ArticleEuropean 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 Surgery2026
Validity and reliability of the total rating of eye, nasal, and dry-mouth (TREND) score.
Article in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo develop and validate the total rating of eye, nasal, and dry-mouth (TREND) score, which is a patient-reported outcome measure of upper aerodigestive tract mucosa dryness.
methodPatients with dry symptoms and findings of mouth, laryngopharynx, nose, and eyes were prospectively recruited between June 2024 to November 2025. Patients and healthy individuals completed TREND score within a 7-day period to assess test-retest reliability. Internal consistency was measured using Cronbach’s α for TREND items and sub- and total scores in patients and controls. For patients with dry vocal fold or reflux-related dry throat, validity was evaluated by comparing the TREND with the reflux symptom score (RSS) and the voice handicap index (VHI). Dry findings were collected. Pre-to posttreatment evolution of TREND was assessed to evaluate the responsiveness to change.
resultsA total of 164 consecutive patients with dry mucosa complaints completed evaluations (106 females), alongside 85 controls (44 females). Mean TREND sub-/total scores were significantly higher in patients versus controls, demonstrating adequate discriminant validity. External validity showed moderate-to-strong correlations between TREND and RSS in LPRD patients (rs=0.650;95%CI: 0.535–0.742;p = 0.001) and between TREND and VHI in hoarseness patients (rs=0.437;95%CI: 0.234–0.603;p = 0.001). Internal consistency was high (α = 0.856), with moderate-to-high test-retest reliability. ROC analysis suggested a TREND > 19 as pathological threshold in this population (AUC = 0.837;sensitivity:83.5%,specificity:54.8%; Youden index:0.383).
conclusionTREND score is a valid and reliable patient-reported outcome questionnaire documenting dry throat, mouth, nose, and eye symptoms in otolaryngology. Future studies are needed to establish psychometric properties of TREND in several other dry disorders.
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