Zulkifli, Shifa Zulkifli
(2013)
The validation of the malay version sino-nasal outcome test 22 (snot-22) in chronic rhinosinusitis patients.
Masters thesis, Universiti Sains Malaysia.
Abstract
Objectives: To translate Sino-Nasal Outcome Test-22 into the Malay language
and to determine the feasibility, validity and reliability of the Malay version of
SNOT-22.
Study Design and Methodology : This was a cross sectional study conducted at
the ORL-HNS general clinic and rhinology clinic in HUSM. 70 CRS
respondents were involved and 39 healthy participants recruited for the control
group. The Malay translated SNOT-22 and a previously Malay validated SF-36
were administered by the respondents. The translation used forward, backward
and respondent testing and has been reviewed for face and content validity. The
Malay version of SNOT -22 was administered again at two to four weeks interval
retesting 55 patients with CRS. The statistical analysis used was feasibility,
cronbach's alpha, intraclass correlation coefficient, Pearson's correlation
coefficient and factor analysis.
Results : Regarding feasibility of this test, the response rate of each question
items was 97.2% in the initial test and 100% in the retest. All items in SNOT-22
have means ranging from 1.10-2.64 with standard deviations ranged from 0.933-
1.486. The Cronbach's alpha was high that is 0.89 in the initial test. The average
intraclass correlation coefficient {ICC) was high that is 0.90 indicating good testretest
reliability. Factor analysis showed that Malay version SNOT -22 have four
unique constructs that is the rhinological symptoms, ear or facial symptoms,
sleep and psychological function. Discriminant validity demonstrate that Malay
version SNOT-22 was able to discriminate between control group and patients
(t=15.33; p<0.001). Concurrent validity findings showed that the subscale of
Role Physical (RP) in Malay version SF-36 statistically correlates significantly
with ear or facial symptoms (r=-0.259, p<0.05) and psychological issues (r=-
0.304, p<0.01) in Malay version SNOT-22. Bodily Pain (BP) domains in Malay
version SF-36 also statistically significant with psychological issues (r-0.498,
p<0.01) within Malay version SNOT-22. Most of the domains within Malay
version SNOT-22 were weakly correlated with the scales of Malay version SF-
36. However, validity of the Malay version SNOT-22 as a reliable and valid tool
for quality of life assessment is established by fulfillment of content, construct,
and discriminant validity.
Conclusions : The translation of the Malay version SNOT -22 was acceptable.
Feasibility was present and scaling assumptions were met. The reliability was
excellent and validity is established. SNOT-22 is recommended for Malaysia's
clinicians and researchers as a patient reported measure of outcome in sino-nasal
disorders such as rhinosinusitis and nasal polyposis.
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