慢性鼻窦炎控制测试与EPOS标准对慢性鼻窦炎疾病控制分类的比较
Comparison of Chronic Rhinosinusitis Disease Control Classification Using the Chronic Rhinosinusitis Control Test Versus EPOS Criteria.
文献信息
| PMID | 42922438 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Nikhil Parail |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA. |
| 期刊 | International forum of allergy & rhinology |
| SCI 分区 | Q1 |
| IF | 4.9 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
引言： 本研究的目的是在真实世界慢性鼻窦炎（CRS）患者队列中，比较使用EPOS标准和慢性鼻窦炎控制测试（CRCT）对CRS控制情况的分类。
方法： 使用EPOS和基于CRCT的分类方法，将305名参与者的CRS控制情况分为控制、部分控制或未控制。CRS疾病负担指标包括总体症状严重程度（OSS）、疾病特异性生活质量（SNOT-22）和一般健康相关生活质量（EQ-5D VAS），以及内镜下疾病负担（改良Lund-Kennedy [MLK]评分）。通过比较每种分类方案下不同CRS控制水平的CRS疾病负担，确定聚合效度和区分效度。
结果： CRCT与EPOS标准对CRS控制分类的一致性为35.7%（κ = 0.366，p < 0.001）。与既往显示的患者和提供者对CRS控制的分类方式一致，与EPOS标准相比，CRCT将更多参与者分类为控制或部分控制CRS，而EPOS标准则严重倾向于将参与者分类为未控制CRS。CRCT控制分类通过反映相应水平的疾病负担且各控制类别间存在显著差异，表现出聚合效度和区分效度。EPOS对控制或部分控制CRS的分类缺乏区分效度，而EPOS对未控制CRS的分类因纳入疾病负担非常轻微的CRS患者而缺乏聚合效度。
结论： 与EPOS指南提出的分类方案相比，CRCT对CRS控制的分类更接近患者和提供者对CRS控制的评估，并具有更好的聚合效度和区分效度。
英文摘要
INTRODUCTION: The objective of this study was to compare classification of CRS control using EPOS criteria and the Chronic Rhinosinusitis Control Test (CRCT) in a real-world cohort of chronic rhinosinusitis (CRS) patients.
METHODS: CRS control was classified as controlled, partly controlled, or uncontrolled in 305 participants using EPOS and CRCT-based classifications. Metrics of CRS disease burden included Overall Symptom Severity (OSS), disease-specific (SNOT-22) and general health-related (EQ-5D VAS) quality of life, and endoscopic disease burden (modified Lund-Kennedy [MLK] score). Convergent and divergent validity were determined by comparing CRS disease burden across different levels of CRS control for each classification scheme.
RESULTS: There was 35.7% agreement (κ = 0.366, p < 0.001) between CRS control classification using the CRCT compared to the EPOS criteria. Consistent with how patients and providers have been previously shown to classify CRS control, the CRCT classified more participants as having controlled and partly controlled CRS compared to the EPOS criteria, which heavily skewed toward classifying participants as having uncontrolled CRS. The CRCT control classifications demonstrated convergent and divergent validity by reflecting appropriate levels of disease burden with significant differences between control classes. The EPOS classifications of controlled and partly controlled CRS lacked divergent validity, and the EPOS classification of uncontrolled CRS lacked convergent validity by including patients with very mild CRS disease burden.
CONCLUSION: Compared to the classification scheme proposed by the EPOS guidelines, the classification of CRS control by the CRCT more closely aligns with patients' and providers' assessments of CRS control and has greater convergent and divergent validity.