title: Development of a severity classification system for subjective nasal obstruction.
abstract: OBJECTIVE
  Nasal airway obstruction is a common presenting symptom in otolaryngology and facial plastic surgery practices, and the potential for multiple contributing causes requires extensive evaluation.
  
  
  OBJECTIVE
  To develop a classification system for nasal obstruction using a subjective, validated quality-of-life instrument.
  
  
  METHODS
  Retrospective study of patients' responses on the Nasal Obstruction Symptom Evaluation (NOSE) instrument performed from July 2011 through May 2012. All patients were seen at a university-based tertiary medical center.
  
  
  METHODS
  Scores from patients with or without nasal obstruction were used to develop a classification system after receiver operating characteristic curve analysis. The classification subdivides nasal obstruction scores into a range of defined classes.
  
  
  RESULTS
  Data analysis was performed using results from 345 patients. A score of 30 on the NOSE survey best differentiated patients with and without nasal obstruction. This threshold also provided intervals used to define the other class ranges. Patients were categorized as having mild (range, 5-25), moderate (range, 30-50), severe (range, 55-75), or extreme (range, 80-100) nasal obstruction, depending on responses on the NOSE survey.
  
  
  CONCLUSIONS
  The NOSE scale is an important tool for gauging symptoms in patients with nasal obstruction. The proposed classification system will improve patient care by providing a framework for the severity of their symptoms and helping them understand potential treatment effects. If the classification is used in future outcomes research, it will allow physicians to better understand the study patient population and the effect of treatment on each severity class.
  
  
  METHODS
  NA.
authors.affiliation: Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lipan
authors.forename: Sam P
authors.initials: SP
authors.lastname: Most
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008875:Middle Aged; D015508:Nasal Obstruction / Q000145:classification* / Q000175:diagnosis; D011788:Quality of Life; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D055815:Young Adult