Objective versus subjective outcomes assessment in rhinology.
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.
Stewart
Michael G
MG
The Bobby R. Alford Department of Otorhinolaryngology and Communicative Sciences, Baylor College of Medicine, Houston, Texas, USA.
Smith
Timothy L
TL
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