Evaluation of Sinonasal Outcome Test (SNOT-22) Domains in the Assessment of the Quality of Life in Patients with Nasopharyngeal Carcinoma

Figures & data

Table 1 Participant Characteristics (n = 275)

Participant Characteristics	Value
Age (years); mean (SD)	54.1 (11.2)
Gender; n (%)
Female	84 (30.5)
Male	191 (69.5)
Clinical AJCC staging; n (%)
I	23 (08.4)
II	81 (29.5)
III	92 (33.4)
IVa	76 (27.6)
IVb	3 (01.1)
Tumor status; n (%)
T1	135 (49.1)
T2	45 (16.4)
T3	57 (20.7)
T4	38 (13.8)
Nodal status; n (%)
N0	38 (13.8)
N1	105 (38.2)
N2	87 (31.6)
N3	45 (16.4)
Metastatic status; n (%)
M0	272 (98.9)
M1	3 (01.1)
Treatment regimen; n (%)
RT alone	15 (05.5)
Chemoradiotherapy	260 (94.5)
Recurrence; n (%)
No	257 (93.5)
Yes	18 (06.5)
Questionnaire
SNOT-22 score; mean (SD)	24.1 (19.9)
ETDQ-7 score; mean (SD)	16.7 (09.8)
Acquiring time after RT (months); median (IQR)	50 (29, 93)

Abbreviations: AJCC, American Joint Committee on Cancer; ETDQ, eustachian tube dysfunction questionnaire; IQR, interquartile range; RT, radiotherapy; SD, standard deviation; SNOT-22, 22-item Sino- Nasal Outcome Test.

Table 2 Goodness-of-Fit Indices for the Sinonasal Outcome Test (SNOT-22) Questionnaire (n = 275) by Model

Variables	Model 0	Model 1	Model 2	Model 3	Model 4	Model 5
X^2	433.36*	N/S	N/S	195.83	200.05	137.03
df	209	N/S	N/S	199	203	199
X^2/df	2.073	N/S	N/S	0.984	0.985	0.688
CFI	0.966	N/S	N/S	1.000	1.000	1.000
TLI	0.962	N/S	N/S	1.001	1.001	1.011
RMSEA	0.063	N/S	N/S	0.000	0.000	0.000
SRMR	0.100	N/S	N/S	0.066	0.067	0.056

Notes: Model 0 is a 1-general-factor model. Model 1 was proposed by DeConde et al in 2014. Model 2 was proposed by Sedaghat et al in 2015. Model 3 was proposed by Crump et al in 2016. Model 4 was proposed by Feng et al in 2017. Model 5 was proposed by Khan et al in 2021. *p <0.05.

Abbreviations: CFI, comparative fit index; RMSEA, root mean square error of approximation; SRMR, standardized root mean square residual; TLI, Tucker-Lewis Index; N/S, The model did not have a solution.

Figure 1 The Model is a five-factor (nasal, ear/facial, sleep, function, and emotion) model; the values assigned to arrows were freely estimated.

Table 3 Descriptive Statistics, Bivariate Correlations, and Convergent and Divergent Validity for Sinonasal Outcome Test (SNOT-22) Domains

SNOT-22 Domain	Mean (SD)	Omega	Pearson Correlation, r (p-value)					Conv & Div Validity
			Ear/Facial	Nasal	Sleep	Function	Emotion	ETDQ-7		p-value^a	p-value^a
Ear/facial (4 items)	3.2 (3.9)	0.81	1.00	---	---	---	---	0.61		---	0.011^c
Nasal (8 items)	8.7 (7.5)	0.88	0.59 (<.001)	1.00	---	---	---	0.50		0.011^b	---
Sleep (4 items)	6.2 (6.2)	0.93	0.45 (<.001)	0.47 (<.001)	1.00	---	---	0.33		<0.001^b	0.002^c
Function (3 items)	3.6 (3.8)	0.86	0.55 (<.001)	0.52 (<.001)	0.72 (<.001)	1.00	---	0.37		<0.001^b	0.012^c
Emotion (3 items)	2.5 (3.2)	0.88	0.58 (<.001)	0.53 (<.001)	0.58 (<.001)	0.68 (<.001)	1.00	0.37		<0.001^b	0.011^c

Notes: ^aFisher’s r-to-z transformation in examining the differences between correlation coefficients. ^bComparing with the coefficient between ear/facial and ETDQ-7. ^cComparing with the coefficient between nasal and ETDQ-7.

Abbreviations: Conv, convergent; div, divergent; ETDQ, eustachian tube dysfunction questionnaire.

Table 4 Known-Group Validity for the Domains of the Sinonasal Outcome Test (SNOT-22) Adjusted by Multiple Linear Regression

	Total Score			Nasal			Ear/Facial
	Coef.	SE	p	Coef.	SE	p	Coef.	SE	p
Age (per 10 years)	−2.9	1.1	0.007*	−1.3	0.4	0.001*	−0.7	0.2	<0.001*
Gender (female vs male)	7.4	2.5	0.003*	1.8	0.9	0.055	0.9	0.5	0.071
AJCC staging (late vs early)	1.7	2.5	0.497	0.9	0.9	0.324	−0.2	0.5	0.731
Treatment regimen (CRT vs RT)	2.0	5.3	0.699	1.3	2.0	0.515	0.4	1.0	0.724
Recurrence (yes vs no)	14.1	4.6	0.002*	4.4	1.7	0.011*	2.9	0.9	0.001*
Acquiring time after RT
6 < QAT ≤ 24 months	(REF)			(REF)			(REF)
24 < QAT ≤ 60 months	2.2	3.1	0.477	0.6	1.2	0.610	−0.1	0.6	0.894
QAT > 60 months	8.6	3.1	0.006*	4.1	1.2	<0.001*	1.6	0.6	0.011*
	Sleep			Function			Emotion
	Coef.	SE	p	Coef.	SE	p	Coef.	SE	p
Age (per 10 years)	−0.2	0.3	0.543	−0.4	0.2	0.044*	−0.2	0.2	0.213
Gender (female vs male)	2.7	0.8	<0.001*	1.0	0.5	0.042*	1.0	0.4	0.020*
AJCC staging (late vs early)	−0.1	0.8	0.930	0.3	0.5	0.553	0.7	0.4	0.084
Treatment regimen (CRT vs RT)	0.6	1.7	0.709	−0.7	1.0	0.480	0.5	0.9	0.577
Recurrence (yes vs no)	1.6	1.5	0.284	2.5	0.9	0.005*	2.7	0.8	<0.001*
Acquiring time after RT
6 < QAT ≤ 24 months	(REF)			(REF)			(REF)
24 < QAT ≤ 60 months	0.7	1.0	0.487	0.3	0.6	0.656	0.7	0.5	0.161
QAT > 60 months	1.1	1.0	0.299	1.0	0.6	0.113	0.9	0.5	0.085

Note: *p ≤ 0.05.

Abbreviations: AJCC, American Joint Committee on Cancer; Coef., Coefficient; CRT, chemoradiotherapy; SE, standard error; QAT, questionnaire acquiring time.