Scientific publications

Allergic rhinitis severity can be assessed using a visual analogue scale in mild, moderate and severe

Dec 26, 2016 | Magazine: Rhinology

Del Cuvillo A (1), Santos V (2), Montoro J (3), Bartra J (4), Davila I (5), Ferrer M (6), Jauregui I (7), Sastre J (8), Mullol J (9), Valero A (4).
(1) Unidad de Rinologia y asma, UGC ORL Hospital de Jerez del Servicio Andaluz de Salud, Cadiz, Spain.
(2) Fundacion para la gestion de la Investigacion Biomedica de Cadiz, Spain.
(3) Unidad de Alergia, Hospital Universitario Arnau de Vilanova, Facultad de Medicina, Universidad Catolica de Valencia San Vicente Martir, Valencia, Spain.
(4) Unitat d Al.lergia, Servei de Pneumologia i Al.lergia Respiratoria, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain.
(5) Servicio de Alergia, Hospital Universitario, IBSAL, Salamanca, Spain.
(6) Departamento de Alergologia e Inmunologia Clinica, Clinica Universidad de Navarra, Pamplona, Spain.
(7) Servicio de Alergia, Hospital Universitario de Basurto, Bilbao, Spain.
(8) Servicio de Alergia, Fundacion Jimenez Diaz, CIBERES, Madrid, Spain.
(9) Unitat de Rinologia i Clinica de l Olfacte, Servei dOtorinolaringologia, Hospital Clinic, Universitat de Barcelona, CIBERES, Barcelona, Spain. 


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.

CITATION  Rhinology. 2016 Dec 26. doi: 10.4193/Rhin16.025

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