Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis - a GA2LEN study

被引：104

作者：

Tomassen, P. ^{[1
]}

Newson, R. B. ^{[2
]}

Hoffmans, R. ^{[3
]}

Lotvall, J. ^{[4
]}

Cardell, L. O. ^{[5
]}

Gunnbjornsdottir, M. ^{[6
]}

Thilsing, T. ^{[7
]}

Matricardi, P. ^{[8
]}

Kraemer, U. ^{[9
,10
]}

Makowska, J. S. ^{[11
]}

Brozek, G. ^{[12
]}

Gjomarkaj, M. ^{[13
]}

Howarth, P. ^{[14
]}

Loureiro, C. ^{[15
]}

Toskala, E. ^{[16
]}

Fokkens, W. ^{[3
]}

Bachert, C. ^{[1
]}

Burney, P. ^{[2
]}

Jarvis, D. ^{[2
]}

机构：

[1] Univ Ghent, Upper Airways Res Lab, Dept Otorhinolaryngol & Logopaed Audiol Sci, B-9000 Ghent, Belgium

[2] Univ London Imperial Coll Sci Technol & Med, Natl Heart & Lung Inst, Resp Epidemiol & Publ Hlth Grp, London, England

[3] Univ Amsterdam, Acad Med Ctr, Dept Otorhinolaryngol, NL-1105 AZ Amsterdam, Netherlands

[4] Univ Gothenburg, Dept Internal Med, Krefting Res Ctr, Gothenburg, Sweden

[5] Karolinska Inst, CLINTEC, Div ENT Dis, Stockholm, Sweden

[6] Uppsala Univ, Akad Sjukhuset, Dept Med Sci Resp Med & Allergol, Uppsala, Sweden

[7] Odense Univ Hosp, Dept Occupat & Environm Med, DK-5000 Odense, Denmark

[8] Charite, Dept Pediat Pneumol & Immunol, D-13353 Berlin, Germany

[9] Tech Univ Munich, Dept Dermatol & Allergy Biederstein, D-8000 Munich, Germany

[10] Univ Dusseldorf, Inst Umweltmed Forsch, Dusseldorf, Germany

[11] Med Univ Lodz, Dept Immunol Rheumatol & Allergy, Lodz, Poland

[12] Med Univ Silesia, Dept Epidemiol, Katowice, Poland

[13] CNR, Ist Biomed & Immunol Mol, Palermo, Italy

[14] Southampton Univ Hosp Trust, Southampton, Hants, England

[15] Hosp Univ Coimbra, Pulmonol Unit, Coimbra, Portugal

[16] Finnish Inst Occupat Hlth, Helsinki, Finland

来源：

ALLERGY | 2011年 / 66卷 / 04期

关键词：

endoscopy; questionnaires; reproducibility of results; sinusitis; validation studies; CHRONIC SINUSITIS; DEFINITION; PREVALENCE; DIAGNOSIS;

D O I：

10.1111/j.1398-9995.2010.02503.x

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

P>Background: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) incorporates symptomatic, endoscopic, and radiologic criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studies, the definition is based on symptoms only. We aimed to assess the reliability and validity of a symptom-based definition of CRS using data from the GA2LEN European survey. Methods: On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, allergic rhinitis, and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in prevalence of CRS between two study points, the standardized absolute repeatability, and the chance-corrected repeatability (kappa) were determined. In two centers, 342 participants underwent nasal endoscopy. The association of symptom-based CRS with endoscopy and self-reported doctor-diagnosed CRS was assessed. Results: There was a decrease in prevalence of CRS between the two study phases, and this was consistent across all centers (-3.0%, 95% CI: -5.0 to -1.0%, I2 = 0). There was fair to moderate agreement between the two occasions (kappa = 39.6). Symptom-based CRS was significantly associated with positive endoscopy in nonallergic subjects, and with self-reported doctor-diagnosed CRS in all subjects, irrespective of the presence of allergic rhinitis. Conclusion: Our findings suggest that a symptom-based definition of CRS, according to the epidemiological part of the EP3OS criteria, has a moderate reliability over time, is stable between study centers, is not influenced by the presence of allergic rhinitis, and is suitable for the assessment of geographic variation in prevalence of CRS.

引用

页码：556 / 561

页数：6

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