The modified SNOT-20 questionnaire: Repeatability and applicability to rhinitis

The modified SNOT-20 Questionnaire: repeatability and applicability to rhinitis

A. Sami ,A. McComb,  J. Jeffs and P. Howarth

<>Background

Rhinitis is a clinically prevalent disease, symptomatically characterised by nasal itch, sneezing and difficulty breathing through the nose. Patients with rhinitis often suffer from associated symptoms related to posterior nasal, sinus and ear disease. Other effects on the psychological well being are also accountable to rhinitis.

A number of these features are encompassed in disease specific quality of life (QoL) questionnaires. However, the Modified SNOT-20 (MSNOT-20) questionnaire aims to correspond to the requirements for a complete and comprehensive assessment of rhinitis and its impact.  It uses a six-point scale to identify clinical severity (0=no problem, 5=very severe problem). <>Method

The MSNOT-20 questionnaire was evaluated in a pilot study of disease and non-disease and then used to assess the prevalence of rhinitis and associated features in a community based survey. Following a successful pilot project, 2000 postal questionnaires were sent to randomly selected adults from the electoral register in Farnborough. Differences in housing, social class and environment were balanced with repeat questionnaires sent for non-respondents. <>Results

In the pilot study, there were significant differences (p < 0.001) in symptom reporting between rhinitics and non-rhinitics, with 92.67% of the healthy controls responding on all 20 questions either 0=no problem (85.67%) or 1=very mild problems (7%) in comparison to 42.07 % in the rhinitis group (28.7 % of responses no problem, 13 % very mild problems). A score of 0 or 1 was thus taken as normal and 2-5 taken as abnormal.

In the community survey in Farnborough, 68% of 1580 evaluable respondents (79.8 % response rate) had a total SNOT-20 score of 0-20 (max 100) with 32% scoring 21 + (max 88). There were significant correlations between the rhinitis domain and the 4 other domains (paranasal [sinus and ear], sleep, social and emotional). The repeatability of these responses was evaluated in a follow-up evaluation in a subpopulation. <>Conclusion

MSNOT-20 questionnaire is a disease-related QoL rhinitis questionnaire, which is valid for the evaluation of rhinitis and the impact of disease on quality of life. It identified a high prevalence of nasal and paranasal problems within the community with significant co-morbidity caused by rhinitis.