Criteria to screen for chronic sinonasal disease

Anne E. Dixon, Elizabeth Sugar, Simion J Zinreich, Raymond G. Slavin, Jonathan Corren, Robert M. Naclerio, Masaru Ishii, Rubin I. Cohen, Ellen D. Brown, Robert A Wise, Charles G. Irvin

Research output: Contribution to journalArticle

Abstract

Background: Sinusitis and rhinitis are associated with uncontrolled asthma. There are no simple, validated tools to screen for these diseases. The objective of this study was to assess instruments to assist in the diagnosis of chronic sinonasal disease. Methods: Participants without acute sinonasal symptoms underwent an extensive evaluation. The results were submitted to an expert panel that used the Delphi method to achieve consensus. Using the consensus diagnosis of the panel, we determined the sensitivity and specificity of test procedures to diagnose chronic sinonasal disease. We determined the reproducibility of the most sensitive and specific instrument in a separate cohort. Results: Fifty-nine participants were evaluated, and the expert panel reached consensus for all (42 participants with chronic sinonasal disease, 17 participants without chronic sinonasal disease). A six-item questionnaire based on the frequency of nasal symptoms was the most sensitive tool used to diagnose sinonasal disease (minimum specificity, 0.90). Reproducibility testing in a separate cohort of 63 participants (41 chronic sinonasal disease with asthma, 22 chronic sinonasal disease without asthma) showed a concordance correlation coefficient of 0.91 (95% CI, 0.85 to 0.94) when this questionnaire was limited to five items (ie, excluding a question on smell). This five-item questionnaire had a sensitivity of 0.90 (95% CI, 0.77 to 0.97), a specificity of 0.94 (95% CI, 0.71 to 1.00), and an area under the receiver operating characteristic curve of 0.97 (95% CI, 0.93 to 1.0). Sinus CT scans and nasal endoscopy lacked sensitivity for use in the diagnosis of chronic sinonasal disease. Conclusions: We have developed a sensitive, specific, and reproducible instrument to screen for chronic sinonasal disease. Validation studies of this five-item questionnaire are needed, including in patients with asthma.

Original languageEnglish (US)
Pages (from-to)1324-1332
Number of pages9
JournalChest
Volume136
Issue number5
DOIs
StatePublished - Nov 1 2009

Fingerprint

Chronic Disease
Asthma
Nose
Consensus
Smell
Validation Studies
Sinusitis
Rhinitis
ROC Curve
Endoscopy
Sensitivity and Specificity
Surveys and Questionnaires

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Dixon, A. E., Sugar, E., Zinreich, S. J., Slavin, R. G., Corren, J., Naclerio, R. M., ... Irvin, C. G. (2009). Criteria to screen for chronic sinonasal disease. Chest, 136(5), 1324-1332. https://doi.org/10.1378/chest.08-1983

Criteria to screen for chronic sinonasal disease. / Dixon, Anne E.; Sugar, Elizabeth; Zinreich, Simion J; Slavin, Raymond G.; Corren, Jonathan; Naclerio, Robert M.; Ishii, Masaru; Cohen, Rubin I.; Brown, Ellen D.; Wise, Robert A; Irvin, Charles G.

In: Chest, Vol. 136, No. 5, 01.11.2009, p. 1324-1332.

Research output: Contribution to journalArticle

Dixon, AE, Sugar, E, Zinreich, SJ, Slavin, RG, Corren, J, Naclerio, RM, Ishii, M, Cohen, RI, Brown, ED, Wise, RA & Irvin, CG 2009, 'Criteria to screen for chronic sinonasal disease', Chest, vol. 136, no. 5, pp. 1324-1332. https://doi.org/10.1378/chest.08-1983
Dixon AE, Sugar E, Zinreich SJ, Slavin RG, Corren J, Naclerio RM et al. Criteria to screen for chronic sinonasal disease. Chest. 2009 Nov 1;136(5):1324-1332. https://doi.org/10.1378/chest.08-1983
Dixon, Anne E. ; Sugar, Elizabeth ; Zinreich, Simion J ; Slavin, Raymond G. ; Corren, Jonathan ; Naclerio, Robert M. ; Ishii, Masaru ; Cohen, Rubin I. ; Brown, Ellen D. ; Wise, Robert A ; Irvin, Charles G. / Criteria to screen for chronic sinonasal disease. In: Chest. 2009 ; Vol. 136, No. 5. pp. 1324-1332.
@article{f7b2091b5ac846b7a6ab4dccef2fc347,
title = "Criteria to screen for chronic sinonasal disease",
abstract = "Background: Sinusitis and rhinitis are associated with uncontrolled asthma. There are no simple, validated tools to screen for these diseases. The objective of this study was to assess instruments to assist in the diagnosis of chronic sinonasal disease. Methods: Participants without acute sinonasal symptoms underwent an extensive evaluation. The results were submitted to an expert panel that used the Delphi method to achieve consensus. Using the consensus diagnosis of the panel, we determined the sensitivity and specificity of test procedures to diagnose chronic sinonasal disease. We determined the reproducibility of the most sensitive and specific instrument in a separate cohort. Results: Fifty-nine participants were evaluated, and the expert panel reached consensus for all (42 participants with chronic sinonasal disease, 17 participants without chronic sinonasal disease). A six-item questionnaire based on the frequency of nasal symptoms was the most sensitive tool used to diagnose sinonasal disease (minimum specificity, 0.90). Reproducibility testing in a separate cohort of 63 participants (41 chronic sinonasal disease with asthma, 22 chronic sinonasal disease without asthma) showed a concordance correlation coefficient of 0.91 (95{\%} CI, 0.85 to 0.94) when this questionnaire was limited to five items (ie, excluding a question on smell). This five-item questionnaire had a sensitivity of 0.90 (95{\%} CI, 0.77 to 0.97), a specificity of 0.94 (95{\%} CI, 0.71 to 1.00), and an area under the receiver operating characteristic curve of 0.97 (95{\%} CI, 0.93 to 1.0). Sinus CT scans and nasal endoscopy lacked sensitivity for use in the diagnosis of chronic sinonasal disease. Conclusions: We have developed a sensitive, specific, and reproducible instrument to screen for chronic sinonasal disease. Validation studies of this five-item questionnaire are needed, including in patients with asthma.",
author = "Dixon, {Anne E.} and Elizabeth Sugar and Zinreich, {Simion J} and Slavin, {Raymond G.} and Jonathan Corren and Naclerio, {Robert M.} and Masaru Ishii and Cohen, {Rubin I.} and Brown, {Ellen D.} and Wise, {Robert A} and Irvin, {Charles G.}",
year = "2009",
month = "11",
day = "1",
doi = "10.1378/chest.08-1983",
language = "English (US)",
volume = "136",
pages = "1324--1332",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "5",

