# Cross-cultural validation of the SNOT-22 questionnaire in the Colombian population

## TL;DR

The SNOT-22 questionnaire was successfully adapted for use in Colombia, showing strong reliability and effectiveness in evaluating chronic rhinosinusitis.

## Contribution

A culturally adapted and validated version of the SNOT-22 for the Colombian population with high diagnostic accuracy.

## Key findings

- The adapted SNOT-22 showed excellent internal consistency (Cronbach’s α = 0.97, omega = 0.96).
- It effectively discriminated between patients with and without rhinosinusitis (mean score difference of 49 points).
- The questionnaire had high diagnostic accuracy with an AUC of 0.92 and 71.5% sensitivity.

## Abstract

•Culturally adapted the SNOT-22 for Colombian patients with expert input.•High internal consistency: Cronbach’s α = 0.97, omega = 0.96.•Strong correlation with symptom severity (VAS, Spearman r = 0.74).•Effectively discriminate patients with and without rhinosinusitis.•High diagnostic accuracy: AUC = 0.92, sensitivity = 71.5%.

Culturally adapted the SNOT-22 for Colombian patients with expert input.

High internal consistency: Cronbach’s α = 0.97, omega = 0.96.

Strong correlation with symptom severity (VAS, Spearman r = 0.74).

Effectively discriminate patients with and without rhinosinusitis.

High diagnostic accuracy: AUC = 0.92, sensitivity = 71.5%.

To validate and culturally adapt the SNOT-22 for use in patients with chronic rhinosinusitis in Colombia.

A cross-sectional study was conducted to assess the content validity, construct validity, and reliability of the SNOT-22 in a Colombian sample. Cultural adaptation involved expert review and patient testing to ensure comprehension and relevance.

Item adaptation and comprehension were achieved through consensus by six expert rhinologists and subsequent validation with 15 otorhinolaryngologists and 24 patients. The third item was modified for better comprehension. Content validity indices confirmed the questionnaire’s relevance, sufficiency, and comprehension, though some redundancy was noted in emotional and ear/facial symptom domains. In a sample of 221 completed questionnaires, polychoric correlations showed positive inter-item relationships. Internal consistency was excellent (Cronbach’s α = 0.97; ω = 0.96), and the model demonstrated good fit. Convergent validity with the Visual Analog Scale showed a Spearman correlation of 0.74. The questionnaire also showed strong discriminative validity, differentiating patients with and without rhinosinusitis (mean score difference of 49-points; Mann-Whitney effect size = 0.41). The Area Under the Curve (AUC) was 0.92, with 71.5% sensitivity and 4.8% false positive rate.

The Colombian version of the SNOT-22 demonstrated strong patient comprehension, content validity, high internal consistency, and effective discriminative capacity. These results support its use as a reliable clinical tool for evaluating chronic rhinosinusitis in the Colombian population.

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