The relationship between subjective assessment instruments in chronic rhinosinusitis

To provide an evidence-based definition for the relationship between three subjective instruments for assessing severity of chronic rhinosinusitis- visual analogue scale, 'mild' 'moderate' and 'severe' (MMS) classification and perception of whether quality of life (QoL) is affected.

One hundred sixteen subjects with chronic rhinosinusitis filled in a questionnaire rating simultaneously their perception of disease severity based (1) upon visual analogue scale, (2) MMS classification and (3) stating whether they felt their QoL was affected.

The mean age of subjects was 50. The inter-quartile range of VAS scores for the respective MMS groups were: Mild 0.80-3.50, Moderate 4.40-6.33, Severe 7.70-9.50. In the group who perceived effects on QoL, the inter-quartile range for VAS scores was 5.10-8.68. This range was 1.53-4.57 in the other group with no effects on QoL. 30.3% of patients in the 'mild' category, 79.6% in the 'moderate' category and 97.4% in the 'severe' category felt that their QoL was affected.

We propose a statistically validated definition of the relationship between MMS classification and VAS scoring. Based on our study we would define 'mild' as being 0- 3 inclusive, 'moderate, as > 3- 7 inclusive and 'severe' as > 7- 10 inclusive on the VAS scoring system. We further propose that in general QoL is more likely to be affected with VAS scores of 5 or more.