The diagnosis of allergic rhinitis: how to combine the medical history with the results of radioallergosorbent tests and skin prick tests.
OBJECTIVE
To identify the most useful combinations of symptoms and the results of radioallergosorbent tests (RASTs) and skin prick tests (SPTs) for the diagnosis of allergic rhinitis.


METHODS
A prospective comparison was made of symptoms and the results of RASTs and SPTs with 7 different nasal allergies; the references used were the "consensus diagnoses" provided by 3 experts.


METHODS
Nineteen general practices in The Netherlands.


METHODS
365 consecutive patients aged 12 or over who visited their general practitioner because of chronic or recurrent nasal symptoms between 1 March 1990 and 1 March 1991.


METHODS
The most useful combinations of items from the history, RASTs, and SPTs, for the diagnosis of 7 different nasal allergies; the predictive probabilities of these combinations.


RESULTS
Diagnostic criteria could be drawn up resulting in a near-perfect discrimination between patients diagnosed as having allergic rhinitis and patients diagnosed as not having allergic rhinitis. Most of these criteria combined only a single item from the history with either RAST or SPT. For nearly all nasal allergies, both the negative predictive probabilities and the positive predictive probabilities were 97% or more.


CONCLUSIONS
The common nasal allergies can be diagnosed with a very high certainty with the aid of simple diagnostic criteria. Data from a strictly limited case history combined with either RAST or SPT are sufficient.
Crobach
M J
MJ
Department of General Practice, Leiden University, The Netherlands.
Hermans
J
J
Kaptein
A A
AA
Ridderikhoff
J
J
Petri
H
H
Mulder
J D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005194:Family Practice; D005260:Female; D006801:Humans; D007428:Intradermal Tests; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009426:Netherlands; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D011852:Radioallergosorbent Test; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis*; D006255:Rhinitis, Allergic, Seasonal / Q000175:diagnosis*