COSMIN database

Measures of health-related quality of life for adults with acute sinusitis. A systematic review

Linder, J. A., Singer, D. E., Ancker, M., and Atlas, S. J.
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.
J Gen Intern Med
0884-8734 (Print)
Publication year:
Symptom status:
Physical state
Functional status:
Physical functioning
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the respiratory system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
6 - Clinical rating scales
CSSD - Chronic Sinusitis Survey-duration based
CSSS - Chronic Sinusitis Survey-severity based
HRQL Instrument of Adelglass et al.
HRQL Instrument of Rakar et al.
HRQoL Instrument of Hoffman et al.
HRQoL Instrument of Rosen et al.
International Conference on Sinus Disease Symptome Score
MMPQ - Modified McGill Pain Questionnaire
Modified Rhinoconjunctivitis Quality of Life Instrument
Nasal Disease-Sepcific Severity Measure of Tomooka et al.
Nasal Disease-Specific Duration Measure of Tomooka et al.
QWB - Quality of Well-Being Scale
RQoLQ - Rhinoconjunctivitis Quality of Life Questionnaire
RSDI - Rhinosinusitis Disability Index
RSOM-31 - Rhinosinusitis Outcome Measure-31
SF-12 - 12-item Short Form Health Survey [alias: RAND-12]
SF-36 - 36-item Short Form Health Survey [alias: RAND-36][alias: Medical Outcomes Study (MOS) SF-36]]    |  | also see:
SNOT-16 - Sinonasal Outcome test-16
SNOT-20 - 20-Item Sino-Nasal Outcome Test