Learn About SPIT – a Patient-Centered Tool for Evaluating Chronic Sialadenitis

Chronic sialadenitis is the most common benign salivary gland disorder, characterized by enlargement and inflammation of one or more of the major salivary glands on the cheek or under the jaw. Symptoms can impair daily functions including eating, mood and talking, which in turn lowers a patient's quality of life. This condition is treated by otolaryngologists who work to improve evaluation and treatment.

Jolie Chang, MD and William Ryan, MD, faculty members in the Department of Otolaryngology – Head and Neck Surgery at the University of California, San Francisco (UCSF OHNS) had previously developed the Chronic Obstructive Sialadenitis Symptoms (COSS) questionnaire to quantify sialadenitis symptom severity and assess response to sialendoscopy-assisted salivary duct surgery.

"The significance of this questionnaire was that it was the first patient-reported outcome measure (PROM) designed to specifically characterize obstructive sialadenitis symptoms," says Dr. Chang. Since then, other disease-specific instruments have been developed for salivary gland disorders, and these PROMs have helped physicians assess and quantify patient symptomatology and monitor longitudinal changes following treatment. "However, chronic sialadenitis PROMs are limited in their reliance on physician consensus alone in identifying items for inclusion. Symptoms of importance to patients in pursuing treatment may not align with those of providers," Dr. Chang explains.

With this in mind, Drs. Chang and collaborators set out to develop an inclusive instrument to obtain both patient and provider input in identifying key domains during development. Their study incorporated feedback from patients regarding the prior COSS questionnaire which suggested that this survey was sometimes difficult for patients to complete. The team then worked to validate the survey for use in clinical practice.

"Thanks to work from collaborators, including first-author Arushi Gulati, BS, and expert colleagues from across the U.S., novel obstructive Salivary Problem Impact Test (SPIT) score is now a reality," says Dr. Chang, the senior author. "This new standardized measure of sialadenitis-associated symptoms was assessed for internal consistency, construct validity and test–retest stability."

Study results were presented earlier this year at the Triological Society 2022 Combined Sections Meeting, and the report was recently published in The LaryngoscopeFurther work by investigators will assess longitudinal changes with treatment.

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