title: Twenty-two-item Sino-Nasal Outcome Test in a control population: a cross-sectional study and systematic review.
abstract: BACKGROUND
  The 22-item Sino-Nasal Outcome Test (SNOT-22) is a commonly utilized outcome measure for chronic rhinosinusitis (CRS). However, what constitutes a normal score remains poorly defined. The goal of this study was to evaluate SNOT-22 scores in a control population without CRS and perform a systematic review and meta-analysis of "normal" values.
  
  
  METHODS
  Ninety-nine subjects without CRS were enrolled, with 95 fully completing the SNOT-22 questionnaire. Multivariable linear regression was used to determine whether demographic factors or medical comorbidities influence SNOT-22 scores in a population without CRS. A systematic literature search was performed, identifying studies that evaluated the SNOT-22 in a non-CRS population and estimates for SNOT-22 values were pooled.
  
  
  RESULTS
  Thirty-six males and 59 females were included in the primary analysis with a mean age of 53.4 ± 17.3 years (range, 18-88 years). The mean SNOT-22 score was 16.4 ± 15.2. Asthma (p = 0.003) and depression (p = 0.002) were found to be independent predictors of higher SNOT-22 scores. Thirteen articles were identified in the literature search and 1 was provided via author correspondence, with 10 reporting sufficient data to be included in the meta-analysis. Weighted mean SNOT-22 score was 11 ± 9.4 (n = 1517). Our data differed significantly from published data (mean difference = 5.4; 95% confidence interval [CI], 3.4 to 7.5; p < 0.0001) likely owing to differences in comorbidities.
  
  
  CONCLUSIONS
  SNOT-22 scores vary in non-CRS populations depending upon the group queried. Asthma and depression are associated with higher SNOT-22 scores and should be considered when determining what constitutes a normal value.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Medical University of South Carolina, Charleston, SC.
authors.forename: Zachary
authors.initials: Z
authors.lastname: Farhood
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Medical University of South Carolina, Charleston, SC.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Schlosser
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Medical University of South Carolina, Charleston, SC.
authors.forename: Madeline E
authors.initials: ME
authors.lastname: Pearse
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Medical University of South Carolina, Charleston, SC.
authors.forename: Kristina A
authors.initials: KA
authors.lastname: Storck
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Medical University of South Carolina, Charleston, SC.
authors.forename: Shaun A
authors.initials: SA
authors.lastname: Nguyen
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, The Medical University of South Carolina, Charleston, SC.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000175:diagnosis* / Q000453:epidemiology; D002908:Chronic Disease; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012015:Reference Standards; D012220:Rhinitis / Q000175:diagnosis* / Q000453:epidemiology; D012852:Sinusitis / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult
keywords: healthy volunteers; meta-analysis; quality-of-life; sinusitis; validation studies