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Measures of health-related quality of life for adults with acute sinusitis

A systematic review

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Abstract

CONTEXT: Symptoms suggestive of acute sinusitis are a common reason for patients to visit primary care providers. Since objective measures of outcome have not been shown to be related to patient reported outcomes, measures of treatment success have focused on symptom relief and improved health-related quality of life (HRQL). Assessing the appropriate role of treatment—for example, antibiotics for patients with acute sinusitis—requires valid, reliable, and responsive measures of outcome. We identified symptom scores and HRQL instruments for adults with sinusitis and assessed their performance characteristics.

DATA SOURCES: Articles identified through computer searches of the MEDLINE, PREMEDLINE, and EMBASE databases, the Cochrane Library, and internet documents; inquiries to experts in sinusitis and outcomes assessment; and review of reference lists.

STUDY SELECTION: Studies that used HRQL instruments or evaluated the performance characteristics of symptom scores in adults with sinusitis, published in English after 1966.

DATA EXTRACTION: Two reviewers independently extracted data on study design, setting, and patient characteristics; instrument length and format; and instrument validity, reliability, responsiveness to change, and interpretability. Study quality was assessed using a 10-point score.

DATA SYNTHESIS: Of 1,340 articles in the original search, 29 articles using 16 HRQL instruments and 5 symptoms scores met inclusion and exclusion criteria. The overall quality of these studies was low; only 4 studies scored higher than 4 of 10 points. Four studies included patients with acute sinusitis, but only 2 included exclusively acute sinusitis patients. Three instruments have been shown to meet basic requirements for validity, reliability, and responsiveness: the Chronic Sinusitis Survey, the Rhinosinusitis Outcome Measure-31, and the Sinonasal Outcome Test-16. No instrument has been validated in a primary care setting or for patients with acute sinusitis.

CONCLUSIONS: Few validated measures of sinusitis-specific HRQL are available. The 3 instruments shown to be valid, reliable, and responsive have been assessed in patients with chronic sinusitis. No measure has been validated in primary care settings or for patients with acute sinusitis. A lack of valid, responsive outcome measures may limit current treatment recommendations for patients with acute sinusitis.

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References

  1. Cherry DK, Burt CW, Woodwell DA. National Ambulatory Medical Care Survey: 1999 Summary. Advance data from vital and health statistics; no. 322. Hyattsville, Md: National Center for Health Statistics; 2001.

    Google Scholar 

  2. Schappert SM. Ambulatory care visits to physician offices, hospital outpatient departments, and emergency departments: United States, 1996. National Center for Health Statistics. Vital Health Stat 13. 1998;134:1–37.

    PubMed  Google Scholar 

  3. Woodwell DA. National Ambulatory Medical Care Survey: 1998 Summary. Advance Data from Vital and Health Statistics. Hyattsville, Md: National Center for Health Statistics; 2000.

    Google Scholar 

  4. Gonzales R, Steiner JF, Sande MA. Antibiotic prescribing for adults with colds, upper respiratory tract infections, and bronchitis by ambulatory care physicians. JAMA. 1997;278:901–4.

    Article  PubMed  CAS  Google Scholar 

  5. Gwaltney JM Jr, Phillips CD, Miller RD, Riker DK. Computed tomographic study of the common cold. N Engl J Med. 1994;330:25–30.

    Article  PubMed  Google Scholar 

  6. Lau J, Zucker D, Engels EA, et al. Diagnosis and Treatment of Acute Bacterial Rhinosinusitis. Evidence Report/Technology Assessment No. 9. Rockville, Md: Agency for Health Care Policy and Research; 1999.

    Google Scholar 

  7. Stewart MG, Donovan DT, Parke RB Jr, Bautista MH. Does the severity of sinus computed tomography findings predict outcome in chronic sinusitis? Otolaryngol Head Neck Surg. 2000;123(1 Pt 1):81–4.

    Article  PubMed  CAS  Google Scholar 

  8. Juniper EF. Quality of life in adults and children with asthma and rhinitis. Allergy. 1997;52:971–7.

    Article  PubMed  CAS  Google Scholar 

  9. Curtis JR, Martin DP, Martin TR. Patient-assessed health outcomes in chronic lung disease: what are they, how do they help us, and where do we go from here? Am J Respir Crit Care Med. 1997;156(4 Pt 1):1032–9.

