Kirtsreesakul Virat, Leelapong Jitanong, Ruttanaphol Suwalee
Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand,
Department of Otolaryngology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Int Arch Allergy Immunol. 2020;181(4):285-291. doi: 10.1159/000505745. Epub 2020 Feb 4.
The visual analogue scale (VAS) is a simple and useful tool to assess the severity of allergic rhinitis. Whether a pretreatment VAS score can guide appropriate medication is unclear.
The aim of this study was to evaluate whether a pretreatment VAS score could be used to predict therapeutic response.
A prospective 4-week cohort study involving 101 allergic rhinitis patients was carried out. All patients were treated with triamcinolone acetonide aqueous nasal spray 220 μg once daily for 28 days. The treatment outcomes were evaluated using VAS scores (0-10 cm), total nasal symptoms scores (TNSSs), nasal mucociliary clearance times (NMCCTs), and global symptom controls (GSCs). The minimal clinically important differences (MCIDs) method was used to separate the patients into with and without improvement groups. Receiver operating characteristic curve analysis was performed to evaluate the predictive value of pretreatment VAS scores in relation to MCIDs after treatment.
Pretreatment VAS scores showed a positive correlation with pretreatment TNSSs and NMCCTs (ρ = 0.66, p < 0.001 and r = 0.44, p < 0.001, respectively), and a negative correlation with GSCs after treatment (r = -0.53, p < 0.001). The MCID values of TNSSs and NMCCTs were 3.19 and 2.78, respectively. The cutoff value of pretreatment VAS ranged between 6.5 and 7.7 points, with an average value of 7.1.
A pretreatment VAS score of 7 or higher was associated with an unfavorable treatment outcome, which suggests the potential therapeutic predictive value of VAS scoring.
视觉模拟评分法（VAS）是评估变应性鼻炎严重程度的一种简单且有用的工具。治疗前VAS评分能否指导合理用药尚不清楚。
本研究旨在评估治疗前VAS评分是否可用于预测治疗反应。
开展了一项为期4周的前瞻性队列研究，纳入101例变应性鼻炎患者。所有患者均接受曲安奈德鼻喷雾剂220μg每日1次治疗，共28天。使用VAS评分（0 - 10厘米）、总鼻症状评分（TNSS）、鼻黏液纤毛清除时间（NMCCT）和整体症状控制（GSC）评估治疗效果。采用最小临床重要差异（MCID）方法将患者分为改善组和未改善组。进行受试者操作特征曲线分析，以评估治疗前VAS评分与治疗后MCID相关的预测价值。
治疗前VAS评分与治疗前TNSS和NMCCT呈正相关（分别为ρ = 0.66，p < 0.001和r = 0.44，p < 0.001），与治疗后的GSC呈负相关（r = -0.53，p < 0.001）。TNSS和NMCCT的MCID值分别为3.19和2.78。治疗前VAS的截断值在6.5至7.7分之间，平均值为7.1。
治疗前VAS评分≥7分与不良治疗结果相关，这表明VAS评分具有潜在的治疗预测价值。
