Diagnosing chronic rhinosinusitis: comparing questionnaire-based and clinical-based diagnosis

Background: The European Position Paper on Rhinosinusitis and Nasal Polyps ((EPOS)-O-3) incorporates Symptomatic and endoscopic Criteria in the clinical diagnosis of chronic rhinosinusitis (CRS), while in epidemiological studios the definition is based on symptoms only. The aim of this study was-to evaluate the correlation between questionnaire-based and clinical-based CRS. Methods: Based on the GA(2)LEN postal survey data a total Of 366 persons participated at the follow-up at the Danish centre and provided information on questionnaire-based CRS. At the same occasion the 366 participants underwent clinical interview and:examination by an otorhinolaryngologist to provide information for a clinical-based CRS diagnosis. The association between questionnaire-based and clinical-based CRS diagnosis was determined using logistic regression models and kappa statistics. Results: Mean age of respondents to the postal questionnaire was 45.3 years and 52.9% were female. Persons with asthma were 8.4 % and 26.2 % were actual smokers. There was moderate agreement between questionnaire-based and clinical-based CRS. Sensitivity and specificity were low comparing questionnaire-based CRS with clinical-based CRS. Incorporation Of self reported CRS and medical history in diagnosing CRS by questionnaire increased the agreement, Sensitivity, and specificity. Conclusion: Evaluating the correlation between questionnaire-based and Clinical-based CRS showed only moderate agreement and questions whether they evaluate the same disease. It brings into consideration that adjustments are needed to justify correlation between questionnaire-based and clinical-based diagnosis of CRS.