title: Allergic rhinitis severity can be assessed using a visual analogue scale in mild, moderate and severe.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Allergic rhinitis severity could be assessed in three degrees by using VAS in a simple, easy, and accurate method.
authors.affiliation: Unidad de Rinologia y asma, UGC ORL Hospital de Jerez del Servicio Andaluz de Salud, Cadiz, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Del Cuvillo
authors.affiliation: Fundacion para la gestion de la Investigacion Biomedica de Cadiz, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Santos
authors.affiliation: Unidad de Alergia, Hospital Universitario Arnau de Vilanova, Facultad de Medicina, Universidad Catolica de Valencia San Vicente Martir, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Montoro
authors.affiliation: Unitat d Al.lergia, Servei de Pneumologia i Al.lergia Respiratoria, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Bartra
authors.affiliation: Servicio de Alergia, Hospital Universitario, IBSAL, Salamanca, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Davila
authors.affiliation: Departamento de Alergologia e Inmunologia Clinica, Clinica Universidad de Navarra, Pamplona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Ferrer
authors.affiliation: Servicio de Alergia, Hospital Universitario de Basurto, Bilbao, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Jauregui
authors.affiliation: Servicio de Alergia, Fundacion Jimenez Diaz, CIBERES, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sastre
authors.affiliation: Unitat de Rinologia i Clinica de l Olfacte, Servei dOtorinolaringologia, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Mullol
authors.affiliation: Unitat d Al.lergia, Servei de Pneumologia i Al.lergia Respiratoria, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Valero
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D011788:Quality of Life; D065631:Rhinitis, Allergic / Q000145:classification / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D064232:Visual Analog Scale