Conceptualization of children-reported outcome measures for sinonasal disease; the pediatric sinus and nasal quality of life questionnaire (pSN-5)

Purpose: A child-reported outcome measure for sinonasal disease is important as it allows the child to participate in decision-making, as well as permitting clinicians to have an objective measure of treatment outcomes. Here, we evaluate the internal validity, test-retest reliability and construct validity of the pediatric sinus and nasal quality of life questionnaires (pSN-5) against the Sinus and Nasal Quality of Life Survey (SN-5). Methods: Eighty-six children aged 7-15 years-old were prospectively enrolled in the study through convenience sampling. The pSN-5 and SN-5 were utilized to determine the impact of sinonasal disease on pediatric QoL. The Cronbach’s α coefficient was used to determine the internal consistency of the study. Test-retest reliability at 4 weeks and construct validity with the SN-5 were evaluated. Sensitivity analysis was performed with the ‘overall item means’ and based on two age categories (7-11 vs 12-15 years-old). Results: Eighty-six patients were recruited. The mean age of participants was 11.0 ± 2.47 years. Overall, the pSN-5 items internal consistency was at α: 0.57 (95% CI: 0.42; 0.67), α:0.69 (95% CI: 0.58;0.79) with overall item means, α:0.70 (95% CI: 0.57;0.84) for those aged 7-11 and α:0.65 (95% CI: 0.48;0.82) in 12-15. The pSN-5 is reliable within the 4-weeks test-retest reliability period. Statistically and clinically significant degree of bias towards the child’s response (pSN-5) can be appreciated in the physical domain. Conclusion: The pSN-5 has acceptable internal consistency and test-retest reliability. The pSN-5 should be used in conjunction with the SN-5 to guide the management of pediatric rhinosinusitis.