Chronic rhinosinusitis, what do patient-reported outcome measures measure?

Chronic rhinosinusitis (CRS) is a multifactorial chronic mucosal inflammatory disease of the nose and paranasal sinuses. The definition of CRS is based on patient-reported outcomes, physician-reported outcomes. This seems a clear way of defining disease, however, there are discrepancies between these different perspectives. To determine the level of control of disease in the course of treatment, it is essential to use an instrument that is validated for that specific use, and to know about the strengths, possible weaknesses and limitations of Patient-reported outcome measurements (PROMs).
This thesis focused on gaining insight on the use of PROMs, in particular 22-item SinoNasal Outcome Test (SNOT-22), applied during diagnosis, evaluation of treatment and in research. It covers the validation of the Dutch translation of the SNOT-22 (NL-SNOT-22) and a comprehensive review on the use of several questionnaires in CRS and allergic rhinitis (AR).
‘Typical’ symptoms to make a phenotypical distinction between patients with CRS with or without nasal polyps are elucidated not to be accurate.
The first-time reported epidemiological study using imaging as physician-reported parameter found that this halves the prevalence compared to the epidemiological definition (symptoms only). Concerning determining level of control of disease in CRS; the use of SNOT-22 items is illustrated and the negative impact of occupational exposure is confirmed.
In the future there will be an increasing role for the use of PROMs in managing CRS. Thorough knowledge on PROMs is indispensable to give opportunities for these future evolutions.