Valero Antonio, Ferrer Montse, Sastre Joaquín, Navarro Ana M, Monclús Laura, Martí-Guadaño Enrique, Herdman Michael, Dávila Ignacio, Del Cuvillo Alfonso, Colás Carlos, Baró Eva, Antépara Ignacio, Alonso Jordi, Mullol Joaquim
Unidad de Alergia, Servicio de Neumología y Alergia Respiratoria, Hospital Clínic, Barcelona, Spain.
J Allergy Clin Immunol. 2007 Aug;120(2):359-65. doi: 10.1016/j.jaci.2007.04.006. Epub 2007 May 25.
Allergic Rhinitis and its Impact on Asthma (ARIA) differentiates mild from moderate/severe patients on the basis of 4 severity items. The high prevalence of moderate/severe patients suggests the need to differentiate between them.
To identify the categorization that maximizes discrimination between moderate and severe allergic rhinitis (AR) by using ARIA guidelines.
Observational, cross-sectional study. Clinical characteristics, nasal symptoms (Total Symptom Score 4), and health-related quality of life (HRQL; Rhinoconjunctivitis Quality of Life Questionnaire and Short Form 12) were assessed. The association of severity items (sleep, daily activities/sport, work/school, and troublesome symptoms) with symptoms and HRQL was analyzed using linear regression models. ANOVA and effect sizes were used to assess differences in symptoms and HRQL among groups defined by the number of affected ARIA items.
Nontreated patients (N = 141) with moderate/severe AR were studied. All severity items showed a similar independent association with symptoms and HRQL scores, and there were no interaction effects, indicating that categorization of patients into moderate and severe could be based only on the number of items affected. Effect sizes were highest between patients with 4 affected ARIA items and those with 3, 2, or 1 affected item (effect sizes greater than 0.8 in all comparisons using Rhinoconjunctivitis Quality of Life Questionnaire and Short Form 12 Physical Composite Summary, and greater than 0.5 using the Total Symptom Score 4; P < .001).
Using ARIA severity items, the criterion that best discriminates AR severity is considering moderate those with 1 to 3 affected items and severe those with 4.
Discrimination between patients with moderate and severe AR should help to obtain homogeneous populations for both research and clinical purposes.
变应性鼻炎及其对哮喘的影响（ARIA）根据4个严重程度项目区分轻度与中/重度患者。中/重度患者的高患病率表明有必要对他们进行区分。
使用ARIA指南确定能最大程度区分中度和重度变应性鼻炎（AR）的分类。
观察性横断面研究。评估临床特征、鼻部症状（总症状评分4）和健康相关生活质量（HRQL；鼻结膜炎生活质量问卷和简明健康调查12项）。使用线性回归模型分析严重程度项目（睡眠、日常活动/运动、工作/学习和困扰症状）与症状及HRQL的关联。使用方差分析和效应量评估由受影响的ARIA项目数量定义的组间症状和HRQL差异。
对141例未治疗的中/重度AR患者进行了研究。所有严重程度项目与症状和HRQL评分均显示出相似的独立关联，且无交互作用，这表明将患者分为中度和重度仅可基于受影响的项目数量。在有4个受影响ARIA项目的患者与有3、2或1个受影响项目的患者之间，效应量最高（使用鼻结膜炎生活质量问卷和简明健康调查12项身体综合汇总进行的所有比较中效应量均大于0.8，使用总症状评分4时效应量大于0.5；P <.001）。
使用ARIA严重程度项目，区分AR严重程度的最佳标准是将有1至3个受影响项目的患者视为中度，将有4个受影响项目的患者视为重度。
区分中度和重度AR患者应有助于为研究和临床目的获得同质化人群。
