Over Diagnosis of Persistent Allergic Rhinitis in Perennial Allergic Rhinitis Patients: A Nationwide Study in Mexico

Larenas‐Linnemann, Désirée; Dinger, Hanna; Shah‐Hosseini, Kija; Michels, Alexandra; Mösges, Ralph; Sensitivity, Spt

doi:10.2500/ajra.2013.27.3957

Cited by 15 publications

(19 citation statements)

References 31 publications

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“…There might be some doubts that the data concerning children might be confounded by the personal input of their parents/guardians, but the way the results turned up make good clinical and epidemiological sense. Thus, congestion appeared as the main motive to seek medical advice for both children and adults, which was in line with the findings of the large majority of epidemiological studies and the international and national guidelines [ 13 – 15 ]. Logically, it was the moderate-severe and severe forms of rhinitis that equally motivated the visit to the physicians’ offices.…”

Section: Discussionsupporting

confidence: 79%

Clinical characteristics of patients seeking medical advice for nasal symptoms in Bulgaria with special focus on children

Mustakov

Popov

Kralimarkova

et al. 2016

World Allergy Organization Journal

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BackgroundIn an attempt to circumvent low response rates and high cost of classical epidemiological trials, we carried out a real-life survey among practicing physicians consulting patients for nasal symptoms. In this fragment of our work we analyze similarities and differences between children and adults and within the different strata of pediatric age.MethodsA survey was carried out by 69 physicians across Bulgaria (general practitioners, allergists and otorhinolaryngologists) and made possible calculation of the proportion of subjects with nasal symptoms from all other patients seen. Its structure allowed classification of rhinitis according the ARIA guidelines.ResultsOut of the 1685 completed survey forms, 506 pertained to the age group below 18 years. The gender predominance differed in children and adults: 57.3 % vs. 42.8 % of males respectively, P < 0.001. The prevalence of persistent rhinitis in children was 55.7 %, lower than in adults, 63.3 %, P = 0.004. In both pediatric and adult patients moderately severe and severe forms of rhinitis prevailed, 93.7 % vs. 94.6 %, with nasal obstruction as leading symptom: 59.9 % vs. 58.8 %. Cough was significantly more prevalent among children, 72.5 %, gradually decreasing until reaching adulthood, 58.7 %, P < 0.001. Prevalence of doctor diagnosed asthma was also higher among children, 25.1 %, than in adults, 19.5 %, P = 0.011. A gradient for characteristics, which were different in children, emerged across the pediatric age strata.DiscussionOur study uses an unorthodox design targeting the patient population visiting physicians’ offices because of nasal symptoms, achieving a much higher level of credibility of the results at minimal expense. As we base our survey on international guidelines, we believe this approach demonstrates the applicability of such consensus documents for practical purposes when in the hands of qualified physicians.ConclusionsModerate and severe rhinitis symptoms motivate patients and their guardians to seek medical advice. While nasal congestion is a leading bothersome symptom in both adults and children, specific other features characterize the pediatric age and differ across its strata.

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Section: Discussionsupporting

confidence: 79%

Clinical characteristics of patients seeking medical advice for nasal symptoms in Bulgaria with special focus on children

Mustakov

Popov

Kralimarkova

et al. 2016

World Allergy Organization Journal

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“…In most studies, a VAS of 50 (on a 100-mm scale) indicates moderate to severe AR [ 45 – 47 ]. Another study set the threshold at 60 mm [ 48 ]. Furthermore, VAS correlate well with the ARIA classification [ 39 , 42 , 43 ].…”

Section: Visual Analogue Scales As a Measurement Instrument In Allergmentioning

confidence: 99%

Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care

et al. 2017

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BackroundVisual analogue scales (VAS) are psychometric measuring instruments designed to document the characteristics of disease-related symptom severity in individual patients and use this to achieve a rapid (statistically measurable and reproducible) classification of symptom severity and disease control. VAS can also be used in routine patient history taking and to monitor the course of a chronic disease such as allergic rhinitis (AR). More specifically, the VAS has been used to assess effectiveness of AR therapy in real life, both in intermittent and persistent disease.MethodsThis position paper takes a detailed look at the historical development of VAS and its method-specific principles. Particular focus is put on aspects of practical application in daily routine and on a critical discussion of the advantages and disadvantages of the individual methods.ResultsVAS are well validated for the measurement of AR symptoms and correlate well with the ARIA (allergic rhinitis and its impact on asthma) severity classification and also correlated well with rTNSS and RQLQ. Moreover, several treatment studies on AR have used VAS as an evaluation parameter. Thanks to the use of new (real-life and real-time) communication technologies, such as smartphone apps, Discussion: VAS can be used relatively simply and highly effectively to assess disease control. The VAS lends itself very well to digitization and has now been incorporated into a smartphone app (called Allergy Diary) to assess AR control and direct treatment decisions as part of an AR clinical decision support system (CDSS). MASK Rhinitis has developed this app, which is currently available in 15 different languages.

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“…VAS can be used in all age groups including preschool children (guardian evaluation) (90) and the elderly (91). Furthermore, it can be used in a wide variety of languages (81,(91)(92)(93)(94)(95)(96)(97). VAS levels vary with the ARIA classification in many languages (76, 79, …”

Section: Measures Of Allergic Rhinitis Controlmentioning

confidence: 99%

“…A VAS level of 50 mm is suggestive of moderate-severe AR (99-101) although in some studies the cut-off was of over 60 mm (94). VAS was used to define SCUAD (16), and patients with a low VAS level after treatment had a considerably improved Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) or work productivity (WPAI-AS).…”

Section: 98)mentioning

confidence: 99%

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

Bousquet

Schünemann

Fonseca

et al. 2015

Allergy

174

172

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Over Diagnosis of Persistent Allergic Rhinitis in Perennial Allergic Rhinitis Patients: A Nationwide Study in Mexico

Cited by 15 publications

References 31 publications

Clinical characteristics of patients seeking medical advice for nasal symptoms in Bulgaria with special focus on children

Clinical characteristics of patients seeking medical advice for nasal symptoms in Bulgaria with special focus on children

Visual analogue scales (VAS): Measuring instruments for the documentation of symptoms and therapy monitoring in cases of allergic rhinitis in everyday health care

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

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