}

TY - JOUR

T1 - Criteria to screen for chronic sinonasal disease

AU - Dixon, Anne E.

AU - Sugar, Elizabeth

AU - Zinreich, Simion J

AU - Slavin, Raymond G.

AU - Corren, Jonathan

AU - Naclerio, Robert M.

AU - Ishii, Masaru

AU - Cohen, Rubin I.

AU - Brown, Ellen D.

AU - Wise, Robert A

AU - Irvin, Charles G.

PY - 2009/11/1

Y1 - 2009/11/1

N2 - Background: Sinusitis and rhinitis are associated with uncontrolled asthma. There are no simple, validated tools to screen for these diseases. The objective of this study was to assess instruments to assist in the diagnosis of chronic sinonasal disease. Methods: Participants without acute sinonasal symptoms underwent an extensive evaluation. The results were submitted to an expert panel that used the Delphi method to achieve consensus. Using the consensus diagnosis of the panel, we determined the sensitivity and specificity of test procedures to diagnose chronic sinonasal disease. We determined the reproducibility of the most sensitive and specific instrument in a separate cohort. Results: Fifty-nine participants were evaluated, and the expert panel reached consensus for all (42 participants with chronic sinonasal disease, 17 participants without chronic sinonasal disease). A six-item questionnaire based on the frequency of nasal symptoms was the most sensitive tool used to diagnose sinonasal disease (minimum specificity, 0.90). Reproducibility testing in a separate cohort of 63 participants (41 chronic sinonasal disease with asthma, 22 chronic sinonasal disease without asthma) showed a concordance correlation coefficient of 0.91 (95% CI, 0.85 to 0.94) when this questionnaire was limited to five items (ie, excluding a question on smell). This five-item questionnaire had a sensitivity of 0.90 (95% CI, 0.77 to 0.97), a specificity of 0.94 (95% CI, 0.71 to 1.00), and an area under the receiver operating characteristic curve of 0.97 (95% CI, 0.93 to 1.0). Sinus CT scans and nasal endoscopy lacked sensitivity for use in the diagnosis of chronic sinonasal disease. Conclusions: We have developed a sensitive, specific, and reproducible instrument to screen for chronic sinonasal disease. Validation studies of this five-item questionnaire are needed, including in patients with asthma.

AB - Background: Sinusitis and rhinitis are associated with uncontrolled asthma. There are no simple, validated tools to screen for these diseases. The objective of this study was to assess instruments to assist in the diagnosis of chronic sinonasal disease. Methods: Participants without acute sinonasal symptoms underwent an extensive evaluation. The results were submitted to an expert panel that used the Delphi method to achieve consensus. Using the consensus diagnosis of the panel, we determined the sensitivity and specificity of test procedures to diagnose chronic sinonasal disease. We determined the reproducibility of the most sensitive and specific instrument in a separate cohort. Results: Fifty-nine participants were evaluated, and the expert panel reached consensus for all (42 participants with chronic sinonasal disease, 17 participants without chronic sinonasal disease). A six-item questionnaire based on the frequency of nasal symptoms was the most sensitive tool used to diagnose sinonasal disease (minimum specificity, 0.90). Reproducibility testing in a separate cohort of 63 participants (41 chronic sinonasal disease with asthma, 22 chronic sinonasal disease without asthma) showed a concordance correlation coefficient of 0.91 (95% CI, 0.85 to 0.94) when this questionnaire was limited to five items (ie, excluding a question on smell). This five-item questionnaire had a sensitivity of 0.90 (95% CI, 0.77 to 0.97), a specificity of 0.94 (95% CI, 0.71 to 1.00), and an area under the receiver operating characteristic curve of 0.97 (95% CI, 0.93 to 1.0). Sinus CT scans and nasal endoscopy lacked sensitivity for use in the diagnosis of chronic sinonasal disease. Conclusions: We have developed a sensitive, specific, and reproducible instrument to screen for chronic sinonasal disease. Validation studies of this five-item questionnaire are needed, including in patients with asthma.

UR - http://www.scopus.com/inward/record.url?scp=70449369143&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70449369143&partnerID=8YFLogxK

U2 - 10.1378/chest.08-1983

DO - 10.1378/chest.08-1983

M3 - Article

VL - 136

SP - 1324

EP - 1332

JO - Chest

JF - Chest

SN - 0012-3692

IS - 5

ER -