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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Response shift in quality of life after endoscopic sinus surgery for chronic rhinosinusitis</title><author><name sortKey="Deconde, Adam S" sort="Deconde, Adam S" uniqKey="Deconde A" first="Adam S." last="Deconde">Adam S. Deconde</name><affiliation><nlm:aff id="A1">Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology – Head and Neck Surgery; Oregon Health & Science University, Portland, Oregon, USA</nlm:aff></affiliation></author><author><name sortKey="Bodner, Todd E" sort="Bodner, Todd E" uniqKey="Bodner T" first="Todd E." last="Bodner">Todd E. Bodner</name><affiliation><nlm:aff id="A2">Department of Psychology, Portland State University, Portland, Oregon, USA</nlm:aff></affiliation></author><author><name sortKey="Mace, Jess C" sort="Mace, Jess C" uniqKey="Mace J" first="Jess C." last="Mace">Jess C. Mace</name><affiliation><nlm:aff id="A1">Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology – Head and Neck Surgery; Oregon Health & Science University, Portland, Oregon, USA</nlm:aff></affiliation></author><author><name sortKey="Smith, Timothy L" sort="Smith, Timothy L" uniqKey="Smith T" first="Timothy L." last="Smith">Timothy L. Smith</name><affiliation><nlm:aff id="A1">Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology – Head and Neck Surgery; Oregon Health & Science University, Portland, Oregon, USA</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25074504</idno><idno type="pmc">4151456</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4151456</idno><idno type="RBID">PMC:4151456</idno><idno type="doi">10.1001/jamaoto.2014.1045</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000405</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000405</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Response shift in quality of life after endoscopic sinus surgery for chronic rhinosinusitis</title><author><name sortKey="Deconde, Adam S" sort="Deconde, Adam S" uniqKey="Deconde A" first="Adam S." last="Deconde">Adam S. Deconde</name><affiliation><nlm:aff id="A1">Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology – Head and Neck Surgery; Oregon Health & Science University, Portland, Oregon, USA</nlm:aff></affiliation></author><author><name sortKey="Bodner, Todd E" sort="Bodner, Todd E" uniqKey="Bodner T" first="Todd E." last="Bodner">Todd E. Bodner</name><affiliation><nlm:aff id="A2">Department of Psychology, Portland State University, Portland, Oregon, USA</nlm:aff></affiliation></author><author><name sortKey="Mace, Jess C" sort="Mace, Jess C" uniqKey="Mace J" first="Jess C." last="Mace">Jess C. Mace</name><affiliation><nlm:aff id="A1">Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology – Head and Neck Surgery; Oregon Health & Science University, Portland, Oregon, USA</nlm:aff></affiliation></author><author><name sortKey="Smith, Timothy L" sort="Smith, Timothy L" uniqKey="Smith T" first="Timothy L." last="Smith">Timothy L. Smith</name><affiliation><nlm:aff id="A1">Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology – Head and Neck Surgery; Oregon Health & Science University, Portland, Oregon, USA</nlm:aff></affiliation></author></analytic><series><title level="j">JAMA otolaryngology-- head & neck surgery</title><idno type="ISSN">2168-6181</idno><idno type="eISSN">2168-619X</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Importance</title><p id="P1">Patient-reported measures are designed to detect a true change in outcome, but they are also subject to change from biases inherent to self-reporting: changing internal standards, changing priorities, and changing interpretations of a given instrument. These biases are collectively known as `response shifts' and can obscure true change after medical interventions.</p></sec><sec id="S2"><title>Objective</title><p id="P2">To determine the presence of response shifts in patients with chronic rhinosinusitis (CRS) after endoscopic sinus surgery.</p></sec><sec id="S3"><title>Design, Setting, and Participants</title><p id="P3">Multisite, prospective, observational cohort study conducted at academic tertiary care centers between February 2011 and May 2013. Study participants comprised a population-based sample of 514 adults (age ≥18 years) with CRS, who elected surgical intervention for continuing medically refractory symptoms.</p></sec><sec id="S4"><title>Intervention</title><p id="P4">Endoscopic sinus surgery.</p></sec><sec id="S5"><title>Main Outcome and Measures</title><p id="P5">Preoperative and postoperative data from the 22-item Sinonasal Outcome Test (SNOT-22) survey instrument was characterized using exploratory factor analysis. Subsequent longitudinal structural equation models were estimated to test structure, potential response shifts, and true change in the SNOT-22.</p></sec><sec id="S6"><title>Results</title><p id="P6">A total of 339 participants (66.0%) provided survey evaluations at baseline and 6-month follow-up. Factor analysis of the SNOT-22 revealed 5 correlated, yet distinguishable, underlying factors. Endoscopic sinus surgery had a differential impact across these factors, with the largest effect size in rhinologic symptoms (mean[SD] SNOT-22 score before and after surgery, 13.18[5.11] and 7.37[5.48], respectively; <italic>d</italic>= −1.13 [P < .001] and extranasal rhinologic symptoms (8.31[3.46] and 4.83[3.68], respectively; <italic>d</italic>= −1.00 [p<0.05]) (d is an effect size measure defined as the difference in means divided by the presurgery SD). Endoscopic sinus surgery had a smaller, yet significant, effect size on the remaining 3 factors: ear/facial symptoms (7.32[4.6] and 3.90[4.1], respectively; <italic>d</italic>= −0.74; P<0.001), psychological dysfunction (11.90[7.21] and 6.50[6.69], respectively; <italic>d</italic>= −0.75; P<0.05), and sleep dysfunction (10.12[5.59] and 5.88[5.37], respectively; <italic>d</italic>= −0.76; P<0.001). Participants were found to undergo recalibration, reprioritization, and reconceptualization of symptoms after intervention; however, the magnitude of these response shifts was small and not clinically significant.