Classification of Seasonal Allergic Rhinitis Patients by Prospective Patient‐Recorded Symptoms: The @ IT .2020 Project
Abstract
BACKGROUND: Seasonal allergic rhinitis (SAR) has been so far classified according to frequency and severity by retrospective information based on the ARIA (Allergic Rhinitis and its Impact on Asthma) classification. Electronic symptom diaries (e-Diaries) are feasible tools to collect prospective patient-reported data. OBJECTIVE: To test the consistency between prospectively recorded symptoms and retrospective ARIA classification and to generate a new SAR classification based on prospective e-Diary data. METHODS: Within the @IT.2020 multicentre observational study, we recruited 815 children and adults with SAR in nine study centres from Mediterranean countries. Participants recorded daily organ-specific (Rhinoconjunctivitis Total Symptom Score; RTSS) and general symptoms (visual analogue scale, VAS) plus quality-of-life measures via an e-Diary app. Retrospective clinical questionnaires were performed at the beginning (T0) and end (T1) of the pollen season. Unsupervised clustering analyses around medoids were implemented to classify SAR by prospective patient-reported data. RESULTS: One third (56/164, 34.1%) and almost half (173/366, 47.3%) of the patients retrospectively over- or underestimated the frequency of their symptoms, respectively. A moderate correlation was found between SAR severity reported at T1 and prospectively recorded symptom severity. An unsupervised clustering approach was able to identify distinct groups (mild, moderate, severe cluster) of patients based on the prospective severity of organ-specific (RTSS) and overall symptoms (VAS), as well as quality of life criteria. CONCLUSIONS: A significant recall bias regarding frequency and severity of symptoms emerged by comparing the retrospective ARIA classification with prospectively recorded data by an e-Diary. A prospective approach to SAR classification, inspired by the retrospective ARIA classification, may facilitate a more precise evaluation of the patient for improved disease management.
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Authors: Stephanie Dramburg, C. J. Hernandez Toro, Ulrike Grittner, E. Potapova, Alessandro Travaglini, S. Tripodi, Stefania Arasi, S. Pelosi, F. Monnati, A. Acar Şahin, Xenofon Aggelidis, A. Barbalace, A. Bourgoin, B. Bregu, M. A. Brighetti, E. Caeiro, S. Caglayan Sozmen, Lucia Caminiti, D. Charpin, M. Couto, L. Delgado, A. Di Rienzo Businco, C. Dimier, M. V. Dimou, J. A. Fonseca, O. Goksel, D. Hernandez, T. M. Hoffmann, D. T. Jang, F. Kalpaklioglu, B. Lame, R. Llusar, M. Makris, A. Mazon, E. Mesonjesi, A. Nieto, A. B. Ozturk, L. Pahus, G. Pajno, I. Panasiti, N. G. Papadopoulos, E. Pellegrini, Ana Margarida Pereira, M. Pereira, N. M. Pinar, A. Priftanji, F. Psarros, C. Sackesen, I. Sfika, J. Suarez, M. Thibaudon, U. Uguz, V. Verdier, V. Villella, Paraskevi Xepapadaki, D. Yazici, Paolo Maria Matricardi
Institutions: Ankara University, Charité - Universitätsmedizin Berlin, Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Universidade do Porto, Inserm, Istituti di Ricovero e Cura a Carattere Scientifico, Ege University, Freie Universität Berlin, Humboldt-Universität zu Berlin, University of Évora, University of Zurich, Universidad de Oviedo, Koç University, National and Kapodistrian University of Athens, Kırıkkale University, Izmir University, Aix-Marseille Université, University of Rome Tor Vergata, Istanbul Arel University, University General Hospital Attikon, Ospedale Sandro Pertini, Athens Naval & Veterans Hospital, Leitat Technological Center, Bambino Gesù Children's Hospital, University of Messina, Assistance Publique Hôpitaux de Marseille, Hôpital de la Timone, Fraunhofer Institute for Translational Medicine and Pharmacology, Italian Association for Cancer Research, Agenzia Regionale per la Protezione Ambientale del Piemonte, Royal Manchester Children's Hospital, CUF Porto Hospital, Policlinico Casilino, Réseau National de Surveillance Aérobiologique, T6 (Italy), Mother Teresa Hospital, Panagiotis & Aglaia Kyriakou Children's Hospital