title: Patient-reported outcome measures for adult chronic rhinosinusitis: A systematic review and quality assessment.
abstract: BACKGROUND
  With a focus on patient-centered care, there is increasing policy interest in patient-reported outcome measures (PROMs) to inform improvements in health care delivery. Given the importance of understanding patient-reported outcomes during the management of chronic rhinosinusitis (CRS), PROMs will play an essential role in informing and tailoring the right intervention to the right patient.
  
  
  OBJECTIVE
  The objective of this systematic review was to identify and assess the quality of PROMs being used for adults with CRS.
  
  
  METHODS
  A systematic review of Ovid MEDLINE (R) (1947-May 2015), Embase, and the Cochrane databases was performed using the following key terms: ["chronic" AND "*sinusitis"] AND [PROM OR patient reported outcome measure* OR quality of life OR questionnaire OR survey OR valid* OR develop*]. An unlimited truncation strategy (placement of *) was used to capture all variations of terms used. The quality of each PROM was assessed and reported using standardized criteria from the COnsensus-based Standards for the selection of health status Measurement INstruments checklist.
  
  
  RESULTS
  A total of 15 PROMs validated for use in adult patients with CRS were identified. Fourteen instruments were specific to adults with CRS, and one was a generic quality-of-life instrument (EuroQol five-dimensional questionnaire [EQ-5D]). There was significant variation in the quality of development and reporting of psychometric properties. Overall, the highest quality validated PROMs for adults with CRS were (1) the 22-item Sinonasal Outcome Test (19 points), (2) the Questionnaire of Olfactory Disorders (14 points), (3) the Sinusitis Control Test (14 points), and (4) the EQ-5D (13 points). Most of the PROMs were developed for research purposes such as determining changes in health-related quality of life or symptoms after an intervention as opposed to improving clinical decision making.
  
  
  CONCLUSIONS
  Based on quality assessment, the 22-item Sinonasal Outcome Test, the Questionnaire of Olfactory Disorders, and the Sinusitis Control Test provided the highest quality CRS-specific PROMs, whereas the EQ-5D provided the highest quality generic quality-of-life instrument. Future CRS PROMs will need to incorporate clinical domains that assess common comorbid diseases along with patient values and preferences to improve clinical decision making.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, Calgary, Alberta, Canada. Electronic address: Lukerudmik@gmail.com.
authors.forename: Luke
authors.initials: L
authors.lastname: Rudmik
authors.affiliation: Department of ENT, Guy's and St Thomas' NHS Trust, London, United Kingdom.
authors.forename: Claire
authors.initials: C
authors.lastname: Hopkins
authors.affiliation: Department of Internal Medicine, Northwestern University Allergy Division, Chicago, Ill.
authors.forename: Anju
authors.initials: A
authors.lastname: Peters
authors.affiliation: Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, Ore.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
authors.affiliation: Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Schlosser
authors.affiliation: Division of Rhinology and Sinus Surgery, Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Soler
mesh_terms: D002908:Chronic Disease; D006801:Humans; D063868:Patient Outcome Assessment; D011788:Quality of Life; D012220:Rhinitis / Q000628:therapy*; D012852:Sinusitis / Q000628:therapy*; D011795:Surveys and Questionnaires
keywords: Chronic rhinosinusitis; evidence-based medicine; patient-reported outcome measure; quality of life; sinusitis; systematic review