Measuring control of disease in Chronic Rhinosinusitis; assessing the correlation between SinoNasal Outcome Test-22 and Visual Analogue Scale item scores

Background: In chronic rhinosinusitis (CRS), aim of treatment is control of disease. EPOS2020 suggests the use of visual analogue scale (VAS) measurements on several symptoms. We aim to determine if individual VAS items can be replaced by widely used SinoNasal Outcome Test-22 (SNOT-22) items when determining control of disease, to avoid using double measurements and to stimulate its use in clinical practice. Methods: Analyses were made on correlations between individual SNOT-22 scores and symptom-specific questions from consecutive patients with CRS visiting our tertiary referral rhinologic clinic for the first time. Results: 157 CRS patients were included. Correlations of individual items were strong (r>0.8). Best parity in sensitivity, specificity, positive predicting value, negative predicting value, odds ratio and Receiver Operating Characteristic curves were found in individual item score of VAS>5 and SNOT item-score ≥3. This cut off is valid for measuring control of disease, combining several nasal, facial pain and sleep symptoms (controlled, partially controlled and uncontrolled). Conclusion: There is strong correlation between individual items measured as SNOT or VAS. For the definition of CRS disease control, as proposed in EPOS2020, the use of symptoms specific SNOT ≥3 is predictive of VAS>5.