Comparison of Chronic Rhinosinusitis Disease Control Classification Using the Chronic Rhinosinusitis Control Test...

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.

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.

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.

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.