{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T03:51:46Z","timestamp":1776743506053,"version":"3.51.2"},"reference-count":37,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T00:00:00Z","timestamp":1713398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["BESWIC20A0"],"award-info":[{"award-number":["BESWIC20A0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["BESWIC22Y5"],"award-info":[{"award-number":["BESWIC22Y5"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["TAYLOR19A0"],"award-info":[{"award-number":["TAYLOR19A0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["ZEMKE19A0"],"award-info":[{"award-number":["ZEMKE19A0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["R25DC020151"],"award-info":[{"award-number":["R25DC020151"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The 22\u2010question SinoNasal Outcome Test (SNOT\u201022) assesses chronic rhinosinusitis (CRS) severity. We aimed to identify predictors of SNOT\u201022 score improvement following highly effective modulator therapy (HEMT) initiation and to corroborate the SNOT\u201022 minimal clinically important difference (MCID) in adults with cystic fibrosis (CF).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective observational data was pooled from four studies across 10\u2009US centers investigating people with CF (PwCF) and CRS. Three studies evaluated HEMT's impact on CRS. For participants enrolled prior to HEMT initiation, SNOT\u201022 scores were obtained at baseline and after 3\u20136\u2009months of HEMT. Multivariate regression identified predictors of improvement. Cronbach's alpha and four distribution\u2010based methods were used to assess internal consistency and calculate the MCID of the SNOT\u201022.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 184 PwCF participated with mean baseline SNOT\u201022 scores ranging from 18.1 to 56.7. Cronbach's alpha was \u22650.90 across sites. Participants at sites with pre\u2010 and post\u2010HEMT data reported improvement in SNOT\u201022 scores after initiating HEMT (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Worse baseline SNOT\u201022 score (odds ratio (OR): 1.05, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001, 95% CI: 1.02\u20131.08), F508del homozygosity (OR: 4.30, <jats:italic>p<\/jats:italic>\u2009=\u20090.040, 95% CI: 1.14\u201318.99), and absence of prior modulator therapy (OR: 4.99, <jats:italic>p<\/jats:italic>\u2009=\u20090.017, 95% CI: 1.39\u201320.11) were associated with greater SNOT\u201022 improvement. The mean MCID calculated via distribution\u2010based methods was 8.5.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Worse baseline sinonasal symptoms, F508del homozygosity, and absence of prior modulator therapy predicted greater improvement after HEMT initiation. The mean MCID for SNOT\u201022 in PwCF is 8.5 points, similar to non\u2010CF individuals with CRS, and provides a threshold specifically for PwCF. The SNOT\u201022 has strong internal consistency in PwCF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3 <jats:italic>Laryngoscope<\/jats:italic>, 134:3965\u20133973, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31438","type":"journal-article","created":{"date-parts":[[2024,4,18]],"date-time":"2024-04-18T09:09:17Z","timestamp":1713431357000},"page":"3965-3973","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Predictors of Sinonasal Improvement After Highly Effective Modulator Therapy in Adults with Cystic Fibrosis"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8612-5442","authenticated-orcid":false,"given":"Daniel M.","family":"Beswick","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-4775","authenticated-orcid":false,"given":"Christine M.","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1152-2512","authenticated-orcid":false,"given":"Jonathan B.","family":"Overdevest","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Columbia University  New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Zemke","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aastha","family":"Khatiwada","sequence":"additional","affiliation":[{"name":"Department of Biostatistics National Jewish Health  Denver Colorado U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1938-9349","authenticated-orcid":false,"given":"David A.","family":"Gudis","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Columbia University  New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9769-187X","authenticated-orcid":false,"given":"Jessa E.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of California  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Kimple","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of North Carolina  Chapel Hill North Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeremy P.","family":"Tervo","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Columbia University  New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"DiMango","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine Columbia University  New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Goralski","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine University of North Carolina  Chapel Hill North Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Keating","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine Columbia University  New York New York U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brent","family":"Senior","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of North Carolina  Chapel Hill North Carolina U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda L.","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery University of Pittsburgh  Pittsburgh Pennsylvania U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia H.","family":"Eshaghian","sequence":"additional","affiliation":[{"name":"Department of Pulmonary Medicine University of California  Los Angeles California U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jess C.","family":"Mace","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Oregon Health &amp; 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