Reliability and Validity of the Arabic Version of the NOSE-Perf Scale

To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation-perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf questionnaire is. Patients with septal perforations, particularly Arabic speakers, lack validated self-assessment tools for subjective symptom evaluation.

Conducted between May 2024 and June 2025, the study included 100 participants-20 patients with septal perforation and 80 controls. Participants filled out a questionnaire consisting of demographic data as well as the Arabic forms of the Sino-Nasal Outcome Test-22 (SNOT-22), NOSE, and NOSE-Perf scales. Cronbach's alpha was applied to determine internal consistency, and the intraclass correlation coefficient (ICC) was utilized to verify test-retest reliability. Discriminative validity was evaluated by comparing score differences, while concurrent validity was analyzed through correlations with the NOSE and SNOT-22 scales.

Strong correlations were observed between the NOSE-Perf and the established NOSE (r = 0.920, p < 0.001) and SNOT-22 (r = 0.885, p < 0.001) measures, confirming the scale's concurrent validity. Discriminative validity was evident: NOSE-Perf scores were significantly higher in cases (29.8 ± 9.48) than controls (5.76 ± 8.10, p < 0.001; AUC = 0.856). NOSE scores also differed (cases: 68.1 ± 26.1; controls: 9.44 ± 21.9; p < 0.001; AUC = 0.931). SNOT-22 scores were 57.1 ± 24.2 in cases and 18.0 ± 18.4 in controls (p < 0.001; AUC = 0.32).

The Arabic adaptation of the NOSE-Perf questionnaire exhibited reliability and validity as a tool for assessing subjective symptoms among individuals experiencing septal perforation.