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Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis - a GA2LEN study

PETER TOMASSEN UGent, Roger Newson, Ruth Hoffmans, Jan Lötvall, Lars-Olaf Cardell, Maria Gunnbjörnsdóttir, Trine Thilsing, Paolo Matricardi, Ursula Kramer and Joanna Makowska, et al. (2011) ALLERGY. 66(4). p.556-561
abstract
Background: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) incorporates symptomatic, endoscopic, and radiologic criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studies, the definition is based on symptoms only. We aimed to assess the reliability and validity of a symptom-based definition of CRS using data from the GA2LEN European survey. Methods: On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, allergic rhinitis, and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in prevalence of CRS between two study points, the standardized absolute repeatability, and the chance-corrected repeatability (kappa) were determined. In two centers, 342 participants underwent nasal endoscopy. The association of symptom-based CRS with endoscopy and self-reported doctor-diagnosed CRS was assessed. Results: There was a decrease in prevalence of CRS between the two study phases, and this was consistent across all centers (-3.0%, 95% CI: -5.0 to -1.0%, I2 = 0). There was fair to moderate agreement between the two occasions (kappa = 39.6). Symptom-based CRS was significantly associated with positive endoscopy in nonallergic subjects, and with self-reported doctor-diagnosed CRS in all subjects, irrespective of the presence of allergic rhinitis. Conclusion: Our findings suggest that a symptom-based definition of CRS, according to the epidemiological part of the EP3OS criteria, has a moderate reliability over time, is stable between study centers, is not influenced by the presence of allergic rhinitis, and is suitable for the assessment of geographic variation in prevalence of CRS.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
DIAGNOSIS, PREVALENCE, DEFINITION, CHRONIC SINUSITIS, ALLERGIC RHINITIS, validation studies, sinusitis, reproducibility of results, endoscopy, questionnaires
journal title
ALLERGY
Allergy
volume
66
issue
4
pages
556 - 561
Web of Science type
Article
Web of Science id
000287700000013
JCR category
ALLERGY
JCR impact factor
6.271 (2011)
JCR rank
2/23 (2011)
JCR quartile
1 (2011)
ISSN
0105-4538
DOI
10.1111/j.1398-9995.2010.02503.x
project
GA_LEN: Global Allergy and Asthma European Network
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1057505
handle
http://hdl.handle.net/1854/LU-1057505
date created
2010-10-11 15:54:13
date last changed
2011-07-06 14:15:39
@article{1057505,
  abstract     = {Background: The European Position Paper on Rhinosinusitis and Nasal Polyps (EP3OS) incorporates symptomatic, endoscopic, and radiologic criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studies, the definition is based on symptoms only. We aimed to assess the reliability and validity of a symptom-based definition of CRS using data from the GA2LEN European survey.
Methods: On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, allergic rhinitis, and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in prevalence of CRS between two study points, the standardized absolute repeatability, and the chance-corrected repeatability (kappa) were determined. In two centers, 342 participants underwent nasal endoscopy. The association of symptom-based CRS with endoscopy and self-reported doctor-diagnosed CRS was assessed.
Results: There was a decrease in prevalence of CRS between the two study phases, and this was consistent across all centers (-3.0\%, 95\% CI: -5.0 to -1.0\%, I2 = 0). There was fair to moderate agreement between the two occasions (kappa = 39.6). Symptom-based CRS was significantly associated with positive endoscopy in nonallergic subjects, and with self-reported doctor-diagnosed CRS in all subjects, irrespective of the presence of allergic rhinitis.
Conclusion: Our findings suggest that a symptom-based definition of CRS, according to the epidemiological part of the EP3OS criteria, has a moderate reliability over time, is stable between study centers, is not influenced by the presence of allergic rhinitis, and is suitable for the assessment of geographic variation in prevalence of CRS.},
  author       = {TOMASSEN, PETER and Newson, Roger and Hoffmans, Ruth and L{\"o}tvall, Jan and Cardell, Lars-Olaf and Gunnbj{\"o}rnsd{\'o}ttir, Maria and Thilsing, Trine and Matricardi, Paolo and Kramer, Ursula and Makowska, Joanna and Brozek, Gregorz and Gjomarkaj, Mark and Howarth, Peter and Loureiro, Claudia and Toskala, Elina and Fokkens, Wytske and Bachert, Claus and Burney, Peter and Jarvis, Deborah},
  issn         = {0105-4538},
  journal      = {ALLERGY},
  keyword      = {DIAGNOSIS,PREVALENCE,DEFINITION,CHRONIC SINUSITIS,ALLERGIC RHINITIS,validation studies,sinusitis,reproducibility of results,endoscopy,questionnaires},
  language     = {eng},
  number       = {4},
  pages        = {556--561},
  title        = {Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis - a GA2LEN study},
  url          = {http://dx.doi.org/10.1111/j.1398-9995.2010.02503.x},
  volume       = {66},
  year         = {2011},
}

Chicago
TOMASSEN, PETER, Roger Newson, Ruth Hoffmans, Jan Lötvall, Lars-Olaf Cardell, Maria Gunnbjörnsdóttir, Trine Thilsing, et al. 2011. “Reliability of EP3OS Symptom Criteria and Nasal Endoscopy in the Assessment of Chronic Rhinosinusitis - a GA2LEN Study.” Allergy 66 (4): 556–561.
APA
TOMASSEN, P., Newson, R., Hoffmans, R., Lötvall, J., Cardell, L.-O., Gunnbjörnsdóttir, M., Thilsing, T., et al. (2011). Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis - a GA2LEN study. ALLERGY, 66(4), 556–561.
Vancouver
1.
TOMASSEN P, Newson R, Hoffmans R, Lötvall J, Cardell L-O, Gunnbjörnsdóttir M, et al. Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis - a GA2LEN study. ALLERGY. 2011;66(4):556–61.
MLA
TOMASSEN, PETER, Roger Newson, Ruth Hoffmans, et al. “Reliability of EP3OS Symptom Criteria and Nasal Endoscopy in the Assessment of Chronic Rhinosinusitis - a GA2LEN Study.” ALLERGY 66.4 (2011): 556–561. Print.