Background: The Rhinitis Symptom Utility Index (RSUI), originally developed in the United States, consists of a patient-preference weighting
scheme and a 10-item questionnaire measuring the severity and frequency of rhinitis related symptoms over a 14-day period.
This study aimed to determine whether the Chinese RSUI could adopt the US-based multi-attribute utility function (MAUF) in
scoring rhinitis symptoms.
Methods: In a Hong Kong study, 116 Chinese adults with allergic rhinitis completed the RSUI questionnaire and 36-item Short-Form
Health Survey (SF-36) after they had been seen by two otorhinolaryngologists for disease-severity ratings. Respondents then
completed computer-administered direct preference measures, i.e., visual analogue scale (VAS) and standard gamble (SG) assessments.
The VAS and SG data were used to estimate a MAUF for the Chinese-based RSUI.
Results: The derived MAUF was somewhat different than the one developed for the US RSUI. Test–retest reliability for the Chinese
RSUI was satisfactory (ICC = 0.71,
p<0.001). Scores differentiated among cases with mild, moderate, and severe symptoms (
p<0.001); and between those who did and did not require medications to control symptoms (
p = 0.031). Findings were significantly correlated with SF-36 domain scores (
r = 0.19 to 0.37;
p=0.041 to <0.001). When the US-based scoring function was applied to the Chinese subjects, the resulting mean RSUI score was
significantly lower (
p<0.001). Comparisons between directly measured VAS and SG scores between the US and Chinese samples, demonstrated significant
differences (all
p<0.05), with the US subjects consistently rating rhinitis symptoms as worse than Chinese subjects.
Conclusions: The Chinese RSUI has good measurement properties that reflect patient preferences from the Chinese. Results suggest that
there are differences in preference rating between US and Chinese subjects and that use of the US-based preference function
for the RSUI would bias the measurement of rhinitis symptom outcomes in Chinese subjects.
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