{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T13:53:59Z","timestamp":1773928439359,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,12,31]],"date-time":"2018-12-31T00:00:00Z","timestamp":1546214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2019,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The minimal clinically important difference (MCID) of the 22\u2010item Sino\u2010Nasal Outcome Test (SNOT\u201022) is specific but not sensitive for identifying patients experiencing noticeable improvement in symptoms of chronic rhinosinusitis (CRS). It is unclear why some patients with less than 1 MCID change in SNOT\u201022 score nevertheless report noticeable improvement in their CRS symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This investigation was a retrospective study of 247 CRS patients undergoing medical management who completed SNOT\u201022 surveys in 2 consecutive visits 2\u201012 months apart. The validated nasal, sleep, ear\/facial discomfort, and emotional SNOT\u201022 subdomain scores were calculated. At the second visit, patients reported their global change in CRS symptoms on a 5\u2010item transition rating scale as: \u201cMuch worse\u201d; \u201cA little worse\u201d; \u201cAbout the same\u201d; \u201cA little better\u201d; or \u201cMuch better.\u201d Patient\u2010reported improvement in symptoms (at least \u201cA little better\u201d) was tested for association with changes in SNOT\u201022 subdomain scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the entire cohort, patient\u2010reported improvement in CRS symptoms was associated with improvement in all SNOT\u201022 subdomain scores (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). In patients with less than 1 MCID (12 points) of change in the SNOT\u201022, only the nasal subdomain (adjusted odds ratio,\u00a00.89; 95% confidence interval [CI], 0.79\u20100.99; <jats:italic>p<\/jats:italic>\u00a0=\u00a00.042) was associated with patient\u2010reported improvement in CRS symptoms. Changes in none of the other SNOT\u201022 subdomain scores were associated with patient\u2010reported improvement in CRS symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Among patients with less than 1 MCID change in the SNOT\u201022, improvement in only nasal symptoms\u2014but not extranasal symptoms\u2014of CRS is associated with those who nevertheless report improvement of their CRS symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.22269","type":"journal-article","created":{"date-parts":[[2018,12,31]],"date-time":"2018-12-31T22:46:17Z","timestamp":1546296377000},"page":"508-513","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Determinants of noticeable symptom improvement despite sub\u2010MCID change in SNOT\u201022 score after treatment for chronic rhinosinusitis"],"prefix":"10.1002","volume":"9","author":[{"given":"Katie 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