The effects of priming on rhinologic patient reported outcome measures: a randomized controlled trial.

BACKGROUND: Patient-reported outcome measures (PROMs) are questionnaires designed to assess a patient's perception of their medical condition. The 22-item Sino-Nasal Outcomes Test (SNOT-22), the Rhinosinusitis Disability Index (RSDI) and the mini-Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ) are validated PROMs commonly used to assess rhinologic conditions. The objective of this study is to determine if responses on these PROMs may be influenced by priming respondents with positive or negative health-related questionnaires. METHODS: Nine hundred patients were prospectively randomized to one of nine groups. Groups A, D and G were positively primed prior to completing the SNOT-22, the RSDI and MiniRQLQ, respectively. Groups B, E, and H were negatively primed. Groups C, F, and I served as control groups, completing the PROMs without priming. Priming was performed by administering a survey designed to make patients think about their health-related quality of life in a positive or negative way. RESULTS: Patients who were primed negatively had statistically significantly worse scores on the SNOT-22, RSDI and MiniRQLQ when compared to patients who were primed positively. When compared to the control group, patients who were primed negatively had statistically worse scores on the SNOT-22 and RSDI. There was no significant difference in scores between the positive priming and the control groups for any PROM. CONCLUSIONS: Priming subjects regarding their health-related quality of life impacts their responses on rhinologic PROMs. Further study is required to understand the clinical and research implications of this novel finding and to clarify the optimal manner for administering and interpreting PROMs.

Nonpharmacological interventions to reduce respiratory viral transmission: an evidence-based review with recommendations.

BACKGROUND: Viral respiratory infections are a leading cause of worldwide mortality and exert the potential to cause global socioeconomic crises. However, inexpensive, efficacious, and rapidly deployable strategies to reduce viral transmission are increasingly important in the setting of an ongoing pandemic, though not entirely understood. This article provides a comprehensive review of commonly employed nonpharmacological interventions to interrupt viral spread and provides evidence-based recommendations for their use. METHODOLOGY: A systematic review of three databases was performed. Studies with defined endpoints of subjects receiving one of five interventions (nasal washing, gargling, personal protective equipment (PPE), social distancing, and hand hygiene) were included. An evidence-based review of the highest level of evidence, with recommendations, was created in accordance with a previously described, rigorous, iterative process. RESULTS: Fifty-four primary studies were included. The most commonly studied intervention was hand hygiene, followed by PPE, gargling, saline nasal washing, and social distancing. CONCLUSIONS: Mask use and hand hygiene are strong recommendations for prevention of viral transmission. Donning gloves, gowns, and eye protection are a recommendation in healthcare settings. Saline nasal washing and gargling are options in selected populations. Although an aggregate level of evidence is not provided, the authors recommend social distancing.