Original article: Visual analog scales can assess the severity of rhinitis graded according to ARIA guidelines


Dr Jean Bousquet
Clinique des Maladies Respiratoires
Hôpital Arnaud de Villeneuve
Centre Hospitalier Universitaire
34295 Montpellier Cedex 5


Background:  The allergic rhinitis and its impact on asthma (ARIA) guidelines provide a new classification of allergic rhinitis, but a quantitative analysis for severity assessment is lacking.

Objective:  To study whether a visual analog scale (VAS) for global rhinitis symptoms could be used to assess the disease severity according to ARIA.

Methods:  Three thousand fifty-two allergic rhinitis patients seen in primary care were tested. Fifty three per cent had an objective diagnosis of allergy and 58% of the patients were treated. Patients were categorized according to ARIA guidelines. The severity of nasal symptoms was assessed using a VAS. Quality of life was measured using the rhinoconjunctivitis quality of life questionnaire (RQLQ).

Results:  Severity had more impact on VAS levels than duration: mild intermittent rhinitis (3.5, 2.4–5.0 cm), mild persistent rhinitis (4.5, 3.2–5.6 cm), moderate/severe intermittent rhinitis (6.7, 5.3–7.7 cm) and moderate/severe persistent rhinitis (7.2, 6.1–8.2 cm). The receiver operating characteristic curve results showed that patients with a VAS of under 5 cm could be classified as ‘mild’ rhinitis (negative predictive value: 93.5%) and those with a VAS of over 6 cm as ‘moderate/severe’ rhinitis (positive predictive value: 73.6%). Receiver operating characteristic curves and a logistic regression showed that current treatment and allergy diagnosis have no effect on the assessment of rhinitis severity using VAS. Visual analog scale and the RQLQ global score were significantly correlated (ρ = 0.46; P < 0.0001).

Conclusion:  A simple and quantitative method (VAS) can be used for the quantitative evaluation of severity of allergic rhinitis.