title: Qualitative development of the sinus control test: a survey evaluating sinus symptom control.
abstract: Ideal management of chronic rhinosinusitis (CRS) requires ongoing monitoring of disease and its control. Existing control instruments are limited in their correlation to patient reported outcomes, the need for endoscopy, or lack of validation from a multidisciplinary group. The goal of this study was to develop a patient-based Sinus Control Test (SCT) for determining CRS control.
  
  
  
  A systematic literature review and focus groups consisting of 20 patients and 11 medical experts in CRS from various medical specialties were used to generate items. A draft 13-item questionnaire was administered to 50 patients with CRS in a prospective fashion. Patients were evaluated using the 22-item Sino-Nasal Outcome Test (SNOT-22) instrument, Lund-Mackay computed tomography (CT) score, and Lund-Kennedy endoscopy score. A rhinologist blinded to the questionnaire results also provided an overall control of the disease for each patient. A regression model was generated to identify which subset of items showed the greatest discriminate ability in relation to specialist's and patient's global rating of disease control.
  
  
  
  Four questions were included in the final questionnaire (p < 0.05), each with a scale of 0 to 4, with an overall total score ranging from 0 to 16. Optimal classification resulted in patients with a score from 1 to 3 (well controlled), 4 to 11 (partially controlled), and 12 to 16 (uncontrolled). SCT scores correctly classified control levels 72% of the time when compared to physician's assessment.
  
  
  
  The SCT is a simple, patient generated questionnaire that can measure the control of CRS without requirement of endoscopy or CT evaluation.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.|Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON, Canada.|Department of Surgery, Otolaryngology-Head and Neck Surgery Division, McMaster University, Hamilton, ON, Canada.
authors.forename: Sarfaraz M
authors.initials: SM
authors.lastname: Banglawala
authors.affiliation: 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: Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, Charleston, SC.
authors.forename: Kristen
authors.initials: K
authors.lastname: Morella
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University, Nashville, TN.
authors.forename: Rakesh
authors.initials: R
authors.lastname: Chandra
authors.affiliation: Department of Surgery, Otolaryngology-Head and Neck Surgery Division, McMaster University, Hamilton, ON, Canada.
authors.forename: Justin
authors.initials: J
authors.lastname: Khetani
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Medical College of Wisconsin, Milwaukee, WI.
authors.forename: David M
authors.initials: DM
authors.lastname: Poetker
authors.affiliation: Department of Pediatrics, University of Toronto, Toronto, ON, Canada.
authors.forename: Meera
authors.initials: M
authors.lastname: Rayar
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Luke
authors.initials: L
authors.lastname: Rudmik
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR.
authors.forename: Nathan B
authors.initials: NB
authors.lastname: Sautter
authors.affiliation: Department of Surgery, Otolaryngology-Head and Neck Surgery Division, McMaster University, Hamilton, ON, Canada.
authors.forename: Doron D
authors.initials: DD
authors.lastname: Sommer
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Portland, OR.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Smith
authors.affiliation: 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: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000175:diagnosis / Q000601:surgery; D010361:Patients; D010820:Physicians; D015203:Reproducibility of Results; D012220:Rhinitis / Q000175:diagnosis* / Q000601:surgery; D012720:Severity of Illness Index; D012852:Sinusitis / Q000175:diagnosis* / Q000601:surgery; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: SNOT-22; chronic rhinosinusitis; computed tomography; endoscopy; evidence-based medicine; sinusitis; statistics