Unbiased Measure of General Quality of Life in Chronic Rhinosinusitis Reveals Disease Modifiers. (2nd October 2020)

• Record Type: Journal Article
• Authors: Epperson, Madison V.; McCann, Adam C.; Phillips, Katie M.; Caradonna, David S.; Gray, Stacey T.; Sedaghat, Ahmad R.
• Is Part Of: Laryngoscope. Volume 131:Number 6(2021)
• Page Start: 1206
• Page End: 1211
• Publication Date: 2020-10-02
• Subjects: chronic rhinosinusitis -- quality of life -- EuroQol 5‐dimensional questionnaire -- health utility value -- visual analog scale -- bias; Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.29139
• Languages: English
• ISSNs: 0023-852X

Abstract

Abstract : Introduction: Chronic rhinosinusitis (CRS) is associated with a significant decrease in general health‐related quality of life (QOL). The EuroQol 5‐dimensional questionnaire measures general health‐related quality of life through a health utility value (EQ‐5D HUV)—based on five domains reflecting mobility, self‐care, activities of daily life, pain/discomfort, and anxiety/depression—and an unbiased visual analog scale (EQ‐5D VAS). We sought to identify characteristics of CRS patients with a high EQ‐5D HUV but low EQ‐5D VAS score. Materials and Methods: Retrospective cross‐sectional study of 300 CRS patients with EQ‐5D HUV equal to 1.0 (reflecting perfect health). All patients completed a 22‐item Sinonasal Outcome Test (SNOT‐22)—from which nasal, sleep, ear/facial discomfort, and emotional subdomain scores were calculated, as well as the EQ‐5D. Low EQ‐5D VAS was defined as a score less than 80. Results: On multivariate analysis, low EQ‐5D VAS was associated with only the SNOT‐22 sleep subdomain score (odds ratio [OR] = 1.07, 95%CI: 1.02–1.12, P = .003). Comorbid asthma was also associated with lower EQ‐5D VAS (OR = 2.16, 95%CI: 1.02–4.59, P = .045). In contrast, polyps were negatively associated with having a lower EQ‐5D VAS (OR = 0.34, 95%CI: 0.17–0.69, P = .003). Conclusion: There are patients with perfect general health‐related QOL according to a health utility value‐based methodology (like the EQ‐5D HUV) who report low general health‐related QOL on an unbiased measure like the EQ‐5D VAS. In CRS patients with perfect EQ‐5D HUV, poor sleep and asthma were associated with low QOL on the EQ‐5D VAS, while polyps were negatively associated with low QOL. Level of Evidence: 3 Laryngoscope, 131:1206–1211, 2021