Development and Validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale1

TLDR

The study aimed to validate a disease‑specific health status instrument for patients with nasal obstruction. The authors conducted a prospective validation at four academic centers with 32 adults, developing an alpha‑version instrument and then testing it for item performance, reliability, validity, and responsiveness. The final NOSE Scale demonstrated adequate test‑retest reliability (0.702), internal consistency (0.785), confirmed validity, and excellent responsiveness, making it a brief, reliable, and responsive tool for outcomes studies in adults with nasal obstruction.

Abstract

OBJECTIVE The study goal was to validate a disease‐specific health status instrument for use in patients with nasal obstruction. DESIGN, SETTINGS, AND PATIENTS The study consisted of a prospective instrument validation conducted at 4 academic medical centers with 32 adults with nasal septal deformity. METHODS Prospective instrument validation occurred in 2 stages. Stage 1 was the development of a preliminary (alpha‐version) instrument of potential items. Stage 2 was a test of the alpha‐version for item performance, internal consistency, and test‐retest reliability; construct, discriminant, criterion validity, and responsiveness; and creation of the final instrument. RESULTS Items with poor performance were eliminated from the alpha‐version instrument. In testing the final instrument, test‐retest reliability was adequate at 0.702; internal consistency reliability was also adequate at 0.785. Validity was confirmed using correlation and comparison analysis, and response sensitivity was excellent. CONCLUSIONS The Nasal Obstruction Symptom Evaluation Scale is a valid, reliable, and responsive instrument that is brief and easy to complete and has potential use for outcomes studies in adults with nasal obstruction.