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Major Symptom Score Utility Index for patients with acute rhinosinusitis

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Evaluation of acute rhinosinusitis treatment effectiveness is based on patient-reported relief of symptoms. This study was designed to develop a multiattribute utility scoring algorithm for the Major Symptom Score (MSS) and secondarily to evaluate the psychometric characteristics (i.e., validity and responsiveness) of the MSS Utility Index (MSSUI).


Adult patients with acute rhinosinusitis were recruited for this longitudinal observational study through primary care and specialist physician offices. One hundred ninety patients participated in a preference elicitation exercise for MSS health states. Resulting preference data were used to generate a utility scoring algorithm for the MSS. Participants completed the MSS and 20-Question Sino-Nasal Outcome Test (SNOT-20) at baseline and completed the MSS twice daily for 15 days via daily diary. On days 7 and 15, participants completed the MSS, SNOT-20, and Overall Treatment Effect scale and were evaluated by physicians via the Physician Global Improvement Scale (PGIS).


At baseline, the mean ± SD. MSSUI score was 0.51 ± 0.17 and was negatively correlated with SNOT-20 scores (r = −0.58; p < 0.001). Days 2‐8 average MSSUI scores were negatively correlated with day 7 SNOT-20 (r = −0.46; p < 0.001) and PGIS (r = −0.22; p < 0.001) scores; whereas days 9‐15 average MSSUI scores were inversely related to day 15 SNOT-20 (r = −0.40; p < 0.001) and PGIS (r = −0.32, p < 0.001) scores. Mean MSSUI scores improved from baseline with effect sizes at days 7 and 15 of 0.82 and 1.20, respectively.


The MSSUI represents an acceptable and psychometrically sound patient-reported end point for clinical trials comparing treatments for acute rhinosinusitis.

Keywords: Acute rhinosinusitis; Major Symptom Score Utility Index; clinical studies; responsiveness; symptom score; utility; validity

Document Type: Research Article

DOI: http://dx.doi.org/10.2500/ajra.2011.25.3575

Affiliations: Center for Health Outcomes Research, United BioSource Corporation, Bethesda, Maryland, USA

Publication date: May 1, 2011

More about this publication?
  • The American Journal of Rhinology & Allergy, is a peer reviewed, scientific publication committed to expanding knowledge and publishing the best clinical and basic research within the fields of Rhinology & Allergy. Its focus is to publish information which contributes to improved quality of care for patients with nasal and sinus disorders. Its primary readership consists of otolaryngologists, allergists, and plastic surgeons. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    Previously published as American Journal of Rhinology, the journal is indexed in Thomson Reuters Web of Science and Science Citation Index, plus the National Library of Medicine's PubMed service.
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