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New CRS control tests: development and validation by EUFOREA
D M Conti1,2, W J Fokkens3, G K Scadding4
1Escuela de Doctorado UAM, Centro de Estudios de Posgrado, Universidad Autónoma de Madrid. Calle Francisco Tomás y Valiente, nº 2, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain.
Background:
Measuring control in Chronic Rhinosinusitis (CRS) is important in clinical evaluation. We developed and validated 2 new tests for the evaluation of control in CRS, the 6-item CRS Control Test (CCT) and the 14-item CRS Patient Control Test (CPCT) and investigated their correlations with existing tools.
Methods:
An international survey was conducted in 1,102 CRS patients in 19 centres in 7 countries using a questionnaire including the newly developed CCT and CPCT, VAS scores for CRS severity and control, the EPOS control test (EPOSCT), the Sino-Nasal Outcome Test 22 (SNOT-22) and the Patient Global Assessment Tool (PGAT). We evaluated convergent and discriminative validity, internal consistency and cross-cultural validity. Furthermore, we performed an Item Response Theory (IRT) analysis and determined cut-off points for CCT and CPCT. Sub-analyses were performed for CRS patients with and without nasal polyps.
Results:
Both CCT (0-24) and CPCT (0-56) demonstrated a high correlation with SNOT-22 and the PGAT. Moderate correlations were observed for all other comparisons. Both tests showed good internal consistency, discriminative validity and cross-cultural validity. We propose for CCT ≤15 to indicate uncontrolled, 16-19 partially controlled, and ≥20 well controlled disease. For the CPCT we propose ≥22 for uncontrolled, 13-21 for partially controlled and ≤12 for well controlled disease.
Conclusion:
The brief CCT and the longer CPCT are new CRS control tests that show moderate to high correlations with existing tools. Both instruments demonstrated good psychometric properties and therefore can be recommended for use in clinical practice and research.