</p></sec><sec id="S7"><title>Conclusions and Relevance</title><p id="P7">The SNOT-22 measures 5 distinct factors, not a single construct. Reporting of individual subscale scores may improve sensitivity of this instrument in future studies. Participants undergoing endoscopic sinus surgery experience only clinically insignificant response shifts, validating assessment of change through use of presurgery and postsurgery SNOT-22 responses.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">101589542</journal-id><journal-id journal-id-type="pubmed-jr-id">40867</journal-id><journal-id journal-id-type="nlm-ta">JAMA Otolaryngol Head Neck Surg</journal-id><journal-id journal-id-type="iso-abbrev">JAMA Otolaryngol Head Neck Surg</journal-id><journal-title-group><journal-title>JAMA otolaryngology-- head & neck surgery</journal-title></journal-title-group><issn pub-type="ppub">2168-6181</issn><issn pub-type="epub">2168-619X</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25074504</article-id><article-id pub-id-type="pmc">4151456</article-id><article-id pub-id-type="doi">10.1001/jamaoto.2014.1045</article-id><article-id pub-id-type="manuscript">NIHMS623534</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Response shift in quality of life after endoscopic sinus surgery for chronic rhinosinusitis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>DeConde</surname><given-names>Adam S.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Bodner</surname><given-names>Todd E.</given-names></name><degrees>Ph.D</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Mace</surname><given-names>Jess C.</given-names></name><degrees>MPH, CCRP</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Timothy L.</given-names></name><degrees>MD MPH</degrees><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Department of Otolaryngology – Head and Neck Surgery; Oregon Health & Science University, Portland, Oregon, USA</aff><aff id="A2"><label>2</label>Department of Psychology, Portland State University, Portland, Oregon, USA</aff><author-notes><corresp id="CR1"><underline><bold>Corresponding Author:</bold></underline> Timothy L. Smith, MD, MPH Oregon Health & Science University Department of Otolaryngology – Head and Neck Surgery Division of Rhinology and Sinus/Skull Base Surgery, Oregon Sinus Center 3181 SW Sam Jackson Park Road, PV-01 Portland, Oregon 97239 FAX: 503-494-4631 <email>smithtim@ohsu.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>27</day><month>8</month><year>2014</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>8</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>8</month><year>2015</year></pub-date><volume>140</volume><issue>8</issue><fpage>712</fpage><lpage>719</lpage><pmc-comment>elocation-id from pubmed: 10.1001/jamaoto.2014.1045</pmc-comment>
<abstract><sec id="S1"><title>Importance</title><p id="P1">Patient-reported measures are designed to detect a true change in outcome, but they are also subject to change from biases inherent to self-reporting: changing internal standards, changing priorities, and changing interpretations of a given instrument. These biases are collectively known as `response shifts' and can obscure true change after medical interventions.</p></sec><sec id="S2"><title>Objective</title><p id="P2">To determine the presence of response shifts in patients with chronic rhinosinusitis (CRS) after endoscopic sinus surgery.</p></sec><sec id="S3"><title>Design, Setting, and Participants</title><p id="P3">Multisite, prospective, observational cohort study conducted at academic tertiary care centers between February 2011 and May 2013. Study participants comprised a population-based sample of 514 adults (age ≥18 years) with CRS, who elected surgical intervention for continuing medically refractory symptoms.</p></sec><sec id="S4"><title>Intervention</title><p id="P4">Endoscopic sinus surgery.</p></sec><sec id="S5"><title>Main Outcome and Measures</title><p id="P5">Preoperative and postoperative data from the 22-item Sinonasal Outcome Test (SNOT-22) survey instrument was characterized using exploratory factor analysis. Subsequent longitudinal structural equation models were estimated to test structure, potential response shifts, and true change in the SNOT-22.</p></sec><sec id="S6"><title>Results</title><p id="P6">A total of 339 participants (66.0%) provided survey evaluations at baseline and 6-month follow-up. Factor analysis of the SNOT-22 revealed 5 correlated, yet distinguishable, underlying factors. Endoscopic sinus surgery had a differential impact across these factors, with the largest effect size in rhinologic symptoms (mean[SD] SNOT-22 score before and after surgery, 13.18[5.11] and 7.37[5.48], respectively; <italic>d</italic>= −1.13 [P < .001] and extranasal rhinologic symptoms (8.31[3.46] and 4.83[3.68], respectively; <italic>d</italic>= −1.00 [p<0.05]) (d is an effect size measure defined as the difference in means divided by the presurgery SD). Endoscopic sinus surgery had a smaller, yet significant, effect size on the remaining 3 factors: ear/facial symptoms (7.32[4.6] and 3.90[4.1], respectively; <italic>d</italic>= −0.74; P<0.001), psychological dysfunction (11.90[7.21] and 6.50[6.69], respectively; <italic>d</italic>= −0.75; P<0.05), and sleep dysfunction (10.12[5.59] and 5.88[5.37], respectively; <italic>d</italic>= −0.76; P<0.001). Participants were found to undergo recalibration, reprioritization, and reconceptualization of symptoms after intervention; however, the magnitude of these response shifts was small and not clinically significant.</p></sec><sec id="S7"><title>Conclusions and Relevance</title><p id="P7">The SNOT-22 measures 5 distinct factors, not a single construct. Reporting of individual subscale scores may improve sensitivity of this instrument in future studies. Participants undergoing endoscopic sinus surgery experience only clinically insignificant response shifts, validating assessment of change through use of presurgery and postsurgery SNOT-22 responses.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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