Cross-cultural adaptation and validation of the sino-nasal outcome test (SNOT-22) for Spanish-speaking patients

Our objective was to perform translation, cross-cultural adaptation and validation of the sino-nasal outcome test 22 (SNOT-22) to Spanish language. SNOT-22 was translated, back translated, and a pretest trial was performed. The study included 119 individuals divided into 60 cases, who met diagnostic criteria for chronic rhinosinusitis according to the European Position Paper on Rhinosinusitis 2012; and 59 controls, who reported no sino-nasal disease. Internal consistency was evaluated with Cronbach’s alpha test, reproducibility with Kappa coefficient, reliability with intraclass correlation coefficient (ICC), validity with Mann–Whitney U test and responsiveness with Wilcoxon test. In cases, Cronbach’s alpha was 0.91 both before and after treatment, as for controls, it was 0.90 at their first test assessment and 0.88 at 3 weeks. Kappa coefficient was calculated for each item, with an average score of 0.69. ICC was also performed for each item, with a score of 0.87 in the overall score and an average among all items of 0.71. Median score for cases was 47, and 2 for controls, finding the difference to be highly significant (Mann–Whitney U test, p < 0.001). Clinical changes were observed among treated patients, with a median score of 47 and 13.5 before and after treatment, respectively (Wilcoxon test, p < 0.001). The effect size resulted in 0.14 in treated patients whose status at 3 weeks was unvarying; 1.03 in those who were better and 1.89 for much better group. All controls were unvarying with an effect size of 0.05. The Spanish version of the SNOT-22 has the internal consistency, reliability, reproducibility, validity and responsiveness necessary to be a valid instrument to be used in clinical practice.