Validating the Sino-Nasal Outcome Test (SNOT-22) in comparison to the Sino-Nasal 5 Questionnaire (SN-5) in a pediatric population.

Objective: To assess test-retest reliability, validity, responsiveness, and clinical interpretability of the SNOT-22 in identifying pediatric patients with CRS from healthy, non-CRS patients by comparing SNOT-22 and SN-5 across multiple visits.

Study Design: Prospective cohort; all pediatric patients between the ages of 6-17, or under the age of 6 but fully verbal, who presented for care between January 2022 through March 2024.

Setting: Tertiary care academic institution's pediatric otolaryngology clinic.

Methods: Minor assent and parental consent for participation was obtained in patients with sinonasal symptoms (experimental) and without (control). Exclusion criteria included nonverbal pediatric patients under 6, with severe learning disabilities, or with sinonasal-related genetic conditions. Data was statistically analyzed using RStudio.

Results: This study included 150 total patients, with 79 experimental and 71 controls. For test-retest reliability in the experimental cohort between visits (n = 41), the SNOT-22 Pearson correlation coefficient (PCC) is -0.0506 (p > 0.05), while the SN-5 PCC is -0.1944 (p > 0.05). For responsiveness, SNOT-22 showed a greater change in scores than SN-5 between clinic visits in experimental versus control groups (p < 0.005). For validity, the SNOT-22 was correlated with SN-5 in all patients who responded to both surveys each visit. Area under curve (AUC) was 0.8191 for SN-5 and 0.8405 for SNOT-22. Interclass correlation coefficient (ICC) was -0.122 (p = 0.781) for SN-5. Pearson correlation coefficient (r) was 0.1944. ICC for SNOT-22 was -0.159 (p = 0.844) with r = 0.0506.

Conclusions: Statistically significant data supports use of SNOT-22 over the SN-5 to potentially help improve early identification and treatment of CRS in children.