title: Correlation between symptoms and objective findings may improve the symptom-based diagnosis of chronic rhinosinusitis for primary care and epidemiological studies.
abstract: BACKGROUND
  In primary care and epidemiological studies of chronic rhinosinusitis (CRS), symptom-based diagnosis is common, yet limited, because endoscopic and radiological signs are not considered.
  
  
  OBJECTIVE
  To evaluate the correlation between symptoms and objective findings of CRS to improve its symptom-based diagnosis for primary care and epidemiological studies by using data from a large-scale nationwide epidemiological study, the Korean National Health and Nutrition Examination Survey (KNHANES).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Data from 2008 to 2012 KNHANES.
  
  
  METHODS
  29,225 Adults aged >19 years.
  
  
  METHODS
  Questionnaires targeted two major (nasal blockage and anterior/posterior nasal drip) and two minor (facial pain/pressure and reduction or loss of smell) symptoms. Nasal polyps or mucopurulent discharge from the middle meatus was defined as positive endoscopic findings for diagnosing CRS.
  
  
  RESULTS
  Of the four symptoms, reduction or loss of smell was the symptom most significantly related to positive endoscopic findings in multivariable analysis (OR=1.936 (95% CI 1.604 to 2.337)). The combinations of symptoms showed higher ORs than individual symptoms and combinations of reduction or loss of smell with other symptoms were statistically more reliable for positive endoscopic findings than other combinations.
  
  
  CONCLUSIONS
  Our results show that reduction or loss of smell was the symptom most significantly related to positive nasal endoscopic findings. Therefore, symptom-based diagnosis of CRS can be improved by considering reduction or loss of smell as an important symptom for positive endoscopic findings of CRS.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Republic of Korea Department of Medicine, Graduate School, Yonsei University, Seoul, Republic of Korea.
authors.forename: Do-Yang
authors.initials: DY
authors.lastname: Park
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Lee
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Otolaryngology, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Yoo Suk
authors.initials: YS
authors.lastname: Kim
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Chan Min
authors.initials: CM
authors.lastname: Jung
authors.affiliation: Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Kyung-Su
authors.initials: KS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004724:Endoscopy; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009298:Nasal Polyps / Q000175:diagnosis*; D009749:Nutrition Surveys; D011320:Primary Health Care; D056910:Republic of Korea; D012220:Rhinitis / Q000175:diagnosis*; D012720:Severity of Illness Index; D012852:Sinusitis / Q000175:diagnosis*; D011795:Surveys and Questionnaires
keywords: OTOLARYNGOLOGY; PRIMARY CARE; PUBLIC HEALTH