Development of the Sinus Headache Screener (SHS).
OBJECTIVES: Facial pain or pressure is often non-rhinogenic but is frequently misdiagnosed as sinusitis, leading to inappropriate treatment with antibiotics and surgery. The objective of this study was to develop and validate a brief self-administered questionnaire, the Sinus Headache Screener (SHS), to help differentiate chronic rhinosinusitis (CRS) from non-rhinogenic facial pain or pressure (NRFP). METHODS: Patients presenting to the rhinology clinic with a chief complaint of facial pain or pressure completed an 89-item questionnaire bank developed previously through qualitative methods. A diagnosis of CRS or NRFP was given based on imaging criteria. Psychometric analysis and logistic regression were utilized to select items and create a scoring system that could reliably differentiate the two conditions. Predictive performance was evaluated through the area under the receiver operating characteristic curve (AUC) with bootstrapping. RESULTS: Of 251 patients enrolled, 114 had CRS and 137 had NRFP. Mean (SD) age was 50 (16), and 69.3% were women. Eight items with scoring weights were included in the SHS. Scores ranged from -4 to 9, with higher positive values predictive of NRFP. With a score cutoff of > 0, the SHS had a sensitivity/specificity of 0.87/0.64, and positive/negative predictive values of 0.74/0.80 for NRFP. The optimism-corrected AUC was 0.798 (95% CI: 0.766, 0.877). CONCLUSION: In patients presenting with sinus headache, the SHS accurately differentiated NRFP from CRS. The use of the SHS as a point-of-care clinical tool can improve diagnostic accuracy and facilitate cost-effective management.
Duke Scholars
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- Otorhinolaryngology
- 3202 Clinical sciences
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Published In
DOI
EISSN
Publication Date
Location
Related Subject Headings
- Otorhinolaryngology
- 3202 Clinical sciences