient and provider.
患者报告结局测量(PROMs)在评估和管理鼻炎和慢性鼻-鼻窦炎(CRS)方面具有重要价值。它们测量的结果可能包括症状、疾病控制、健康状况和健康相关生活质量(QOL)。鼻炎和鼻-鼻窦炎的 PROMs 通常在干预之前和之后使用,例如药物、治疗程序,或者在变应性鼻炎(AR)中使用过敏原免疫疗法。尽管在 AR 和结膜炎的临床试验中广泛使用,但症状评分 PROMs 的验证程度不如疾病控制或 QOL 测量。AR 最有效的验证 PROM 是鼻炎生活质量问卷,但症状和疾病控制 PROM 没有普遍接受的标准。对于 CRS,在临床研究中至少使用了 15 种不同的标准来评估疾病控制,但 CRS 疾病控制的含义以及如何测量它是不断发展的概念。CRS 最常用的 QOL 测量是 22 项鼻-鼻窦结局测试。尽管 PROMs 在支持鼻炎和鼻-鼻窦炎的临床决策和共同决策方面仍有许多挑战,包括选择首选工具、何时以及如何管理、合并症的影响以及患者和提供者的问卷疲劳。