Psychometric validation of the Standard Tests for Asthma, Allergic Rhinitis, and Chronic Rhinosinusitis in the United States

BACKGROUND: Chronic rhinosinusitis with nasal polyposis is an inflammatory disease associated with type 2 inflammation, which is present in lower airway disease (asthma). Current tools used to track symptoms and quality-of-life burden of disease, such as the 22-item Sinonasal Outcome Test (SNOT-22), lack specificity in the symptoms evaluated.

OBJECTIVE: To combat this shortcoming, we validated a new survey, Standard Tests for Asthma, Allergic Rhinitis, and Chronic Rhinosinusitis (STARR-15), in a population of US patients with chronic rhinosinusitis with nasal polyposis.

METHODS: In this project, STARR-15 was tested in a population of patients with chronic rhinosinusitis with nasal polyposis at a single tertiary care center in the United States. The survey was also compared with a corresponding population of patients with chronic rhinosinusitis without nasal polyps from the same institution.

RESULTS: The survey was assessed within the population of patients with chronic rhinosinusitis with nasal polyposis and found to demonstrate good test-retest reliability with an intraclass correlation coefficient of 0.93. The survey was internally valid, with Cronbach alpha of 0.85. Furthermore, the survey was assessed for external validity by comparing it with the SNOT-22. STARR-15 correlated positively with the SNOT-22, with a Pearson coefficient of 0.77.

CONCLUSION: This work has implications in helping follow patient symptoms over time for patients who have not only chronic rhinosinusitis with nasal polyps but also other inflammatory conditions of the lower airways. It also has potential to be used as a screening tool for patients with chronic rhinosinusitis, asthma, and allergic rhinitis.