Applicability Of Three Symptom Scoring Methods To Evaluate The Severity Of Allergic Rhinitis

Objective: to explore the applicability of symptom scoring method in the assessment of AR severity by analyzing the correlation between symptom scores of AR patients assessed by TSS,Multi-VAS and Uni-VAS and the quality of life questionnaire(RQLQ)scores related to rhinoconjunctivitis.Methods: According to the requirements of Diagnostic and Therapeutic Guidelines for Allergic Rhinitis(Tianjin,2015),239 AR patients aged 18–50 years were collected and divided into mild group and moderate to severe group according to the quality of life questionnaire(RQLQ)results.At the same time,each patient scored four nasal symptoms including nasal obstruction,nasal itching,sneezing and watery nasal discharge plus two ocular symptoms(itchy eyes,tears,red eyes and burning eyes)according to the requirements of TSS score,Multi-VAS score and Uni-VAS score respectively,and the correlation between the score and RQLQ score was analyzed.The evaluation values obtained by using the three different scoring methods for each AR patient were input into SPSS26.0,and the ROC curves of the three different scoring methods were drawn in sequence.The area under the curve(AUC)was calculated by SPSS26.0 operation system as the evaluation ability index of the corresponding scoring method.The obtained optimal threshold was used as the threshold of the corresponding scoring method corresponding to the scores of mild and moderate to severe.Result: statistical analysis of 239 AR patients show that the correlation between TSS and Multi-VAS was r=0.587,P<0.01,the correlation between TSS and Uni-VAS was r=0.604,P<0.01,the correlation between MultiVAS and Uni-VAS was r=0.693,P<0.01,the correlation between TSS and RQLQ was r=0.454,P<0.01,R=0.533,P<0.01 for Uni-VAS and RQLQ,and r=0.417,P<0.01 for Multi-VAS and RQLQ.AUC for severity of AR assessed by TSS,Multi-VAS,and Uni-VAS were 0.874(95%CI0.822-0.925),0.877(95%CI0.836-0.918),and 0.917(95% CI 0.884-0.950),respectively;The optimal cut-off values were 5.50,23.35,and 3.95.Sensitivity was 77.2%,96.7%,and 85.9%;Specificity was 91.8%,61.9%and 78.2%;The Positive Likelihood Ratio,PLR)was 9.410,2.538,and3.940.The negative Likelihood Ratios(NLR)were 0.240,0.050,and 0.180.Z-test analysis showed that the difference of AUC between the three was statistically significant.Conclusions:1.TSS symptom score,Multi-VAS symptom score and Uni-VAS symptom score are all applicable to the assessment of AR severity.2.The AUC of AR severity assessed by the three symptom scoring systems is best assessed by Uni-VAS,followed by Multi-VAS and TSS.The sensitivity Uni-VAS was slightly lower than that of Multi-VAS,but better than that of TSS symptom scoring method.Uni-VAS was not as specific as TSS,but it was better than Multi-VAS in symptom scoring.3.The optimal thresholds for the three different symptom scoring systems corresponding to mild and moderate to severe were: TSS 5.50,Multi-VAS 23.35 and Uni-VAS 3.95,respectively.