Development of a Severity Classification System for Subjective Nasal Obstruction
Abstract
Importance: Nasal airway obstruction is a common presenting symptom in otolaryngology and facial plastic surgery practices, and the potential for multiple contributing causes requires extensive evaluation. Objective: To develop a classification system for nasal obstruction using a subjective, validated quality-of-life instrument. Design, Setting, and Participants: Retrospective study of patients’ responses on the Nasal Obstruction Symptom Evaluation (NOSE) instrument performed from July 2011 through May 2012. All patients were seen at a university-based tertiary medical center. Main Outcomes and Measures: Scores from patients with or without nasal obstruction were used to develop a classification system after receiver operating characteristic curve analysis. The classification subdivides nasal obstruction scores into a range of defined classes. Results: Data analysis was performed using results from 345 patients. A score of 30 on the NOSE survey best differentiated patients with and without nasal obstruction. This threshold also provided intervals used to define the other class ranges. Patients were categorized as having mild (range, 5-25), moderate (range, 30-50), severe (range, 55-75), or extreme (range, 80-100) nasal obstruction, depending on responses on the NOSE survey. Conclusions and Relevance: The NOSE scale is an important tool for gauging symptoms in patients with nasal obstruction. The proposed classification system will improve patient care by providing a framework for the severity of their symptoms and helping them understand potential treatment effects. If the classification is used in future outcomes research, it will allow physicians to better understand the study patient population and the effect of treatment on each severity class. Level of Evidence: NA
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Social value orientation is a relatively stable personality feature describing a person's intrinsic willingness to behave prosocially, and it has been found to predict trusting decisions and sensitivity to social cues.
“SVO is a relatively stable personality feature describing a person's intrinsic willingness to behave prosocially 48 , that has been found to predict trusting decisions 49 and sensitivity to social cues 50 .”
From A registered replication study on oxytocin and trust (2020) · cites this paper as [49]
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Anterior Septal Reconstruction: Outcomes After a Modified Extracorporeal Septoplasty Technique
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A registered replication study on oxytocin and trust
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- Authors
- Lipan, M. J., & Most, S. P.
- Affiliations
- Stanford Medicine (US)
- Corresponding author
- Most, Sam P.
- ORCID
- Most, Sam P.
- Venue
- JAMA Facial Plastic Surgery
- Publisher
- SAGE Publications
- Published
- 2013-09
- Volume
- 15
- Issue
- 5
- Pages
- 358-361
- ISSN
- 2168-6076 (ISSN-L)
- 2168-6092
- OpenAlex
- W2098953988
- Cited by
- 212
- References
- 6
- Citations by year
- 2026: 12 · 2025: 14 · 2024: 21 · 2023: 19 · 2022: 18 · 2021: 23 · 2020: 28 · 2019: 25 · 2018: 18 · 2017: 12 · 2016: 9 · 2015: 11 · 2014: 2
- FWCI
- 7.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA Facial Plastic Surgery (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Nasal Surgery and Airway Studies
- Health Sciences › Medicine › Otorhinolaryngology › Sinusitis and nasal conditions
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- nasal obstruction, severity classification, Nasal Obstruction Symptom Evaluation, NOSE scale, quality of life, symptom assessment, cut-off values, patient-reported outcomes
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Humans, Middle Aged, Quality of Life, Retrospective Studies, ROC Curve, Severity of Illness Index, Nasal Obstruction, Young Adult
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