Association between Chronic Rhinosinusitis and Health-Related Quality of Life in Adults with Cystic Fibrosis
Bibliographic record
Abstract
RATIONALE: Over the past four decades, the median age of survival has nearly doubled for individuals living with cystic fibrosis (CF). Chronic diseases such as chronic rhinosinusitis increase in prevalence with age. In the non-CF population, chronic rhinosinusitis is associated with reduced health-related quality of life. OBJECTIVES: Our objectives were to determine the prevalence of chronic rhinosinusitis among adults with CF and to evaluate the impact of chronic rhinosinusitis on health-related quality of life. METHODS: Individuals from a large academic teaching hospital in Vancouver, British Columbia, Canada, were eligible to participate in this cross-sectional study. Included subjects were at least 19 years of age, had a confirmed diagnosis of CF, and attended the CF clinic between September 2013 and April 2014. Participants completed a CF-specific health-related quality of life questionnaire (the Cystic Fibrosis Questionnaire-Revised for adolescents and adults over 14 years of age [CFQ-R 14+]) and underwent symptom and endoscopic assessment for diagnosis of chronic rhinosinusitis. Medical charts were reviewed for potential confounders, including sociodemographic (age, sex, and body mass index) and clinical (age at CF diagnosis, type of CF mutation, lung function, and chronic Pseudomonas aeruginosa infection) factors. Multivariable linear regression was used to model the relationship between chronic rhinosinusitis and CFQ-R 14+ domains, adjusted for potential confounders. MEASUREMENTS AND MAIN RESULTS: A total of 121 individuals were contacted in the clinic, of whom 113 (93.4%) consented to participate. The prevalence of chronic rhinosinusitis was found to be 59.2% (95% confidence interval [CI], 49.6-68.2%). Sociodemographic and clinical factors were similarly distributed between chronic rhinosinusitis-positive and chronic rhinosinusitis-negative groups. Lung function, as measured by FEV1 (% predicted value), did not significantly differ between participants with versus those without chronic rhinosinusitis (mean difference, 2.0%; 95% CI, -8.1% to 13.0%). Following adjustment for sex and lung function, individuals with chronic rhinosinusitis reported significantly worse scores on the respiratory symptoms domains compared with their counterparts without chronic rhinosinusitis (regression coefficient, -3.93; 95% CI, -8.02 to 0.15). CONCLUSIONS: The majority of adults with CF have evidence of concomitant chronic rhinosinusitis. Chronic rhinosinusitis is independently associated with worse respiratory symptom on the CFQ-R 14+. Chronic rhinosinusitis should be diagnosed and managed to optimize the health-related quality of life of adults with CF. Clinical trial registered with clinicaltrials.gov (NCT02003079).
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".