Del Cuvillo A, Santos V, Montoro J, Bartra J, Davila I, Ferrer M, Jauregui I, Sastre J, Mullol J, Valero A
Unidad de Rinologia y asma, UGC ORL Hospital de Jerez del Servicio Andaluz de Salud, Cadiz, Spain.
Fundacion para la gestion de la Investigacion Biomedica de Cadiz, Spain.
Rhinology. 2017 Mar 1;55(1):34-38. doi: 10.4193/Rhin16.025.
Allergic rhinitis is a global healthcare problem due to its high prevalence, impact on individuals and socioeconomic burden for the nations. Allergic rhinitis severity evaluation is the key to a correct treatment, prevention of comorbidities and improving the quality of life of patients. This evaluation should be made with a simple, easy, fast but accurate and reliable methodology, both in a primary care and specialist setting. The visual analogue scale (VAS) meets all requirements to be the ideal tool to assess allergic rhinitis severity and has already been validated by using a single cut-off point, but this classification in two degrees of severity suffer from not allocating the patients uniformly and from giving a blind interval to classify the patients when the score is between 5 to 6 cm.
The main objective of our study is to describe the optimal cut-off points by using a VAS to discriminate between three degrees of allergic rhinitis severity (mild, moderate, and severe) following the ARIA modified severity criteria that has been previously validated. Sensitivity, specificity, positive and negative predictive values just like receiver operating characteristic curves were used to select the best cut-off values.
In a cross-sectional multicentre study with 3,572 patients included we have found that VAS has a significant correlation with nasal symptom score and quality of life and that the best cut-off points to differentiate between mild, moderate an severe allergic rhinitis are a VAS score of 4 and 7, respectively.
Allergic rhinitis severity could be assessed in three degrees by using VAS in a simple, easy, and accurate method.
变应性鼻炎因其高患病率、对个人的影响以及给国家带来的社会经济负担，成为一个全球性的医疗保健问题。变应性鼻炎严重程度评估是正确治疗、预防合并症以及提高患者生活质量的关键。在初级保健和专科环境中，都应以简单、便捷、快速且准确可靠的方法进行这种评估。视觉模拟量表（VAS）满足作为评估变应性鼻炎严重程度理想工具的所有要求，并且已经通过使用单一临界点得到验证，但是这种分为两个严重程度等级的分类存在患者分配不均的问题，并且当分数在5至6厘米之间时，在对患者进行分类时存在一个盲区。
我们研究的主要目的是按照先前已验证的变应性鼻炎治疗和鼻结膜炎联合指南（ARIA）修订的严重程度标准，使用VAS描述区分变应性鼻炎三个严重程度等级（轻度、中度和重度）的最佳临界点。使用敏感性、特异性、阳性和阴性预测值以及受试者工作特征曲线来选择最佳临界点值。
在一项纳入3572例患者的横断面多中心研究中，我们发现VAS与鼻部症状评分和生活质量显著相关，区分轻度、中度和重度变应性鼻炎的最佳临界点分别为VAS评分为4和7。
使用VAS可以通过一种简单、便捷且准确的方法将变应性鼻炎严重程度分为三个等级进行评估。
