Introduction
The Rhinoplasty Outcome Evaluation (ROE) is a 6-item patient-reported measure of outcomes, satisfaction and quality of life after rhinoplasty. Ramsey Alsarraf introduced it in 2000 in Aesthetic Plastic Surgery. It quantifies subjective surgical results across physical, mental and emotional, and social factors, and it has received about 455 citations.
Surgeons use the ROE to evaluate individual outcomes and to compare procedures or techniques. This guide explains its six questions, its 0–100 scoring and the translated versions that followed.
Key Features of the Rhinoplasty Outcome Evaluation (ROE)
Purpose and Use
The ROE measures patient-reported outcomes, satisfaction and quality of life specifically after rhinoplasty. It helps surgeons evaluate individual patient outcomes and compare different procedures or techniques.
Target Population
The ROE is intended for people aged 15 and older who have had rhinoplasty.
Structure
The ROE contains 6 questions about key determinants of patient satisfaction:
Liking the appearance of the noseAbility to breathe through the noseHow friends and loved ones appreciate the noseLimits on social or professional activities due to nasal appearanceConfidence that the nose looks the best it canDesire to surgically change the appearance or function of the noseScoring Method
Each question is scored on a 0–4 rating scale, where 0 is the most negative response and 4 the most positive.
Scaled score: divide the total raw score by 24 and multiply by 100, giving a score from 0 to 100.Interpretation: 0 represents the least patient satisfaction and 100 the most.Not reported: reverse scoring, subscale scores and cut-off values.Administration Format
The ROE is a patient-reported questionnaire, so patients complete it themselves. Its six questions make it quick to complete and easy to score.
Applications of the Rhinoplasty Outcome Evaluation (ROE)
The ROE supports clinical practice and research:
Individual outcomes: quantifying a patient's satisfaction after rhinoplasty.Comparing techniques: comparing results across procedures or surgical techniques.Normative comparisons: normal values have been published for comparison.Languages and availability
Researchers have translated and studied the ROE in many languages:
Arabic: validation and clinical applicationSpanish: Spanish version (PDF)German: the ROE-D in functional rhinoplastyBrazilian Portuguese: normal valuesTurkish: validation and clinical applicationPersian: development and validationReliability and Validity
The original introduction of the ROE did not report formal reliability and validity testing, and no Cronbach's alpha was reported. Later translation studies, for example in Arabic, Turkish and Persian, have examined its measurement properties, and a normative study has examined ROE scores in septorhinoplasty.
Validation studies:
Outcomes research in facial plastic surgery: a review and new directions (2000): study linkHow to predict the outcome of septorhinoplasty? A normative study of ROE scores (2021): study linkLimitations and Considerations
Keep these points in mind:
Original testing: formal reliability and validity testing were not established in the original introduction.No cut-off scores: no cut-offs, subscales or reverse scoring are reported.Self-report: scores reflect the patient's own satisfaction.Other Versions And Related Questionnaires
The ROE belongs to a family of outcome evaluations by the same approach:
Facelift Outcomes Evaluation (FOE)Blepharoplasty Outcomes Evaluation (BOE)Skin Rejuvenation Outcomes Evaluation (SROE)Additional Resources
The original article: linkA copy of the questionnaire (supplementary material): linkFor inquiries, contact Dr. Ramsey (Rami) Alsarraf, MD, at The Newbury Center, 69 Newbury St, 3rd Floor, Boston, MA 02116, USA.Browse more ENT questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Rhinoplasty Outcome Evaluation measure?The ROE measures patient satisfaction and quality of life after rhinoplasty, covering nasal appearance, breathing, others' appreciation, social limits, confidence and the wish for further surgery.
How is the ROE scored?Each of the 6 questions is scored 0 to 4. Divide the total by 24 and multiply by 100 for a 0–100 score, where 100 means the most satisfaction.
Is the ROE validated?The original introduction did not establish formal reliability and validity testing. Later translation studies, such as the Arabic, Turkish and Persian versions, have examined it further.
Who can complete the ROE?The ROE is designed for patients aged 15 and older after rhinoplasty, and its six questions make it quick to complete.
A Word from ResRef About the Rhinoplasty Outcome Evaluation (ROE)
The ROE is a concise, 6-item patient-reported instrument designed to quantify patient satisfaction and quality of life following rhinoplasty. It addresses physical, emotional, and social dimensions of surgical outcomes in a quick, easily scorable format suitable for clinical practice. However, clinicians should note that formal reliability and validity testing were not established in this original introduction study.
References
Alsarraf, R. (2000). Outcomes Research in Facial Plastic Surgery: A Review and New Directions. Aesthetic Plastic Surgery, 24(3), 192–197. https://doi.org/10.1007/s002660010031Mulafikh, D. S., Alharethy, S. E., Alqabbani, A. A., & Mesallam, T. A. (2021). Validation and clinical application of the Arabic rhinoplasty outcomes evaluation questionnaire. Saudi Medical Journal, 42(6), 655–659. https://doi.org/10.15537/smj.2021.42.6.20210038Bulut, O. C., Plinkert, P. K., Wallner, F., & Baumann, I. (2016). Quality of life in functional rhinoplasty: rhinoplasty outcomes evaluation German version (ROE-D). European Archives of Oto-Rhino-Laryngology, 273(9), 2569–2573. https://doi.org/10.1007/s00405-016-3920-xIzu, S. C., Kosugi, E. M., Brandão, K. V., Lopes, A. S., Garcia, L. B. S., Suguri, V. M., & Gregório, L. C. (2012). Valores de normalidade para o questionário Rhinoplasty Outcome Evaluation (ROE). Brazilian Journal of Otorhinolaryngology, 78(4), 76–79. https://doi.org/10.1590/s1808-86942012000400015Çelik, M., & Altıntaş, A. (2019). The Turkish Version of the Rhinoplasty Outcomes Evaluation Questionnaire: Validation and Clinical Application. Balkan Medical Journal, 36(2), 129–133. https://doi.org/10.4274/balkanmedj.galenos.2018.2018.1129Mahmoudi, S., & Rabbani Zadeh, M. (2022). Development and Validation of the Rhinoplasty Outcomes Evaluation (ROE) Questionnaire: An Analytical Study. World Journal of Plastic Surgery, 11(2), 68–74. https://doi.org/10.52547/wjps.11.2.68Plath, M., Sand, M., Cavaliere, C., Plinkert, P. K., Baumann, I., & Zaoui, K. (2021). How to predict the outcome of septorhinoplasty? A normative study of ROE and FROI-17 scores. Acta Otorhinolaryngologica Italica, 41(4), 327–335. https://doi.org/10.14639/0392-100x-n1291