    PubMed  CAS  Google Scholar 

  10. Wilson IB, Cleary PD. Linking clinical variables with health-related quality of life. A conceptual model of patient outcomes. JAMA. 1995;273:59–65.

    Article  PubMed  CAS  Google Scholar 

  11. Spilker B, Revicki DA. Taxonomy of quality of life. In: Spilker B, ed. Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd ed. Philadelphia: Lippincott-Raven; 1996:25–31.

    Google Scholar 

  12. Scientific Advisory Committee of the Medical Outcomes Trust. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res. 2002;11:193–205.

    Article  Google Scholar 

  13. Lohr KN, Aaronson NK, Alonso J, et al. Scientific Advisory Committee Instrument Review Criteria. Boston, Mass: Medical Outcomes Trust; 1997.

    Google Scholar 

  14. Streiner DL, Norman GR. Health Measurement Scales: A Practical Guide to Their Development and Use, 2nd ed. Oxford: Oxford University Press; 1995.

    Google Scholar 

  15. Juniper EF, Guyatt GH, Jaeschke R. How to develop and validate a new health-related quality of life instrument. In: Spilker B. ed. Quality of Life and Pharmacoeconomics in Clinical Trials, 2nd ed. Philadelphia: Lippincott-Raven; 1996:49–56.

    Google Scholar 

  16. Juniper EF, Guyatt GH, Willan A, Griffith LE. Determining a minimal important change in a disease-specific quality of life questionnaire. J Clin Epidemiol. 1994;47:81–7.

    Article  PubMed  CAS  Google Scholar 

  17. Gill TM, Feinstein AR. A critical appraisal of the quality of quality-of-life measurements. JAMA. 1994;272:619–26.

    Article  PubMed  CAS  Google Scholar 

  18. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16:297–334.

    Article  Google Scholar 

  19. Deyo RA, Diehr P, Patrick DL. Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Control Clin Trials. 1991;12(suppl 4):142–158.

    Article  Google Scholar 

  20. Katz JN, Larson MG, Phillips CB, Fossel AH, Liang MH. Comparative measurement sensitivity of short and longer health status instruments. Med Care. 1992;30:917–25.

    Article  PubMed  CAS  Google Scholar 

  21. Piccirillo JF, Edwards D, Haiduk A, Yonan C, Thawley SE. Psychometric and clinimetric validity of the 31-item rhinosinusitis outcome measure (RSOM-31). Am J Rhinol. 1995;9:297–306.

    Google Scholar 

  22. Alsarraf R, Kriet J, Weymuller EA Jr. Quality-of-life outcomes after osteoplastic frontal sinus obliteration. Otolaryngol Head Neck Surg. 1999;121:435–40.

    Article  PubMed  CAS  Google Scholar 

  23. Anderson ER, Murphy MP, Weymuller EA Jr. Clinimetric evaluation of the Sinonasal Outcome Test-16. Student Research Award 1998. Otolaryngol Head Neck Surg. 1999;121:702–7.

    Article  PubMed  CAS  Google Scholar 

  24. Heatley DG, McConnell KE, Kille TL, Leverson GE. Nasal irrigation for the alleviation of sinonasal symptoms. Otolaryngol Head Neck Surg. 2001;125:44–8.

    Article  PubMed  CAS  Google Scholar 

  25. Gliklich RE, Hilinski JM. Longitudinal sensitivity of generic and specific health measures in chronic sinusitis. Qual Life Res. 1995;4:27–32.

    Article  PubMed  CAS  Google Scholar 

  26. Gliklich RE, Metson R. Effect of sinus surgery on quality of life. Otolaryngol Head Neck Surg. 1997;117:12–7.

    Article  PubMed  CAS  Google Scholar 

  27. van Agthoven M, Fokkens WJ, van de Merwe JP, Marijke van Bolhuis E, Uyl-de Groot CA, Busschbach JJ. Quality of life of patients with refractory chronic rhinosinusitis: effects of filgrastim treatment. Am J Rhinol. 2001;15:231–7.

    PubMed  Google Scholar 

  28. Witsell DL, Dolor RJ, Bolte JM, Stinnett SS. Exploring healthrelated quality of life in patients with diseases of the ear, nose, and throat: a multicenter observational study. Otolaryngol Head Neck Surg. 2001;125:288–98.

