Evidence map›Paper›PMID 29053911›Full record

Observational studyInternational forum of allergy & rhinology2017

Investigating the minimal clinically important difference for SNOT-22 symptom domains in surgically managed chronic rhinosinusitis.

Naweed I Chowdhury, Jess C Mace, Todd E Bodner, Jeremiah A Alt, Adam S Deconde, Joshua M Levy, Timothy L Smith

Abstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in International forum of allergy & rhinology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Definition and characteristics of acute exacerbation in adult patients with chronic rhinosinusitis: a systematic review.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale · 2020
    Pooled it
  5. Timing of Surgery and Outcomes in Chronic Rhinosinusitis: A Narrative Review and Meta-Analysis.Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale
    Pooled it
  6. A Novel Device to Improve the Tolerability of Intranasal Corticosteroid Sprays for Allergic Rhinitis and Postoperative Chronic Rhinosinusitis: A Crossover Trial.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2026
    Trial
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  9. Predictive factors of a beneficial quality of life outcome in patients undergoing primary sinonasal surgery: a population-based prospective cohort study.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2018
    Trial
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  13. More than a drink: The behavioral impact of alcohol sensitivity in AERD.The journal of allergy and clinical immunology. In practice · 2026
    Article
  14. Review
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1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Naweed I ChowdhuryDepartment of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, TN.
Jess C MaceDepartment of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR.
Todd E BodnerDepartment of Psychology, Portland State University, Portland, OR.
Jeremiah A AltDepartment of Surgery, Division of Otolaryngology-Head & Neck Surgery, University of Utah School of Medicine, Salt Lake City, UT.
Adam S DecondeDivision of Otolaryngology, Department of Surgery, University of California, San Diego School of Medicine, San Diego, CA.
Joshua M LevyDepartment of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA.ORCID 0000-0001-5907-3421
Timothy L SmithDepartment of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR.ORCID 0000-0002-6424-7083

Funding

DETERMINANTS OF SURGICAL OUTCOMES IN CHRONIC SINUSITISR01DC005805 · NIDCD · OREGON HEALTH & SCIENCE UNIVERSITY · PI SMITH, TIMOTHY L, SOLER, ZACHARY M · 2004 to 2020
$7.6M
University of Utah Center for clinical and Translational ScienceKL2TR001065 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$1.1M
NCATS NIH HHS KL2 TR001065NIDCD NIH HHS R01 DC005805
6 · The paper itself

Abstract

backgroundPrior work has described 5 domains within the 22-item Sino-Nasal Outcomes Test (SNOT-22) that allow for stratification of symptoms into similar clusters and that can be used to direct therapy. Although the outcomes of various interventions on these symptom domains have been reported, minimal clinically important difference (MCID) values have not been investigated, which has limited clinical interpretation of these results.

methodsThis study was designed as a secondary analysis of a prospective, multi-institutional, observational cohort. A total of 276 patients with medically refractory CRS who underwent surgical management were enrolled. Distribution-based methods (half-standard deviation, standard error of measurement, Cohen's d, and the minimum detectable change) were used to compute MCID values for both SNOT-22 total and domain scores. The Medical Outcomes Study Short Form 6D (SF-6D) health utility score was used to operationalize anchor-based associations using receiver-operating characteristic (ROC) curves.

resultsThe mean MCID of several distribution-based methods for total SNOT-22 scores was 9.0, in agreement with previously published metrics. Average MCID values for the rhinologic, extranasal rhinologic, ear/facial, psychological, and sleep domain scores were 3.8, 2.4, 3.2, 3.9, and 2.9, respectively. Anchor-based approaches with the SF-6D did not have strong predictive accuracy across total SNOT-22 scores or domains (ROC areas under-the-curve ≤ 0.71), indicating weak associations between improvement in SNOT-22 scores and health utility as measured by the SF-6D.

conclusionThis estimation of MCID values for the SNOT-22 symptom domains allows for improved clinical interpretation of results from past, present, and future rhinologic outcomes research.

Indexed as

Minimal Clinically Important DifferenceSeverity of Illness IndexAdolescentAdultAgedAged, 80 and overChronic DiseaseFemaleHumansMaleMiddle AgedRhinitisSinusitisSurveys and QuestionnairesSymptom AssessmentYoung Adultchronic diseasepatient outcome assessmentquality of lifesinusitissinus surgery

Identifiers

PMID29053911
PMCPMC5716928

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.