Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) Scale

Michael G. Stewart, David L. Witsell, Timothy L. Smith, Edward M. Weaver, Bevan Yueh, Maureen T. Hannley

Research output: Contribution to journalArticlepeer-review

773 Scopus citations


OBJECTIVE: The study goal was to validate a disease-specific health status instrument for use in patients with nasal obstruction. DESIGN, SETTINGS, AND PATIENTS: The study consisted of a prospective instrument validation conducted at 4 academic medical centers with 32 adults with nasal septal deformity. METHODS: Prospective instrument validation occurred in 2 stages. Stage 1 was the development of a preliminary (alpha-version) instrument of potential items. Stage 2 was a test of the alpha-version for item performance, internal consistency, and test-retest reliability; construct, discriminant, criterion validity, and responsiveness; and creation of the final instrument. RESULTS: Items with poor performance were eliminated from the alpha-version instrument. In testing the final instrument, test-retest reliability was adequate at 0.702; internal consistency reliability was also adequate at 0.785. Validity was confirmed using correlation and comparison analysis, and response sensitivity was excellent. CONCLUSIONS: The Nasal Obstruction Symptom Evaluation Scale is a valid, reliable, and responsive instrument that is brief and easy to complete and has potential use for outcomes studies in adults with nasal obstruction.

Original languageEnglish (US)
Pages (from-to)157-163
Number of pages7
JournalOtolaryngology - Head and Neck Surgery
Issue number2
StatePublished - Feb 2004
Externally publishedYes

Bibliographical note

Funding Information:
Supported by Career Development Award CD-98318 from the Health Services Research and Development Service of the Veterans Health Administration, Department of Veterans Affairs (Dr Yueh).

Funding Information:
To perform a prospective assessment of subjective treatment outcomes, a validated outcome instrument is needed, which was the purpose of this study. The development and validation of the outcomes instrument, named the Nasal Obstruction Symptom Evaluation (NOSE) Scale, was conducted as part of a parallel prospective multicenter observational clinical study. This multicenter study was commissioned and funded by the American Academy of Otolaryngology–Head and Neck Surgery Foundation and coordinated under the auspices of its National Center for the Promotion of Research in Otolaryngology.


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