    Article  PubMed  CAS  Google Scholar 

  29. Benninger MS, Senior BA. The development of the Rhinosinusitis Disability Index. Arch Otolaryngol Head Neck Surg. 1997;123:1175–9.

    PubMed  CAS  Google Scholar 

  30. Murphy C, Davidson TM, Jellison W, et al. Sinonasal disease and olfactory impairment in HIV disease: endoscopic sinus surgery and outcome measures. Laryngoscope. 2000;110(10 Pt 1):1707–10.

    Article  PubMed  CAS  Google Scholar 

  31. Desrosiers MY, Salas-Prato M. Treatment of chronic rhinosinusitis refractory to other treatments with topical antibiotic therapy delivered by means of a large-particle nebulizer: results of a controlled trial. Otolaryngol Head Neck Surg. 2001;125:265–9.

    Article  PubMed  CAS  Google Scholar 

  32. Gliklich RE, Metson R. Techniques for outcomes research in chronic sinusitis. Laryngoscope. 1995;105(4 Pt 1):387–90.

    Article  PubMed  CAS  Google Scholar 

  33. Gliklich RE, Metson R. The health impact of chronic sinusitis in patients seeking otolaryngologic care. Otolaryngol Head Neck Surg. 1995;113:104–9.

    Article  PubMed  CAS  Google Scholar 

  34. Jones ML, Piccirillo JF, Haiduk A, Thawley SE. Functional endoscopic sinus surgery: do ratings of appropriateness predict patient outcomes? Am J Rhinol. 1998;12:249–55.

    PubMed  CAS  Google Scholar 

  35. Krouse JH. Computed tomography stage, allergy testing, and quality of life in patients with sinusitis. Otolaryngol Head Neck Surg. 2000;123:389–92.

    Article  PubMed  CAS  Google Scholar 

  36. Metson R, Gliklich RE. Endoscopic treatment of sphenoid sinusitis. Otolaryngol Head Neck Surg. 1996;114:736–44.

    Article  PubMed  CAS  Google Scholar 

  37. Metson R, Gliklich RE. Clinical outcome of endoscopic surgery for frontal sinusitis. Arch Otolaryngol Head Neck Surg. 1998;124:1090–6.

    PubMed  CAS  Google Scholar 

  38. Stewart MG, Sicard MW, Piccirillo JF, Diaz-Marchan PJ. Severity staging in chronic sinusitis: are CT scan findings related to patient symptoms? Am J Rhinol. 1999;13:161–7.

    PubMed  CAS  Google Scholar 

  39. Winstead W, Barnett SN. Impact of endoscopic sinus surgery on global health perception: an outcomes study. Otolaryngol Head Neck Surg. 1998;119:486–91.

    Article  PubMed  CAS  Google Scholar 

  40. Adelglass J, Jones TM, Ruoff G, et al. A multicenter, investigatorblinded, randomized comparison of oral levofloxacin and oral clarithromycin in the treatment of acute bacterial sinusitis. Pharmacotherapy. 1998;18:1255–63.

    PubMed  CAS  Google Scholar 

  41. Dolor RJ, Witsell DL, Hellkamp AS, Williams JW Jr, Califf RM, Simel DL. Comparison of cefuroxime with or without intranasal fluticasone for the treatment of rhinosinusitis. JAMA. 2001;286:3097–105.

    Article  PubMed  CAS  Google Scholar 

  42. Gosepath J, Belafsky P, Kaldenbach T, Rolfe KW, Mann WJ, Amedee RG. The use of acoustic rhinometry in predicting outcomes after sinonasal surgery. Am J Rhinol. 2000;14:97–100.

    Article  PubMed  CAS  Google Scholar 

  43. Tomooka LT, Murphy C, Davidson TM. Clinical study and literature review of nasal irrigation. Laryngoscope. 2000;110:1189–93.

    Article  PubMed  CAS  Google Scholar 

  44. Hoffman SR, Dersarkissian RM, Buck SH, Stinziano GD, Buck GM. Sinus disease and surgical treatment: a results oriented quality assurance study. Otolaryngol Head Neck Surg. 1989;100:573–7.

