Adaptation and Validation of the Hebrew Version of the Nasal Obstruction Symptom Evaluation (NOSES Scale

Background: Nasal obstruction is one of the most common complaints in the practice of rhinology.Objective: To adapt the Nasal Obstruction Scale Evaluation (NOSE) questionnaire to Hebrew (H-NOSE) and to assess its sensitivity and specificity.Methods: Candidates for surgical intervention due to isolated nasal obstruction and healthy volunteers (controls) were in-cluded in the validation. The English NOSE questionnaire was translated into Hebrew and re-translated for translation valid-ity. Patients completed the H-NOSE questionnaire before and after surgery for nasal obstruction. The same questionnaire was completed by the controls. Test-retest reliability was per-formed within 2 weeks. Psychometric properties (reliability, reproducibility, validity, and responsiveness) were assessed by a test-retest procedure, internal consistency, correlation to the Hebrew Sino-Nasal Outcome Tool 22 (He-SNOT-22), and response sensitivity.Results: In total, 179 patients with nasal obstruction and 74 con-trols completed the questionnaire. Cronbach's alpha score was 0.93 for internal consistency. The receiver operating character-istic curve demonstrated high sensitivity and specificity (< 90%) and area under the curve was 0.97. We found no significant dif-ference in test-retest reliability. The difference between the pre -and postoperative questionnaire scores was highly significant (13.9 +/- 4.0 vs. 3.2 +/- 4.1, respectively, P < 0.001).Conclusions: The H-NOSE questionnaire demonstrated reli-able internal consistency, sensitivity, specificity, and reliabil-ity. The Hebrew version differentiated between patients and heathy controls and was easy to administer. This instrument is useful for Hebrew speaking patients who undergo surgery for nasal obstruction.