title: Objective versus subjective outcomes assessment in rhinology.
abstract: BACKGROUND
  Prior studies on the relationship between computed tomography scan findings and patient-based quality of life in chronic rhinosinusitis (CRS) have found very low correlations. Whereas surprising, similarfindings have been noted in other diseases.
  
  
  METHODS
  We performed a cross-sectional analysis of the association between objective and subjective findings in nasal septal deformity and a systematic review and synthesis of the literature on CRS and other diseases.
  
  
  RESULTS
  We found no association between objective anatomic findings and subjective symptoms in nasal obstruction (R = 0.03; Kruskal-Wallis test, p = 0.97). Multiple studies in CRS and other diseases-sleep apnea, hearing loss, asthma, etc.- have found similarly low correlations between objective and subjective testing.
  
  
  CONCLUSIONS
  For nasal septal deviation and CRS, the patient's subjective perception of disease severity has, at best, a very weak association with objective assessment of severity. Patient-based outcomes assessment remains important; these instruments apparently quantify an aspect of disease not detected by objective testing.
authors.affiliation: The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Stewart
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
mesh_terms: D006801:Humans; D015508:Nasal Obstruction / Q000628:therapy*; D009300:Nasal Septum / Q000473:pathology; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D012852:Sinusitis / Q000628:therapy