Skip to main content
Log in

Longitudinal sensitivity of generic and specific health measures in chronic sinusitis

  • Research Papers
  • Published:
Quality of Life Research Aims and scope Submit manuscript


The utility of reliable health measures for longitudinal studies in chronic sinusitis depends on their ability to detect clinically relevant change. Sixtythree patients with chronic sinusitis were evaluated before and three months after ethmoid sinus surgery using the Chronic Sinusitis Survey (CSS) and the generic Short-Form 36-Item Health Survey (SF-36). Statistically significant improvement was found for several SF-36 subscales including physical functioning, role functioning-physical, bodily pain, vitality and all CSS subscales. However, the differences between the instruments in longitudinal sensitivity to change as measured by standardized response means (SRM) and effect sizes (ES) were large. For the SF-36, sensitivity to change ranged from minimal to small (SRM: 0.01–0.43; ES: 0.01–0.52) with bodily pain and role functioning-physical scores most sensitive. For the CSS, sensitivity to change ranged from moderate to large (SRM: 0.56–0.82; ES: 0.48–1.12) with symptom-based and total index scores most sensitive. Despite this, the SF-36 yielded useful information concerning the relative burden of chronic sinusitis and failure of these patients to achieve normal levels of general health 3 months after sinus surgery. We conclude that the disease-specific CSS was more sensitive to change than the SF-36 survey in patients following ethmoid sinus surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. AdamsPF, BensonV. Current estimates from the National Health Interview Survey 1989. National Center for Health Statistics Vital Health Stats 1990; 10: 76.

    Google Scholar 

  2. SchappertSM. National Ambulatory Medical Care Survey: 1991 Summary. Hyattsville, MD: National Center for Health Statistics, 1992.

    Google Scholar 

  3. StankiewiczJA. Complications of endoscopic nasal surgery: occurrence and treatment. Am J Rhinol 1987; 1: 45–49.

    Google Scholar 

  4. StankiewiczJA. Complications in endoscopic intranasal ethmoidectomy: an update. Laryngoscope 1989; 99: 686–690.

    Google Scholar 

  5. StankiewiczJA. Blindness and intranasal ethmoidectomy: prevention and management. Otolaryngol Head Neck Surg 1989; 101: 320–329.

    Google Scholar 

  6. KennedyDW, ZinreichSJ, ShaalanH, et al. Endoscopic middle meatal antrostomy: theory, technique, and patency. Laryngoscope 1987; 97: 1–9.

    Google Scholar 

  7. BinghamB, ShankarL, HawkeM. Pitfalls in computer tomography of the paranasal sinuses. J Otolaryngol 1991; 20: 414–18.

    Google Scholar 

  8. HoffmanSR, MahoneyMC, ChmielJF, StinzianoGD, HoffmanKN. Symptom relief after endoscopic sinus surgery: an outcomes-based study. Ear Nose Throat J 1993; 72: 413–420.

    Google Scholar 

  9. Gliklich RE, Metson R. Techniques for outcomes research in chronic sinusitis. Laryngoscope; in press.

  10. GuyattG, WalterS, NormanG. Measuring change over time: assessing the usefulness of evaluative instruments. J Chronic Dis 1987; 40: 171–178.

    Google Scholar 

  11. NormanGR. Issues in the use of change scores in randomized trials. J Clin Epidemiol 1989; 42: 1097–1105.

    Google Scholar 

  12. PhillipsRC, LanskyDJ. Outcomes management in heart valve replacement surgery: early experience. J Heart Valve Dis 1992; 1: 42–50.

    Google Scholar 

  13. KantzME, HarrisWJ, LevitskyK, WareJE, DaviesAR. Methods of assessing condition-specific and generic functional status outcomes after total knee replacement. Med Care 1992; 30: MS240-MS252.

    Google Scholar 

  14. HylandME, KenyonCAP, JacobsPA. Sensitivity of quality of life domains and constructs to longitudinal change in a clinical trial comparing salmeterol with placebo in asthmatics. Qual Life Res 1994; 3: 121–126.

    Google Scholar 

  15. PatrickDL, DeyoRA. Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989; 27: S217-S232.

    Google Scholar 

  16. LipseyMW. A scheme for assessing measurement sensitivity in program evaluation and other applied research. Psychol Bull 1983; 94: 152–165.

    Google Scholar 

  17. LiangMH, FosselAH, LarsonMG. Comparisons of five health status instruments for orthopedic evaluation. Med care 1990; 28: 632–642.

    Google Scholar 

  18. KazisLE, AndersonJJ, MeenanRF. Effect sizes for interpreting changes in health status. Med Care 1989; 27: S178–89.

    Google Scholar 

  19. DeyoRA, CentorRM. Assessing the responsiveness of functional scales to clinical change: an analogy to diagnostic test performance. J Chron Dis 1986; 39: 897–906.

    Google Scholar 

  20. KatzJN, LarsonMG, PhillipsCB, FosselAH, LiangMH. Comparative measurement sensitivity of short and longer health status instruments. Med Care 1992; 30: 917–25.

    Google Scholar 

  21. Gliklich RE, Metson R. A comparison of sinus computed tomography staging systems for outcomes research. Am J Rhinol (in press).

  22. WareJE. How to Score the MOS 36-Item Short-Form Health Survey (SF-36). Boston, MA: The Health Institute, 1991.

    Google Scholar 

  23. StewartAL, WareJE. Measuring Functioning and Well-Being: the Medical Outcomes Study Approach. Durham, NC: duke University Press, 1992.

    Google Scholar 

  24. WareJE, SnowKK, KosinskiM, GandekB. SF-36 Health Survey Manual and Interpretation Guide. Boston, MA: The Health Institute, 1993.

    Google Scholar 

  25. GuyattGH, KirshnerB, JaeschkeR. Measuring health status: what are the necessary measurement properties? J Clin Epidemiol 1992; 45: 1341–45.

    Google Scholar 

  26. CohenJ. Statistical Power Analyses for the Behavioral Sciences. New York: Academic Press, 1977.

    Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and permissions

About this article

Cite this article

Gliklich, R.E., Hilinski, J.M. Longitudinal sensitivity of generic and specific health measures in chronic sinusitis. Qual Life Res 4, 27–32 (1995).

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI:

Key words