[Development of the Chinese Nasal Obstruction Symptom Evaluation (NOSE) Questionnaire]

Objective: To develop the Chinese version of the nasal obstruction symptom evaluation (NOSE) questionnaire.

Methods: After introduction, forward and backward translation, synthesis, expert committee review, pretest, adaptation and validation followed the international guidelines, the Chinese version of NOSE scale was tested among 223 nasal septal deviation patients and 80 health volunteers to further assess its psychometric and clinical properties. SPSS 19.0 software was used to analyze the data.

Results: The Chinese version demonstrated satisfactory evaluation results. The acceptance rate of the questionnaire was 97.6% and 94.1% in the patient group and control group respectively, and the completion time was (1.5 ± 0.5)min and (1.0 ± 0.5)min. Internal consistency reliability (Cronbach's α) was calculated to be 0.869. Test-retest reliability coefficient was adequate at rs = 0.996. Content validity was approved by our expert committee. Criteria validity (Spearman correlation coefficient) between NOSE Chinese version and SF-36, as well as VAS was -0.837 and 0.725 separately. Construct validity of Chinese version was similar to that of the original edition. The standardized response mean and the effect size at three months postoperatively was respectively 1.34 and 1.21, indicating high responsiveness. Calculated by Mann-Whitney U test, the instrument showed excellent sensitivity to discriminate the subjects with or without nasal obstruction (P < 0.01). The NOSE scores were also correlated with nasal resistance by rhinomanometry.

Conclusions: The NOSE Chinese version was successfully cross-cultural adapted and validated. It therefore can be recommended as a robust tool for future measuring subjective severity of nasal obstruction in China.