    PubMed  CAS  Google Scholar 

  45. Rakkar S, Roberts K, Towe BF, Flores SM, Heyd A, Warner J. Moxifloxacin versus amoxicillin clavulanate in the treatment of acute maxillary sinusitis: a primary care experience. Int J Clin Pract. 2001;55:309–15.

    PubMed  CAS  Google Scholar 

  46. Rosen FS, Sinha UK, Rice DH. Endoscopic surgical management of sphenoid sinus disease. Laryngoscope. 1999;109:1601–6.

    Article  PubMed  CAS  Google Scholar 

  47. Taccariello M, Parikh A, Darby Y, Scadding G. Nasal douching as a valuable adjunct in the management of chronic rhinosinusitis. Rhinology. 1999;37:29–32.

    PubMed  CAS  Google Scholar 

  48. Tarabichi M. Characteristics of sinus-related pain. Otolaryngol Head Neck Surg. 2000;122:842–7.

    PubMed  CAS  Google Scholar 

  49. Walker FD, White PS. Sinus symptom scores: what is the range in healthy individuals? Clin Otolaryngol. 2000;25:482–4.

    Article  PubMed  CAS  Google Scholar 

  50. Bhattacharyya T, Piccirillo J, Wippold FJ II. Relationship between patient-based descriptions of sinusitis and paranasal sinus computed tomographic findings. Arch Otolaryngol Head Neck Surg. 1997;123:1189–92.

    PubMed  CAS  Google Scholar 

  51. Williams JW Jr, Aguilar C, Makela M, et al. Antibiotics for acute maxillary sinusitis (Cochrane Review). In: The Cochrane Library, Issue 4, 2001. Oxford: Update Software; 2001.

    Google Scholar 

  52. Axelsson A, Chidekel N, Grebelius N, Jensen C. Treatment of acute maxillary sinusitis. A comparison of four different methods. Acta Otolaryngol. 1970;70:71–6.

    PubMed  CAS  Google Scholar 

  53. Gananca M, Trabulsi LR. The therapeutic effects of cyclacillin in acute sinusitis: in vitro and in vivo correlations in a placebocontrolled study. Curr Med Res Opin. 1973;1:362–8.

    PubMed  CAS  Google Scholar 

  54. Lindbaek M, Hjortdahl P, Johnsen UL. Randomised, double blind, placebo controlled trial of penicillin V and amoxycillin in treatment of acute sinus infections in adults. BMJ. 1997;313:325–9.

    Google Scholar 

  55. van Buchem FL, Knottnerus JA, Schrijnemaekers VJ, Peeters MF. Primary-care-based randomised placebo-controlled trial of antibiotic treatment in acute maxillary sinusitis. Lancet. 1997;349:683–7.

    Article  PubMed  Google Scholar 

  56. Stalman W, van Essen GA, van der Graaf Y, de Melker RA. The end of antibiotic treatment in adults with acute sinusitis-like complaints in general practice? A placebo-controlled double-blind randomized doxycycline trial. Br J Gen Pract. 1997;47:794–9.

    PubMed  CAS  Google Scholar 

  57. Hickner JM, Bartlett JG, Besser RE, et al. Principles of appropriate antibiotic use for acute rhinosinusitis in adults: background. Ann Intern Med. 2001;134:498–505.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. the General Medicine Division, Massachusetts General Hospital, Boston, Mass, USA

    Daniel E. Singer MD, Melissa van den Ancker MPH & Steven J. Atlas MD, MPH

  2. Division of General Medicine, Brigham and Women’s Hospital, 75 Francis St., 02115, Boston, MA

    Jeffrey A. Linder MD, MPH

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  1. Jeffrey A. Linder MD, MPH
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  2. Daniel E. Singer MD
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Correspondence to Jeffrey A. Linder MD, MPH.

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This study was supported by a grant from Aventis Pharmaceuticals through a Quality Care Research Fund award. Dr. Linder was supported in part by National Research Service Award 5T32PE11001-12.

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Linder, J.A., Singer, D.E., van den Ancker, M. et al. Measures of health-related quality of life for adults with acute sinusitis. J GEN INTERN MED 18, 390–401 (2003). https://doi.org/10.1046/j.1525-1497.2003.20744.x

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