title: Use of the modified SNOT-16 in primary care patients with clinically diagnosed acute rhinosinusitis.
abstract: OBJECTIVE
  To determine the reliability, validity, responsiveness, and the minimal important difference (MID) for the Sinonasal Outcome Test-16 (SNOT-16) in the measurement of disease-specific quality of life (QOL) in adults with acute rhinosinusitis.
  
  
  METHODS
  Randomized controlled trial to evaluate antibiotic treatment for acute rhinosinusitis.
  
  
  METHODS
  Ten community practices in St Louis, Missouri.
  
  
  METHODS
  The modified SNOT-16 was completed at baseline (by both face-to-face and telephone interviews) and by telephone interview at 3, 7, and 10 days by 166 adults with acute rhinosinusitis diagnosed clinically using standardized criteria (36% were male, 78% were white). Considering severity and frequency, patients rated how much they were bothered by each item using a 4-point scale. The mean SNOT-16 score (ranging from 0 [no problem] to 3 [large problem]) was compared with the patients' global assessment of change to evaluate responsiveness and the MID.
  
  
  RESULTS
  The instrument was easy to use and took less than 5 minutes to complete. The SNOT-16 score identified statistically significant differences in the hypothesized direction for those reporting more or less severe symptoms (P = .02) and more or less bother (P < .001) demonstrating construct-related validity. The Cronbach α ranged from 0.82 to 0.91, demonstrating high internal consistency. There was a statistically significant decrease in scores with time (multivariate analysis of variance, P < .001). The effect sizes at days 3, 7, and 10 were 1.45, 2.34, and 2.90, respectively, indicating high sensitivity to clinical change. The MID was 0.5 units.
  
  
  CONCLUSIONS
  The modified SNOT-16 is a valid instrument to assess effectiveness of interventions to improve disease-specific QOL in adults with acute rhinosinusitis.
  
  
  BACKGROUND
  clinicaltrials.gov Identifier: NCT00377403.
authors.affiliation: Department of Medicine, Washington University School of Medicine, Washington University, St Louis, MO 63110, USA. jgarbutt@dom.wustl.edu
authors.forename: Jane
authors.initials: J
authors.lastname: Garbutt
authors.forename: Edward
authors.initials: E
authors.lastname: Spitznagel
authors.forename: Jay
authors.initials: J
authors.lastname: Piccirillo
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D011788:Quality of Life; D015203:Reproducibility of Results; D012220:Rhinitis / Q000175:diagnosis* / Q000188:drug therapy; D012852:Sinusitis / Q000175:diagnosis* / Q000188:drug therapy; D011795:Surveys and Questionnaires
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin