Exploring Completion Rates of the SNOT-22 Questionnaire

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Abstract
Background: The 22-item Sinonasal Outcome Test (SNOT-22) is a widely used patient-reported outcome measure (PROM) for assessing chronic rhinosinusitis (CRS). However, incomplete surveys may impact its predictive utility. Aims: This study explores SNOT-22 completion rates, response trends, and potential factors influencing survey omissions aiming to optimize its predictive utility and practical application. Methods: SNOT-22 surveys were retrospectively collected from patients at various time points throughout their CRS treatment. Surveys with at least one question unanswered were included in the study. Completely unanswered surveys were excluded. Survey response dynamics and trends were analyzed and reported. Results: 1,034 SNOT-22 surveys were collected, 18% of the surveys were incomplete. Questions on “Ear fullness” and “Embarrassed” were most unanswered, while “Need to blow nose” and “Nasal blockage” were least unanswered. Questions later in the survey showed a moderate positive correlation with missing responses. Mean scores per question were higher in incomplete than in complete surveys, though differences in SNOT-22 scores between partially and fully completed surveys weren’t significant. Conclusion: Our study found that a large number of SNOT-22 surveys were incomplete, higher than rates reported in similar PROMs. Mean scores did not differ significantly between partial and complete surveys, suggesting interpretation should prioritize individual responses over total scores. Potential barriers to survey completion include question wording, symptom relevance, and survey length. Future research should further investigate survey completion through qualitative methods and randomized question ordering to refine survey design.

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